Foot and Ankle

Diagram of human ankle and foot with labeled parts and muscle groups in red and blue, showing the bones, tendons, and muscles including the heel, ankle joint, and toes.
Diagram of the Achilles tendon showing the direction of fiber bundlesl, with arrows indicating the orientation of the fibers.

(Plantar Fasciopathy, Achilles Tendinopathy)

Core message: Progressive mechanical loading through eccentric or heavy slow resistance exercise improves tendon remodeling, pain, and durability beyond passive modalities or injections.

Key evidence:

  1. Alfredson H et al., Am J Sports Med 1998;26(3):360‑366 — Landmark trial introducing eccentric training for chronic Achilles tendinosis with superior outcomes.

  2. Beyer R et al., Am J Sports Med 2015;43(7):1704‑1711 — Heavy slow resistance and eccentric training equally effective for midportion Achilles tendinopathy.

  3. Rathleff MS et al., Scand J Med Sci Sports 2015;25(3):e292‑e300 — Strength training for plantar fasciopathy superior to stretching at 3‑month follow‑up.

Foot/Ankle: Chronic Tendinopathies

Clinical Layer:

  • Mechanical loading (eccentric and progressive resistance) is the gold standard for Achilles, plantar, and other lower leg tendinopathies.

Chronobiological Layer:

  • Disruption of tendon clocks via poor light exposure or evening screen time diminishes tissue resilience.​

  • Collagen synthesis peaks nocturnally; loading must be paired with proper circadian entrainment for maximal effect.

Why Should I Care?:
Targeted exercises rebuild foot and ankle tendons, but aligning your sleep and morning light with therapy can make tissue stronger and speed recovery.

An illustration of the anatomy of the human foot and plantar fascia