Achilles Tendinitis

Achilles tendinitis is a common condition that causes pain along the back of  the leg near the heel.

The Achilles tendon is the largest tendon in the body. It connects your calf  muscles to your heel bone and is used when you walk, run, and jump.

Although the Achilles tendon can withstand great stresses from running and  jumping, it is also prone to tendinitis, a condition associated with overuse and  degeneration.


Simply defined, tendinitis is inflammation of a tendon. Inflammation is the  body’s natural response to injury or disease, and often causes swelling, pain,  or irritation. There are two types of Achilles tendinitis, based upon which part  of the tendon is inflamed.

Noninsertional  Achilles tendinitis

Noninsertional Achilles Tendinitis

In noninsertional Achilles  tendinitis, fibers in the middle portion of the tendon have begun to break down  with tiny tears (degenerate), swell, and thicken.

Tendinitis of the middle portion of the tendon more commonly affects younger,  active people.

Insertional Achilles Tendinitis

Insertional Achilles tendinitis  involves the lower portion of the heel, where the tendon attaches (inserts) to  the heel bone.

In both noninsertional and insertional Achilles tendinitis, damaged tendon  fibers may also calcify (harden). Bone spurs (extra bone growth) often form with  insertional Achilles tendinitis.

Tendinitis that affects the insertion of the tendon can occur at any time,  even in patients who are not active.

Insertional Achilles  tendinitis


Achilles tendinitis is typically not related to a specific injury. The  problem results from repetitive stress to the tendon. This often happens when we  push our bodies to do too much, too soon, but other factors can make it more  likely to develop tendinitis, including:


A bone spur that has  developed where the tendon attaches to the heel bone.


  • Sudden increase in the amount or intensity of exercise activity—for example,  increasing the distance you run every day by a few miles without giving your  body a chance to adjust to the new distance
  • Tight calf muscles—Having tight calf muscles and suddenly starting an  aggressive exercise program can put extra stress on the Achilles tendon
  • Bone spur—Extra bone growth where the Achilles tendon attaches to the heel  bone can rub against the tendon and cause pain

Common symptoms of Achilles tendinitis include:

  • Pain and stiffness along the Achilles tendon in the morning
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain the day after exercising
  • Thickening of the tendon
  • Bone spur (insertional tendinitis)
  • Swelling that is present all the time and gets worse throughout the day with  activity

If you have experienced a sudden “pop” in the back of your calf or heel, you  may have ruptured (torn) your Achilles tendon. See your doctor immediately if  you think you may have torn your tendon.



Nonsurgical Treatment

In most cases, nonsurgical  treatment options will provide pain relief, although it may take a few months  for symptoms to completely subside. Even with early treatment, the pain may last  longer than 3 months. If you have had pain for several months before seeking  treatment, it may take 6 months before treatment methods take effect.

Rest. The first step in reducing pain is to decrease or even  stop the activities that make the pain worse. If you regularly do high-impact  exercises (such as running), switching to low-impact activities will put less  stress on the Achilles tendon. Cross-training activities such as biking,  elliptical exercise, and swimming are low-impact options to help you stay  active.

Ice. Placing ice on the most painful area of the Achilles  tendon is helpful and can be done as needed throughout the day. This can be done  for up to 20 minutes and should be stopped earlier if the skin becomes numb. A  foam cup filled with water and then frozen creates a simple, reusable ice pack.  After the water has frozen in the cup, tear off the rim of the cup. Then rub the  ice on the Achilles tendon. With repeated use, a groove that fits the Achilles  tendon will appear, creating a “custom-fit” ice pack.

Non-steroidal anti-inflammatory medication. Drugs such as  ibuprofen and naproxen reduce pain and swelling. They do not, however, reduce  the thickening of the degenerated tendon. Using the medication for more than 1  month should be reviewed with your primary care doctor.

Exercise. The following exercise can help to strengthen the  calf muscles and reduce stress on the Achilles tendon.

  • Calf stretch Lean forward against a wall with one  knee straight and the heel on the ground. Place the other leg in front, with the  knee bent. To stretch the calf muscles and the heel cord, push your hips toward  the wall in a controlled fashion. Hold the position for 10 seconds and relax.  Repeat this exercise 20 times for each foot. A strong pull in the calf should be  felt during the stretch.

