Therapeutic exercise
Alfredson Heel-Drop Protocol (Achilles Eccentric)
The classic Alfredson eccentric protocol for chronic Achilles tendinopathy, with strong evidence and positive outcomes in 85% of non-insertional cases.
How to perform
- Starting position. Stand on a step with the forefoot supported and the heels free over the edge.
- Step 2. Rise onto the balls of your feet using the unaffected leg (or both).
- Step 3. Transfer your weight to the affected leg and slowly lower the heel below the level of the step.
- Return. Use the unaffected leg to return to the high position (do not rise with the affected leg).
When not to perform
- Partial tendon rupture confirmed by imaging
- Intense pain (VAS >5) during the exercise
Medical disclaimer. These exercises are presented for informational purposes only. Always consult your physician before starting any exercise program, especially in case of acute pain, recent injury, or underlying clinical condition.
Related Exercises
Isometric Calf Raise
Isometric calf contraction used in Achilles tendinopathy during an irritable phase, when the Alfredson eccentric protocol provokes pain.
Gastrocnemius Wall Stretch
Calf stretch with the knee straight. Restores flexibility of the posterior chain and reduces traction on the Achilles tendon.
Soleus Stretch (Bent-Knee)
Stretches the soleus — the deep calf muscle that is only isolated with the knee bent. Complements the gastrocnemius stretch (knee straight) for complete flexibility of the calf complex.