Achilles Tendonitis & Achilles Pain Relief: Hot/Cold Therapy That Stays Put

Struggling with Achilles tendonitis or Achilles pain? Learn when to use ice vs. heat, how long to treat, and how a HurtSkurt® wearable hot/cold pack can speed recovery.

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If you searched for something like:

• “Achilles tendonitis ice or heat”

• “Achilles tendon pain relief at home”

• “ice pack for Achilles injury”

• “Achilles tendonitis recovery hot cold pack”

…you’re dealing with stubborn pain at the back of your heel or lower calf and you want real, practical relief, not just theory.

This guide breaks down what Achilles tendonitis is, when to use cold therapy vs. heat therapy, and exactly how to use a HurtSkurt® wearable hot/cold sleeve as a hands-free ice pack for injury, tendonitis, and long-term Achilles recovery.

As always, this is educational—not a substitute for medical advice. If you’ve got a sudden “pop,” can’t push off your foot, or can’t walk without a limp, see a provider right away.

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Your Achilles tendon is the thick cord that connects your calf muscles to your heel bone. It takes a beating with every step, jump, sprint, and hill repeat. Achilles tendonitis (or Achilles tendinopathy) happens when this tendon gets irritated from:

• Sudden spikes in training (more miles, more hills, faster speeds)

• Tight calves and limited ankle mobility

• Poor footwear or worn-out shoes

• Hard surfaces and lots of impact

• Repetitive sports: running, basketball, pickleball, tennis, soccer

Common symptoms include:

• Aching or burning pain at the back of the heel or just above it

• Morning stiffness that eases as you move around

• Pain when you push off, run, or climb stairs

• Tenderness if you squeeze the tendon

Most early-stage Achilles tendonitis can be managed at home with load management (smart rest), cold therapy, sometimes carefully-timed heat, and a gradual strengthening program. Ice and heat don’t “fix” the tendon, but they make pain manageable so you can actually stick with your rehab. 

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For tendon issues like Achilles tendonitis, the big picture looks like this:

• Cold therapy (ice packs / cold compression) helps reduce pain and inflammation in the early, irritated stage and during flare-ups. Applying ice 15–20 minutes at a time multiple times per day is commonly recommended in Achilles protocols. 

• Heat therapy (warm packs / hot compresses) can sometimes help with later-stage, chronic stiffness by increasing blood flow and relaxing tight muscles—but only once swelling has calmed down and with caution for Achilles injuries specifically. 

The tricky part: the Achilles tendon is a bit “special.” Some orthopedic sources emphasize that heat in the early, inflamed phase can actually make Achilles problems worse, so ice is the primary tool early on, with heat reserved (if at all) for chronic, non-swollen stiffness and only after talking with a clinician. 

That’s where a wearable hot/cold pack like HurtSkurt® shines: you can follow the right temperature at the right time (cold first, cautious heat later if appropriate) without juggling slippery bags of ice.

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Use these as general guidelines—always follow your provider’s instructions if they differ.

Signs:

• Sharp or more intense pain

• Visible swelling or warmth

• Recent jump in training or a very specific “I overdid it” moment

Best choice: Cold therapy only

• Apply an ice pack for Achilles tendonitis or a cold HurtSkurt® for 15–20 minutes, about 2–4 times per day or after any activity that increases pain. 

• Always use a thin cloth or sock between your skin and the cold source.

• Elevate the leg when you can and avoid anything that clearly increases pain (sprinting, jumping, hills).

Avoid:

• Heat on a visibly swollen, hot, angry tendon in the first 48–72 hours—this can worsen inflammation. 

Signs:

• Dull ache instead of sharp pain

• Stiffness first thing in the morning that improves with gentle movement

• Little to no obvious swelling

Primary tool: Cold therapy for pain control

You still use cold for pain and post-activity soreness (especially after rehab sessions), but some clinicians allow gentle, brief heat before stretching once swelling is gone to ease stiffness. 

If your provider says it’s okay, a simple plan might look like:

• Light warmth (not hot) before mobility work to loosen the calf and Achilles

• Ice after activity if the tendon feels irritated or sore again

Because Achilles is easy to re-irritate, if heat ever makes your symptoms worse, skip it and return to cold only.

