Achilles Injuries

Can Massage Help Achilles tendonitis?

Conclusion: Pressure massage is a useful treatment for Achilles tendinopathy. Compared with eccentric exercise treatment, pressure massage gives similar results. Combining the treatments did not improve the outcome.

What is Achilles Tendonitis?









(Aliases: Achilles tendonitis, Achilles tendonitis, Achilles tendon pain, Achilles tendinosis, Achilles tendinopathy)

Achilles Tendonitis is a term that commonly refers to an inflammation of the Achilles tendon or its covering. It is an overuse injury that is common especially to joggers and jumpers, due to the repetitive action and so may occur in other activities that require the same repetitive action.

Most experts now use the term Achilles tendinopathy to include both inflammation and micro-tears. But many doctors may still use the term tendonitis out of habit.

What Causes Tendon Pain?

Tendons are the tough fibers that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but usually, it is the result of many tiny tears to the tendon that have happened over time.

Health professionals may use different terms to describe a tendon injury. You may hear:

Tendonitis (or Tendinitis): This actually means “inflammation of the tendon,” but inflammation is rarely the cause of your tendon pain.

Tendinosis: This refers to tiny tears in the tissue in and around the tendon caused by overuse.

What Causes Achilles Tendonitis?

Achilles tendonitis is an overuse injury that is common especially to joggers and jumpers, due to the repetitive action and so may occur in other activities that require the same repetitive action.

Most tendon injuries are the result of gradual wear and tear to the tendon from overuse or aging. Anyone can have a tendon injury, but people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon.

A tendon injury can happen suddenly or little by little. You are more likely to have a sudden injury if the tendon has been weakened over time.

Common Causes of Achilles Tendonitis include:

  • Over-training or unaccustomed use – “too much too soon”
  • Sudden change in training surface – e.g. grass to bitumen
  • Flat (over-pronated) feet
  • High foot arch with tight Achilles tendon
  • Tight hamstring (back of thigh) and calf muscles
  • Toe walking (or constantly wearing high heels)
  • Poorly supportive footwear
  • Hill running.
  • Poor eccentric strength

What are the Symptoms of Achilles Tendonitis?



Achilles tendonitis may be felt as a burning pain at the beginning of the activity, which gets less during activity and then worsens following activity. The tendon may feel stiff first thing in the morning or at the beginning of the exercise.

  • Achilles tendonitis usually causes pain, stiffness, and loss of strength in the affected area.
  • The pain may get worse when you use your Achilles tendon.
  • You may have more pain and stiffness during the night or when you get up in the morning.
  • The area may be tender, red, warm, or swollen if there is inflammation.
  • You may notice a crunchy sound or feeling when you use the tendon.

How is Achilles Tendonitis Diagnosed?

Your physiotherapist or sports doctor can usually confirm the diagnosis of Achilles tendonitis in the clinic. They will base their diagnosis on your history, symptom behavior, and clinical tests.

Achilles tendons will often have a painful and prominent lump within the tendon.

Achilles Tendonitis Massage

Massage has many benefits but specifically for Achilles tendonitis, it can help break down scar tissue, stimulate blood flow, and therefore healing and aid in the stretching of the calf muscles.

Technique 1: Effleurage

Effleurage should be used at the start of any massage to spread the oil evenly and to warm-up the tissue in preparation for deeper techniques. Effleurage of the whole of the calf should be performed to ensure the whole of the tendon and the junction where the tendon joins the muscle, are covered. Apply pressure from the heel, up towards the knee. Once the knee is reached, move the hands to the outsides of the leg and gently return to the heel and repeat.

Technique 2:Transverse mobilization

With the first finger of one hand and the thumb of the other hand, alternate to apply transverse pressure. This pulls the tendon across one way and then the other. Too much oil can make this technique difficult to control so wipe off any excess oil. This technique will mobilize the tendon making it more supple.

Technique 3: Stripping the Achilles tendon

With the thumbs apply sustained pressure along the full length of the Achilles tendon.

Technique 4: Cross frictions

With the first two fingers apply gentle pressure in a transverse direction to the Achilles tendon. Again, too much oil and the therapist will find they are unable to apply the technique correctly. Apply frictions for between 2 and 5 minutes.

Technique 5: Circular frictions

Place a finger on each side of the Achilles tendon and apply pressure in a circular direction. Aim to feel the tendon underneath the fingers. Massage may be uncomfortable but should not be so painful that the athlete tightens up. This is unlikely to be of benefit. Apply frictions for between 2 and 5 minutes.

The above techniques can help to reduce swelling, aid circulation, and prevent the build-up of adhesions (sticky bits that prevent the tendon from sliding properly in its sheath). It may also help to apply ice or cold therapy after treatment for 10 minutes.

Light massage can usually be performed daily, however, for deeper techniques alternate days may be more appropriate allowing the tissues time to recover. It is important to assess the results of treatment both afterward and the next day. Has pain and swelling increased? If so then discontinue.

Good Links:
Pro Massage by Nicola, LMT Specializing in Sports Injuries, Santa Barbara, Goleta, Ca.
Pro Massage by Nicola, LMT Specializing in Sports Injuries, Santa Barbara, Goleta, Ca.

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis, or medical advice, nor do they represent an endorsement of any product, company, or specific massage therapy technique, modality, or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.