# What a rehab ladder is, and why it runs underneath your plan

> Four stages, each earned on clean sessions rather than dates. How Stronge structures a managed injury without taking your week away.

Source: https://stronge.app/hub/what-a-rehab-ladder-is

Injuries · 2 min read · Updated 2026-08-24

## The shape of it

Tell Stronge you’re managing something (an Achilles, a patellar tendon, a hip) and a staged
protocol starts underneath everything else:

1. **Calming isometrics.** Holds first. Quiet the area before you load it.
2. **Heavy slow strength.** Load the tissue, slowly, under weight, when completions are clean.
3. **Spring work.** Return the stretch–shorten cycle that running and riding actually use.
4. **Sport-specific loading.** Then the running or riding the injury has to survive.

Each rung has a number of clean sessions that steps you up. A pain flag on the flagged movement
resets the count on that rung; a settled morning the next day withdraws the flag. The ladder
never disappears; stage one is the floor.

## Why it runs underneath, not instead

You keep your plan. The ladder shapes the session, deciding what is forced in and what is held
back, without replacing the strength and mobility work for the rest of you. The session says which
pins or exercises were held back and why (a clinical rule, your kit, the time you had).

## What it is not

It is not medical advice and it does not replace a physiotherapist. Stronge’s clinical rules are
hand-written and sit above the engine: contraindicated work does not appear, whatever you pin.

## Sources

- Rio et al. 2015, isometric exercise for tendon pain, Br J Sports Med
- Silbernagel et al. 2007, continued running during Achilles rehabilitation, Am J Sports Med
- Beyer et al. 2015, heavy slow resistance for Achilles tendinopathy, Am J Sports Med

Stronge is not medical advice and does not replace a physio or doctor. Nothing here promises an injury outcome.