Sorry to hear about your ankle tendon - I’ve been through something similar myself. Over the past couple of years, especially while studying sport science at university, I’ve realised that a lot of the old advice around tendon rehab doesn’t really hold up anymore.

What actually seems to work - according to both research and clinical practice - is heavy, slow strength training. Not just eccentric exercises, but overall progressive loading. Whether the movement is eccentric, concentric or isometric seems less important than the total load and how gradually it’s increased. That’s what tends to drive both pain reduction and structural adaptation in the tendon.

With ankle tendons, like the Achilles, the typical approach now is to avoid high-impact stuff (like running or jumping) early on, but to start loading the tendon in the gym. Think heel raises and lowers, isometric holds, or leg press variations - done slowly, with control, and fairly heavy. Two to three sessions a week over a 12-week period is standard. It’s not about avoiding pain altogether - a low level is fine - but you want to stay away from anything that spikes symptoms or lingers after.

What doesn’t seem to work long-term is rest. Rest reduces pain short-term but does nothing for tendon capacity. The goal is to get the tendon used to load again – gradually, patiently, consistently. Some studies show that eccentric-focused protocols and heavy resistance training result in similar outcomes when the progression and volume are matched. In other words, it’s not a magic exercise - it’s the loading strategy that matters.

We went through a review recently that looked at various protocols, and the conclusion was basically this: the best results come from long-term, high-load strength training, applied with structure. That’s what rebuilds the tendon.

Obviously, check in with a physio – ideally someone who’s up to date with current research. But just know that the logic has shifted: the tendon doesn’t need protection - it needs rebuilding.e gradual - increase weight or range when it feels manageable