Achilles Tendinitis

Q I am a man in my 40s who enjoys marathons. Will I be able to run again after treatment for Achilles tendonitis?

A. Once appropriate treatment and rehabilitation exercises are completed, most patients can return to sports activities, including running. The time required for a full return varies depending on the condition of the tendon and the degree of muscle strength recovery, but it usually takes 3 to 6 months. Even after returning, you can continue exercising without recurrence if you strictly adhere to gradual training increases and warm-up exercises.

Q I was recommended surgery by an orthopedic surgeon; can I avoid surgery through Korean medicine treatment?

A. In the stages of partial tendon degeneration and calcification, sufficient recovery is often possible through conservative treatment before surgery, and regenerative therapies such as moxibustion, fire acupuncture, and thread embedding can serve as realistic alternatives to surgery. Unless there is a complete rupture or mechanical impingement caused by bone spurs, it is generally recommended to attempt non-surgical treatment for 3 to 6 months first. The goal is to avoid unnecessary surgery by recovering as much as possible through Korean medicine treatment rather than completely ruling out surgery.

Q I’ve heard that plantar fasciitis often occurs alongside Achilles tendonitis. Is it possible to treat them simultaneously?

A. The Achilles tendon and plantar fascia form a continuous structure connected at the heel bone. If a problem arises in one side, stress concentrates on the other, making co-occurrence common. It is possible to treat them simultaneously; in fact, treating both conditions together is beneficial for restoring the function of the entire hindfoot. We proceed by combining acupuncture, moxibustion, and stretching prescriptions tailored to each condition.

Q Is it okay to stretch while being treated for Achilles tendinitis? I'm afraid it might get worse if I do it wrong.

A. It is safer to avoid strenuous stretching during periods of severe acute pain, and to start gradually with light calf stretches once the pain subsides. Gentle static stretching (holding a wall push position for 30 seconds) is effective for restoring tendon flexibility. Avoid stretching that causes pain, and determine the range of motion and intensity according to your medical team's guidelines.

Q Is ice pack or hot pack better for Achilles tendonitis? How should I manage it at home?

A. During the period of acute pain and swelling, the priority is to reduce the inflammatory response using ice packs (15–20 minutes, 3 times a day). Once the acute phase passes and chronic pain and stiffness become the main symptoms, using hot packs to promote blood circulation is effective. After applying the compress, wear a heel pad or heel cushion and avoid strenuous walking.

Q Is knife acupuncture safe for the Achilles tendon? I'm scared that it might rupture if something goes wrong.

A. Knife acupuncture is safe when performed by a precisely trained Korean medicine doctor. Using ultrasound guidance allows the lesion site to be directly visualized during the procedure, minimizing the risk of damage to normal tendon tissue. The risk of tendon rupture is very low; on the contrary, it is effective in removing adhered scar tissue and inducing tendon tissue regeneration. There may be temporary, mild pain after the procedure, but it usually improves within 1–2 days.

Q Is it okay to receive treatment at a Korean medicine clinic while taking anti-inflammatory medication prescribed by an orthopedic clinic?

A. Generally, external treatments such as acupuncture and moxibustion can be performed concurrently while taking anti-inflammatory painkillers. However, it is safer to decide whether to take herbal medicine after consulting with a medical professional. Due to the potential for interactions between certain NSAIDs and herbal ingredients, you must inform the Korean medicine clinic of any medications you are currently taking. During the acute inflammatory phase, you can expect a synergistic effect on recovery by controlling pain with anti-inflammatory drugs while simultaneously improving meridian circulation through acupuncture treatment.

Q How long does it take to recover from Achilles tendonitis? I'm worried because I heard it takes a long time.

A. Acute Achilles tendonitis often improves within 4 to 8 weeks with appropriate treatment and rest, while the chronic form, accompanied by tendon degeneration, may require consistent treatment for 3 to 6 months or more. Recovery takes longer if symptoms have been present for a long time or if the condition has been left untreated. Since continuing strenuous activity during treatment significantly prolongs the recovery period, it is important to strictly follow the activity guidelines provided by medical staff.

Q Does Achilles tendonitis keep recurring once it develops? Are there ways to prevent recurrence?

A. The recurrence rate of Achilles tendonitis is high if the underlying causes—decreased tendon flexibility and muscle strength imbalance—are not corrected. Calf stretching, eccentric strengthening exercises, and the selection of appropriate footwear are key to preventing recurrence. Even after treatment, making regular stretching and pre-workout warm-ups a habit can significantly lower the risk of recurrence.

Q I am an office worker in my 40s who enjoys playing soccer every weekend, but the area above my heel keeps hurting. Why does Achilles tendinitis occur?

