The Use of Tuina in the Treatment of Achilles Tendinitis

Tuina Therapy for Achilles Tendinitis
Achilles tendinitis is an inflammatory condition affecting the Achilles tendon, which is the large tendon connecting the calf muscles to the heel bone. This tendon plays a crucial role in ankle movement. Inflammation is often caused by overuse—such as from running, jumping, or walking in inappropriate footwear—leading to symptoms like pain, swelling, and tightness in the tendon area.

Tuina (推拿), a therapeutic massage technique in Traditional Chinese Medicine (TCM), can help treat and relieve the symptoms of Achilles tendinitis.

Causes of Achilles Tendinitis
- Overuse, such as prolonged running or jumping without sufficient rest
- Improper footwear, especially thin-soled or non-supportive shoes
- Sudden changes in exercise intensity, like increasing running difficulty too quickly
- Tight or weak calf muscles, which place excess strain on the Achilles tendon
- Abnormal foot structure, such as flat feet or high arches

Symptoms of Achilles Tendinitis
- Pain and tightness around the Achilles tendon, especially after waking up or exercising
- Pain intensifies with running or stair climbing
- Swelling and tenderness may be present along the tendon
- In some cases, a creaking or crackling sound (crepitus) can be heard when moving the ankle

TCM Perspective and Tuina Principles for Treatment
In TCM theory, inflammation is often due to Qi (气) and blood (血) stagnation, which causes pain and swelling. Tuina therapy helps to:
- Stimulate the circulation of Qi and blood
- Relieve muscular and tendon tension
- Eliminate waste and inflammatory by-products from the affected area

Tuina Techniques Commonly Used
- An Fa (按法 – Pressing): Pressing the calf muscles and relevant meridian points around the Achilles tendon with fingers or the palm
- Rou Fa (揉法 – Kneading): Kneading around the Achilles tendon to improve circulation and reduce inflammation
- Ba Shen Fa (拔伸法 – Stretching): Gently holding and stretching the ankle to help loosen the tendon

Meridian Points Used in Treatment
- Chengshan (承山, BL57)
Meridian: Urinary Bladder
Effect: Relieves Achilles tendon pain
Location: Depression in the middle of the calf, halfway between the knee crease and Achilles tendon

- Taixi (太溪, KI3)
Meridian: Kidney
Effect: Nourishes the kidneys and tendons
Location: Between the medial ankle bone and the Achilles tendon

- Kunlun (昆仑, BL60)
Meridian: Urinary Bladder
Effect: Alleviates pain and tightness in the Achilles tendon
Location: Between the lateral ankle bone and the Achilles tendon

Treatment Frequency
Tuina therapy is recommended 1–2 times per week in the initial stages. The frequency may be adjusted depending on symptom improvement.

Precautions
- Avoid intense physical activity such as running, jumping, or vigorous workouts during recovery
- Do not overstretch the calf muscles or Achilles tendon; begin with gentle stretching and gradually increase intensity
- Avoid deep or forceful massage during the acute inflammatory stage (marked by redness, swelling, and severe pain), as it may worsen the inflammation
- If symptoms persist or become severe, consult a healthcare professional for further evaluation and treatment planning

References
FanFanHua. Tuinaxue. Beijing: China Traditional Chinese Medicine Publishing House, 2008.

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Written by:
陈泰任 中医师
TCM. Dr. Chantouch Chen (Chen Tai Ren)