Physical Therapy. Physical therapy is very helpful in  treating Achilles tendinitis. It has proven to work better for noninsertional  tendinitis than for insertional tendinitis.

Eccentric Strengthening Protocol. Eccentric strengthening is  defined as contracting (tightening) a muscle while it is getting longer.  Eccentric strengthening exercises can cause damage to the Achilles tendon if  they are not done correctly. At first, they should be performed under the  supervision of a physical therapist. Once mastered with a therapist, the  exercises can then be done at home. These exercises may cause some discomfort,  however, it should not be unbearable.

  • Bilateral heel drop Stand at the edge of a stair,  or a raised platform that is stable, with just the front half of your foot on  the stair. This position will allow your heel to move up and down without  hitting the stair. Care must be taken to ensure that you are balanced correctly  to prevent falling and injury. Be sure to hold onto a railing to help you  balance.Lift your heels off the ground then slowly lower your heels to the lowest  point possible. Repeat this step 20 times. This exercise should be done in a  slow, controlled fashion. Rapid movement can create the risk of damage to the  tendon. As the pain improves, you can increase the difficulty level of the  exercise by holding a small weight in each hand.
  • Single leg heel drop This exercise is performed  similarly to the bilateral heel drop, except that all your weight is focused on  one leg. This should be done only after the bilateral heel drop has been  mastered.

Cortisone injections. Cortisone, a type of steroid, is a  powerful anti-inflammatory medication. Cortisone injections into the Achilles  tendon are rarely recommended because they can cause the tendon to rupture  (tear).

Supportive shoes and orthotics. Pain from insertional  Achilles tendinitis is often helped by certain shoes, as well as orthotic  devices. For example, shoes that are softer at the back of the heel can reduce  irritation of the tendon. In addition, heel lifts can take some strain off the  tendon.

Heel lifts are also very helpful for patients with insertional tendinitis  because they can move the heel away from the back of the shoe, where rubbing can  occur. They also take some strain off the tendon. Like a heel lift, a silicone  Achilles sleeve can reduce irritation from the back of a shoe.

If your pain is severe, your doctor may recommend a walking boot for a short  time. This gives the tendon a chance to rest before any therapy is begun.  Extended use of a boot is discouraged, though, because it can weaken your calf  muscle.

Extracorporeal shockwave therapy (ESWT). During this  procedure, high-energy shockwave impulses stimulate the healing process in  damaged tendon tissue. ESWT has not shown consistent results and, therefore, is  not commonly performed.

ESWT is noninvasive—it does not require a surgical incision. Because of the  minimal risk involved, ESWT is sometimes tried before surgery is  considered.


Ginger for Tendonitis Relief

  1. Using Ginger to Relieve Tendonitis

    • Ginger is a perennial plant which is grown in tropical climates such as  China, Jamaica and India. It is used as a culinary spice and has also been used  as a traditional medicine in Asia and India since ancient times. It has a long  folk history in Asia as a popular treatment of bursitis. In the West it has been  used for treating tendonitis and also bursitis.

      Ginger is used to reduce symptoms of tendonitis because it has both  anti-inflammatory effects as well as pain-relieving properties. Ginger works by  inhibiting the production of inflammatory chemicals. A compound in ginger called  6-shogaol has been shown to reduce pain by blocking transmission of pain  signals. Ginger has also been known to reduce inflammation of the joints and  muscle tissue as it improves circulation.

      Ginger can be taken by capsules, tincture, teas or ground ginger root.  Rubbing ginger essential oil on sore tendons can also help to alleviate the pain  as well as easing stiffness. The maximum daily dose of ginger recommended is 4  g. Taking pills instead of powder can reduce possible stomach upset sometimes  associated with ginger. Physicians have also recommended that individuals with  gallbladder disease do not use  ginger.


      Naturopathic (Natural) Treatment for

      Achilles Tendonitis

      In some cases, Achilles tendonitis, also sometimes called Achilles tendinitis  or inflammation of the Achilles tendon, can be treated naturally with various  anti-inflammatory agents. An anti-inflammatory diet can decrease  discomfort and reduce systemic inflammation and the risk for associated  diseases.

