The Best Achilles Tendon Heel Pain Treatments of 2019

Achilles tendon heel pain treatment can take 3-6 months to start to improve. FIX your tight & sore Achilles tendon pain as FAST as possible!





Achilles tendon pain is most commonly caused by two types of Achilles tendon injury.

These are Achilles Tendonitis: Insertional Achilles tendonitis (heel pain) and non-insertional Achilles tendonitis (2-6cm above the heel):


Achilles Tendinopathy (Tendonitis):

  • The most common cause of Achilles tendon pain is a Achilles tendinopathy or Achilles tendinitis: This is when you have inflammation and even partial split tears throughout the tendon.
  • This occurs when the tendon is extremely tight, painful and swollen.
  • This is most likely to occur in people who have put on weight, and have decreased flexibility through the Achilles tendon.
  • It can also occur with significant overload.
  • We would probably estimate that this is over 80% of all Achilles tendon injuries that we see in the office.


Insertional Achilles Tendonitis:

  • Insertional Achilles tendinitis is where the tendon actually inserts into the back of the calcaneus.
  • The calcaneus is also known as your heel bone.
  • If your pain is at the bottom of the hill bone, this is most likely called plantar fasciitis.
  • If the pain is at the back of your calcaneus, this is known as insertional Achilles tendinitis.
  • If this goes on for numerous years, it is possible to develop back of the heel spur.
  • This is called an insertional Achilles tendon spur.
  • The spur is a sign of chronic Achilles tendinitis.


Non-insertional Achilles Tendonitis:

  • Non-insertional Achilles tendinitis is when it is about 2 to 6 cm above the heel bone.
  • This is the more common type of Achilles tendinitis people who are jumping and running regularly.
  • ┬áThis means that you have a short were tight Achilles tendon.
  • The key is to protect this and take pressure off of it, as continued pressure can cause a possible rupture in the future.
  • Basketball players are especially at risk for this.


Other causes of Achilles tendon pain:


Ruptured or torn Achilles tendon:


  • This most likely occurs when you land really hard on your Achilles tendon and you actually hear a pop and it ruptures.
  • This is a very severe injury that sometimes does require surgery. This is most common during falls, coming up or down the stairs, or playing basketball.
  • This is a very severe injury that requires you to see your podiatrist as quickly as possible.


Partially torn Achilles tendon:


  • It is possible to have a partially torn Achilles tendon, this can also be very severe, you should go in for evaluation most immediately.
  • This occurs when only some of the fibers in the tendon are torn.


Achilles tendon strain:


  • In Achilles tendon strain is also extremely common.
  • This usually happens towards people who, for example are playing tennis and pushoff very fast.
  • You can feel a pull, it is not quite torn, but is very sore and bruised.
  • This can be very sore for 2 to 4 weeks.

Achilles tendon pain
This is not insertional Achilles tendinitis. If the pain is about to the 2 to 6 cm above the heel bone, this is non insertional Achilles tendinitis. If it is right into the bone, this is called insertional Achilles tendinitis.


Symptoms of Achilles tendon pain can include:


Achilles tendinitis(insertional or non insertional):

  • Sore achilles tendon in the morning:
  • Swollen achilles tendon
  • Bruised achilles tendon
  • Inflamed achilles tendon
  • Chronic achilles tendon


Achilles tendon tear or injury:

  • It can feel like a pop or a snack when it happens.
  • It is usually a traumatic injury.
  • This strain can be pushing off and is more of the leg in the muscle.
  • Care, or a partial tear, or important tendon will usually be a traumatic injury about to 6 cm above the heel.
  • A tear usually does not happen in the muscle just below the knee.


Risk factors for Achilles tendinitis:

  • Flat or unsupportive shoes.
  • Recent increases in weight, or being overweight for a repetitive activity such as running or long-distance walking.
  • Exercising on uneven surfaces.
  • A recent increase in heavy-duty activity.
  • Excessive activity after a long period of inactivity.
  • Weakness in the muscles to support your upper body.
  • Foot issues such as being flat-footed or having a short were tight Achilles tendon.
  • A recent ankle sprain or injury.


