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Exercises / Leg & ankle

3D athlete for the eccentric heel drop (alfredson)

Eccentric heel drop (Alfredson)

  • Tendon loading
  • Leg & ankle
  • Step, Backpack with weight (to progress)

Rise on both legs, lower slowly on the affected leg, with the knee straight (gastrocnemius) and bent (soleus).

Also called Alfredson protocol, eccentric calf raise, heel drops.

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Where you stand

No published distribution for this exercise yet. We add one only from a peer-reviewed study.

Muscles worked

Filled: primary. Outlined: secondary.

How much

The original protocol: 3 × 15, straight- and bent-knee, twice daily for 12 weeks; add load as pain allows.

Start: Standing on a step edge

Steps

  1. Stand with the forefoot on a step edge.
  2. Rise onto the toes using both legs.
  3. Shift weight to the affected leg and lower the heel slowly below the step level.
  4. Repeat with the knee straight and with the knee bent.

Cues

  • 3-second lowering
  • Use the other leg to rise

Common mistakes

  • Dropping quickly
  • Rolling onto the outside of the foot

Used for

Take care (1)
Evidence (2)

Easier

References (4)
  1. Alfredson H, Pietilä T, Jonsson P, Lorentzon R. Am J Sports Med. 1998;26(3):360-366. Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis
  2. Hébert-Losier K, Schneiders AG, García JA, Sullivan SJ, Simoneau GG. J Strength Cond Res. 2012;26(11):3124-3133. Influence of knee flexion angle and age on triceps surae muscle activity during heel raises
  3. Chimenti RL, Neville C, Houck J, Cuddeford T, Carreira D, Martin RL. J Orthop Sports Phys Ther. 2024;54(12):CPG1-CPG32. Achilles pain, stiffness, and muscle power deficits: midportion Achilles tendinopathy revision – 2024
  4. Dalley AF, Agur AMR. Wolters Kluwer. Moore's Clinically Oriented Anatomy. 9th ed.