A. Achilles tendinitis occurs when micro-damage accumulates in the tendon tissue due to repetitive impact and overuse. Stress is concentrated on the tendon if you suddenly increase exercise intensity without warming up or engage in activity for a long time on hard surfaces. A lack of flexibility in the calf muscles is also a major cause of excessive tension on the Achilles tendon.

Q I am a housewife in my 50s, and my heel suddenly started hurting even though I haven't been exercising. Is age a cause?

A. As you age, the collagen composition of tendon tissue changes, reducing elasticity and blood supply, making it easy for inflammation to occur even from minor impacts. Hormonal changes after menopause also have an impact, as they lower the recovery capacity of musculoskeletal tissues. Everyday activities such as standing for long periods or going up and down stairs can also place a cumulative load on aging Achilles tendons.

Q Are there any foods that are good for Achilles tendonitis? Would eating pig's trotters or ox knee soup, which are rich in collagen, help?

A. Collagen-containing foods such as pig's trotters and ox knee soup help supply the protein that serves as the building block for dry tissues. However, since excessive saturated fat can worsen the inflammatory environment, balanced consumption is important. Consuming them with vegetables rich in Vitamin C increases the efficiency of collagen synthesis.

Q I heard that high heels or shoes without cushioning worsen Achilles tendonitis. What kind of shoes should I wear when commuting to and from Dongincheon?

A. High heels fix the Achilles tendon in a shortened state, reducing its stretching ability, while flat shoes without cushioning transmit impact directly to the tendon. Shoes with a heel height of 1–2 cm, sufficient cushioning, and a wide toe box are most suitable for the Achilles tendon. When commuting with frequent brisk walking or long-distance travel, it is recommended to switch to sneakers and only change into different shoes upon reaching your destination.

Q How often do I need to visit a Korean medicine clinic for Achilles tendonitis? It is a burden to go while working.

A. During the initial intensive treatment period, visiting 2 to 3 times a week is effective. Once symptoms stabilize, the frequency is reduced to once a week for maintenance treatment. The total treatment duration varies depending on the degree of tendon degeneration, but it is generally planned for 8 to 12 weeks as a baseline. For office workers, you can utilize after-work or weekend hours, and we will coordinate the schedule for you before the appointment.

Q What kind of treatment is received in the early stages of Achilles tendonitis? Since this is my first visit to a Korean medicine clinic, I am curious about the process.

A. During the initial consultation, a treatment plan is established after evaluating the condition of the tendon through a heel ultrasound examination and a medical history interview. In the acute phase, acupuncture is used to rapidly control pain and inflammation, and if necessary, pharmacopuncture is added to enhance the anti-inflammatory effect. You will also receive guidance on lifestyle guidelines, such as activity restrictions, taping, and wearing a heel cup.

Q Is the treatment for chronic Achilles tendinitis different? I have been in pain for over 6 months; are there any options other than surgery?

A. The key treatments for chronic Achilles tendinitis are moxibustion, fire acupuncture, and thread embedding, which regenerate degenerated tendon tissue; simple anti-inflammatory treatment alone has limited effectiveness. Since surgery is a last resort considered only when there is no improvement after sufficient attempts at conservative treatment, it is worth trying Korean traditional medicine first. Even with chronic tendinopathy lasting more than 6 months, significant improvement can be expected by combining systematic regenerative therapy with exercise rehabilitation.

Q I took anti-inflammatory medication and received physical therapy at the orthopedic clinic, but it isn't getting better. Is traditional Korean medicine actually effective for Achilles tendonitis?

A. Acupuncture and moxibustion are effective for improving blood flow around tendons and releasing adhesions, and domestic and international studies have reported significant results in reducing chronic tendon pain and restoring function. When pain is suppressed solely with anti-inflammatory drugs, the recovery of the tendon tissue itself may be insufficient, leading to frequent recurrence. Korean traditional medicine aims for fundamental improvement by addressing both tendon tissue regeneration and the strengthening of the body's overall recovery capacity.

Q I've heard that herbal medicine helps with Achilles tendonitis, but is there any evidence to support this? I'm worried it might just be a waste of money.

A. Research has shown that the anti-inflammatory and tissue-regenerating components of herbal medicine (such as safflower, Achyranthes root, and Eucommia bark) promote collagen synthesis in tendons and ligaments and inhibit inflammatory mediators. Oral medication plays a role in accelerating recovery by regulating systemic circulation and organ function in areas where local treatment cannot reach. Since prescriptions are tailored to individual constitution and pathological conditions, effectiveness may vary, so it is recommended to consult with a medical professional before making a decision.