Achilles & Calcaneal Tendon Anatomy:


What is the Achilles tendon?

  • The Achilles tendon and gastrocnemius is the strongest and most durable muscle in your body.
  • Achilles tendon is a very strong bundle of fibers that attach the calcaneus(heel bone) to the calf muscle which is called the gastrocnemius.


How does one get a short Achilles tendon?

  • As we get older and exercise and stretch less, it is possible for the muscle to get we current contract.
  • If many years go by without stretching or high-intensity activity, the tendon can become shorter and weak.


What does the Achilles tendon do?

  • The Achilles tendon is the most powerful and essential muscle for running, jumping, and even long-distance walking.


Why does the Achilles tendon get injured?

  • It is a very durable muscle, but even it has its limits!
  • It can be prone to wear and tear.
  • It is very good at up-and-down bending of the foot, but when the foot starts bending up and down and twisting out at the same time, it can become at risk for injury and rupture.
  • This is a very strong and durable muscle, but in the center. It does have less blood flow than other parts of the body.
  • The most likely area for developing Achilles tendinitis and worker rupture is 2 to 6 cm above the calcaneus insertion site.


Achilles Tendinosis:

  • Achilles tendinosis is when the tendon is so damaged that the center starts to die.
  • The center can actually read and develop Mucinous fluid at the center.
  • This means that the center of the tendon is dying and is at risk for rupture.


Achilles Peritendinitis:

  • This means that the sheath surrounding the tendon is inflamed.
  • This is another way of saying Achilles tendinitis.


Achilles Heel Spur:

  • An Achilles heel spur develops when the Achilles tendon rips of the calcaneus for very long period of time.
  • This is a very dangerous situation to develop, as the spur can allow the Achilles tendon to rupture and create further damage.




Achilles Tendon Pain & Running:


Achilles tendon pain running:

  • Runners and people who are running are some of the most at risk people for Achilles tendon pain.
  • We see thousands of patients come in, with pain in their Achilles tendon when they start a new exercise routine like walking or running.
  • This is most common in patients who have not been running or jogging for very long time, and start into very high levels of activity.
  • This can put you at risk for significant injury.
  • It is very difficult to start high level of activity without having an elastic and well stretched Achilles tendon or other muscles. It is very important to start crosstraining in doing other types of activities that can strengthen your muscles and strengthen your Achilles tendon without injuring it first.


What can I do about my sore achilles after running:

  • The best thing you can do is work on decreasing inflammation: start by taking pressure off your Achilles tendon.
  • What we recommend for patients is usually to start riding a bike, swimming and weightlifting during this time.
  • It can take a month or two for your Achilles tendinitis to calm down.
  • It is very important to do this before the problem gets worse. It definitely sucks that you have Achilles tendinitis, but don’t make the problem worse and damage or tendon or put yourself out for even more months!


Achilles Tendonitis and Running Treatment Options:

  • Read the treatment guide below to find out exactly what you can do.
  • The key is to decrease inflammation, get your Achilles tendon more flexible, and start other exercise programs like swimming, bike riding or weightlifting.
  • Focus on good shoes, good orthotics, good flexibility, and strengthening your other muscles while reducing your weight.



Achilles Tendonitis Treatment:

To treat your Achilles tendinitis. There are two stages to this important process.


Control pain and inflammation:


Step number one is to control the pain and inflammation of the Achilles tendon:

  • This can involve resting foot and ankle while the tendon gets better.
  • What we know about tendon healing is sometimes at this can take weeks or even months!.
  • If you are putting hundreds of pounds of body weight onto it. Tens of thousands of times every single day with running or jogging, this can make it impossible to heal. We get it, it sucks. We wish you could get better quicker, and this is the number one complaint we hear from people. But get over it, you have to start getting better as quick as possible!


