Achilles Tendinitis - Blood Stasis Pattern

Dr. Li Wei, DACM

Achilles Tendinitis · Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Ankle

Pattern Overview

Blood Stasis is a common pattern in chronic Achilles tendinitis, characterized by sharp, fixed pain that worsens at night, often with a history of overuse or repeated microtrauma. The core pathogenesis is stagnation of blood in the tendon collateral vessels, blocking the free flow of Qi and Blood, leading to pain and fibrosis.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Sharp, stabbing pain in the Achilles tendon, fixed location, worse at night |

| Associated Symptoms | Tenderness on palpation, history of overuse or repetitive strain, possible swelling |

| Tongue and Pulse | Purple-dark tongue with petechiae, thin white coating, hesitant or choppy pulse |

| Pathogenesis | Blood stasis obstructing the collateral vessels of the tendon |

| Etiology | Chronic microtrauma, inadequate recovery from exercise |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| BL60 Kunlun | Depression between lateral malleolus and Achilles tendon | Unblocks the Bladder meridian; treats ankle pain |

| BL57 Chengjin | Middle of the calf, below the gastrocnemius muscle belly | Relieves calf and Achilles tension |

| KI3 Taixi | Depression between medial malleolus and Achilles tendon | Tonifies Kidney Qi and promotes blood circulation |

| Ashi points | Tender spots around the tendon | Local blood invigoration and pain relief |

Clinical Recommendation: Filiform needle, reducing method; may combine with cupping at Ashi points to enhance blood stasis resolution.

Herbal Formula

Base Formula: Tao Hong Si Wu Tang (桃红四物汤)

Composition:

Peach Kernel (Tao Ren), Safflower (Hong Hua), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Red Peony (Chi Shao), Rehmannia (Sheng Di)

Action: Invigorates blood, resolves stasis, nourishes blood, and relieves pain.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe pain | Add Ru Xiang, Mo Yao to enhance pain relief |

| Swelling | Add Dan Shen, Ji Xue Teng to improve microcirculation |

| Chronic fibrosis | Add San Leng, E Zhu to break up stasis |

Western Mechanism Reference

Chronic microtrauma with fibrosis, local microcirculation disturbance, and platelet aggregation. Blood Stasis pattern corresponds to tendinopathy with impaired healing and excessive fibrous tissue formation, often seen in chronic overuse injuries.

References

  1. Acupuncture and Moxibustion Textbook.

  2. WHO. (2023). Musculoskeletal pain. World Health Organization.

Explore More

  • Find your solution at MendGod.com – Personalized herbal protocols and acupressure tools for tendon pain relief.

  • Deepen your knowledge at TcmCIO.com – Full research papers and clinical case studies on TCM tendon health.