Month: December 2021

Upskill your calf

A calf raise or heel raise is a common exercise prescribed by physiotherapists as part of the rehabilitation in a range of lower limb conditions. At times this can be performed poorly and as such will not have the desired result. Research conducted by Rio et al 2016 focusing on the calf raise as part of Achilles tendinopathy rehab suggests that the simple use of a metronome can lead to a reduction in tendon pain as well as an increase in our control over the muscle (referred to as motor control).


Exercises are normally used as part of rehabilitation to create physiological changes to the muscle with the goal of improving strength. When combined with an external cue (such as a metronome) this begins to target motor control as well. To complete any task successfully you need both the strength and motor control aspect of the movement. This is particularly important in tendinopathy rehab as the pain associated with tendinopathy has been shown to lead to abnormal tendon loading and changes in neural drive (messages from your brain to the muscle both of which affect our motor control. These changes are part of our body’s protective response.


The use of a metronome to pace the concentric (rising up onto your heels) and the eccentric (lower down to the floor) phase has been shown to restore a normal pattern of tendon loading in those individuals with Achilles tendinopathy. This will also lead to an increase in time under tension during your repetitions and thus improvements in the physiological changes within the muscle. As a starting point, set your metronome at 60 beats per minute and aim for a two-beat rise, a two-beat pause at the top and a two beat lower for each repetition. Though this has been predominantly researched in calf raises, there is a further investigation into its applicability for other exercises.


Rio E, Kidgell D, Moseley GL, et al Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review

British Journal of Sports Medicine 2016;50:209-215.