  • Anti-inflammatory medication such as aspirin and ibuprofen can be. Successful.
  • We personally don’t recommend this as you can get side effects from using this. So use these at your own risk, they definitely do decrease the inflammation, but consider that you’re only reducing your pain enough to cause even more damage.
  • Don’t rely on just anti-inflammatories. They do have side effects and they are not meant for long-term use.
  • They do not actually heal your medical problem, they only let you feel better.


Icing vs. heat:

This is probably the most effective.

  • Studies showed that ice is effective for 20 minutes at a time, with a short break in between so you don’t freeze your skin.
  • There are some great options for devices that can both ice and massage at the same time.



Creams and gels:

  • There are some great options for both creams and gels, one of our favorites is mental based creams.
  • Bio freeze is a cost-effective mental based cream that has been studied well.
  • Essentially, it performs a similar function to ice, in that it relieves pain for about two times as long as ice.
  • This also helps you avoid sitting around for 20 minutes at a time with an ice pack stuck to the back of your leg!


  • Studies show that massage sticks and massaging can help temporarily remove your inflammation.
  • This is not a situation we can just keep massaging for the rest of time and will keep getting better and better.
  • Studies show that before walking around and moving around. You should massage for about 30 to 60 seconds, and this gives you a few hours of increased flexibility and decreased pain.
  • Don’t go crazy with this and waste half your afternoon massaging like some people do. Stick to what the study show which is 30 to 60 seconds, and then start stretching afterwards.
  • These are some of our recommended and favorite massage devices.



The best shoes for Achilles tendon pain:

  • There’s no way around it, if you are wearing flimsy and flexible minimalist shoes, you will have significant Achilles tendon and foot pain.
  • Especially for ankle and Achilles tendon pain, you need is shoe that does not been in the back or the bottom.
  • In the associated video, Dr. Tom Biernacki goes over specifically what you want to look for an issue.
  • But in summary here: you want to get a shoe that does not bend across the bottom except for the big toe, does not bend in the back, and it has enough room to fit in orthotic.
  • Other than that, you don’t have to get too fancy and blow hundreds of dollars.



How to buy and fit shoes:

  • We love brands like ASICs,New Balance, Hoka, Saucony, and Brooks are excellent. If you get one of the issues you basically can’t go wrong.
  • If you need help trying to fit the shoes, watch this video about how to fit your shoes online!



The best orthotics for Achilles pain:

  • Great shoes are essential for getting your Achilles tendinitis pain better, but really good orthotics are crucial as well to get that pain, feeling much better.
  • Custom orthotics are amazing, but you’ll have to make your first car for Ferrari! Start with something that will get you from point A to point B.
  • Over-the-counter inserts can work really well and for a lot of time you can get them immediately for pretty low price.
  • Yes your foot type, does matter, yes it does matter how much you pronated, but getting some of these inserts is 100 times better than the cheap, flimsy gel pads you will get at the convenience store.
  • It doesn’t matter if you step on a machine that checks your foot, this is just a marketing gimmick!
  • The bottom line is, these are one dollar made in China gel pads, it doesn’t matter if a machine tells you which one of them is the best.

Full length orthotics are the most supportive orthotics:

  • Full-length orthotics are what you should go with if you are able to.
  • These give you the best results in the most control, the only downside is they don’t fit in every type of shoe.
  • If you have really bad Achilles tendinitis, go with a full-length supportive orthotic. Don’t try to where flimsy shoe that can only fit half orthotic.
  • You are cheating yourself and making your foot take much longer to heal.


The best dress shoe orthotics:

  • We understand here at Michigan foot that people do have to wear dress shoes at work.
  • These are are recommended in favor dress shoe orthotics.


The best woman’s shoe orthotics:

  • If by some chance you do have to wear nice cute shoes: try these favorites that we have.
  • Just keep in mind that if you keep wearing unsupportive shoes like heels or flats, your Achilles tendon pain will take much longer to get better than it would in a good running shoe, with a good full-length orthotic.