      An anti-inflammatory diet is based on the following foods:

      • Include: fresh vegetables and fruits, flax seed meal, flax seed oil, deep  water fish, fresh water, organically raised foods
      • Avoid: sugar, refined white flour products (e.g., pasta and bread),  processed foods, fast food, saturated animal fats (red meat and dairy products)

      Nutritional and herbal anti-inflammatory supplements include:

      • Manganese: 25 to 100 mg twice a day for the first 2 weeks after injury, then  10 to 15 mg twice a day
      • Selenium: 100 to 200 mcg daily
      • Vitamin E: 400 IU daily
      • Flax seed oil: 1 to 2 tsp daily
      • Bromelain: 400 mg 3 times a day, not with food
      • Wobenzyme tablets: 5 tablets 3 to 5 times a day, not with food.


      How to Make a Bath Treatment for
      This gentle bath soak treatment is perfect for tendonitis. Tendonitis is the  inflammation of a tendon. Symptoms of tendonitis often include swelling,  stiffness, pain and sometimes a burning sensation surrounding the tendon. This  bath treatment works by helping to relieve the symptoms, and helping to treat  the inflammation of tendonitis

      Things You’ll Need

      • 1/4 Cup of Celtic Sea  Salt

      • 5 Drops of Cypress Oil

      • 5 Drops of Eucalyptus  Oil

      • 5 Drops of Chamomile Oil


          • 1In a small mixing bowl, gently stir together the celtic sea salt with the cypress oil, eucalyptus oil and chamomile oil. Use either a wooden or plastic spoon or spatula, but avoid using any metal utensils if possible.

      Run a warm bath. Ideally, the water should be around 100 degrees but not much  hotter than that. Water that is too hot will weaken the essential oils used in  the treatment.

      • Gently pour the salt mixture under the running water. Once the salt appears to have dissolved, settle in to the bath. Soak in the treatment for a total of around thirty minutes.
      • I suggest using the treatment daily until the tendonitis has healed.

      Natural Home Remedies For Tendonitis

      • Rest: first and foremost, rest is very crucial. Do not move the affected part for some time. It does not mean that you stop all activity, only do not exert the affected part too  much.
      • Ginger: ginger tea is recommended for most pains and inflammations. Boil grated ginger in a cup of water, for 15 minutes, consume once daily. The root supplies loads of anti inflammatory agents called gingerols that are known to decrease the inflammatory process appreciably, and consequently ease      pain.
      • Garlic: have 2 flakes of raw garlic daily for a week. The pain and swelling will begin to subside quickly.
      • Black sesame seeds: black sesame seeds are really effective for pains and stiffness, associated with  tendonitis.
      Soak a spoonful every night and consume in the morning.

      • Massage therapy: is recommended. Ensure that your therapist knows your complete health history. Massage helps alleviate pain, discomfort, swelling and stiffness, and improves flexibility. Using essential oils such as clove,  lavender, blended with a carrier oil, will afford speedy relief.

      Baking Soda for Tendonitis

      Baking soda is known to help manage pains and cramps. It especially helps combat muscle fatigue which may be associated with the  condition. However, do not take large quantities of baking soda; it comes with a host of side effects.

      Exercises For Tendonitis In Heels

      The following exercises are highly beneficial to manage tendonitis of the heel tendon, the tendon that is most commonly affected.

      Leg Lift

      • Lie down and place both legs on top of one another. Tighten the muscle on the top of the thigh, then lift the leg off ground to make 45 to 60 degree angle with the leg below. Do not flex either leg at the knee. Count 20 and then release the posture and repeat 3  times.

      Heel Raise

      • Using the wall or a chair as support, raise your body and balance all the weight on your toes. Count 10 and slowly come back to the initial position. Repeat 5 times. Once the pain decreases, try to bring one leg down at a time, and balance all your weight on to one leg.

      Quadriceps Stretch

      • Use the wall or a chair for support. Slowly pull the heel of the injured leg towards the buttocks. Hold the position for 15 seconds. Repeat this exercise about 5 times.

      Ice application is recommended by doctors and  experts. However, do not apply the ice directly. Use either an ice bag, or place the ice cubes in a cloth and place the cloth over the inflamed area. Place the ice bag for 15 minutes, repeat at least 5 to 6 times daily. Ice reduces inflammation, swelling and pain speedily.

       Acupressure for Achilles Tendonitis

      Acupressure for Bone Spurs