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A traditional ice pack for injury wants to slide off your heel every time you move. HurtSkurt® is a wearable hot/cold therapy sleeve that gives you 360° coverage around your lower calf, ankle, and heel—so the Achilles gets real contact and you get to stay hands-free.

• Most people will use a Small or Medium HurtSkurt® for the Achilles.

• For cold therapy, lay the sleeve flat in the freezer for at least 2 hours so the gel fully chills.

• For heat therapy later in recovery (if approved by your provider), warm it in the microwave per package directions in short bursts until it’s comfortably warm, never hot.

You want the densest gel panels covering:

• The back of the heel and

• The lower part of the calf where the tendon runs

To do that:

1. Sit or lie with your knee slightly bent and foot relaxed.

2. Slide the HurtSkurt® up from your toes or ankle so the gel area sits behind your heel and along the Achilles tendon.

3. Rotate the sleeve so you feel cold (or gentle heat) directly over the tender zone.

4. If you’re moving around, add a SkurtStrap™ lightly above the ankle or around the lower calf for extra compression and to keep everything in place.

For cold therapy:

• Session length: 15–20 minutes per session. 

• Frequency: 2–4 times per day in early stages, and after any irritating activity.

• Always have a thin layer (sock, wrap, or fabric) between the sleeve and skin if your skin is sensitive.

For heat therapy (only if your doctor/physio says it’s appropriate):

• Wait until the tendon is in a chronic, non-swollen stage. 

• Use mild warmth for 10–15 minutes before stretching, never on a hot, red, swollen tendon.

• Stop if you feel throbbing, increased pain, or see more swelling.

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Here’s a sample daily routine you can customize with your provider:

Morning

• Gently move the ankle up and down a few times before getting out of bed.

• Slip on a cold HurtSkurt® for 15–20 minutes if you wake up with a flare of pain.

• Wear supportive shoes or sandals right away—no barefoot on hard floors.

Mid-day / pre-rehab (chronic phase only, if cleared for heat)

• If stiffness is your main issue and swelling is gone, you may use a warm HurtSkurt® for 10–15 minutes before your prescribed calf stretches and eccentric Achilles exercises. 

• Do your rehab exercises exactly as instructed—this is what actually rebuilds the tendon.

After activity or rehab

• Re-cool the tendon with a cold HurtSkurt® session (15–20 minutes) to calm irritation. 

• Elevate the leg on pillows when you’re resting to help reduce lingering swelling.

Evening

• If you’ve been on your feet all day, another cold therapy session can help calm the tendon before bed.

• Light calf stretching only if it’s comfortable—no aggressive, bouncing stretches.

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Hot/cold therapy, a wearable ice pack for injury, and smart rest are powerful tools, but they’re not enough if:

• Pain is sharp and sudden, especially with a “pop”

• You can’t rise onto your toes or push off when walking

• The back of the heel is extremely swollen or bruised

• Pain persists or worsens after a week or two of rest and cold therapy

• You’re not sure if it’s tendonitis, a partial tear, or something else

In those cases, see a sports medicine doctor, podiatrist, or physical therapist. They can rule out more serious injury, recommend imaging if needed, and build a full loading plan so you don’t keep re-injuring the tendon.

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For most people, ice is the first-line choice, especially in the first 48–72 hours or during painful flare-ups. It helps reduce pain and swelling when used 15–20 minutes at a time. 

Heat may have a limited role later on for long-standing stiffness with no swelling, and only if your provider okays it. The Achilles is sensitive; some experts recommend avoiding heat altogether in early and mid-stage Achilles injuries. 

Mild cases can calm down in a few weeks with rest, cold therapy, and gradual strengthening. More stubborn Achilles tendonitis can take several months to truly resolve, especially if you’ve had symptoms for a long time or keep training through pain. 

The more consistent you are with load management, rehab, and smart hot/cold therapy, the better your chances of a faster, safer recovery.

Light walking for daily life is usually okay as long as pain stays mild and doesn’t worsen after. Running and jumping are another story—most rehab programs temporarily reduce or pause impact sports until the tendon calms down, then reintroduce them slowly. 

If walking itself is painful or you’re limping, get checked by a professional.

Traditional ice packs:

• Are hard to mold around the back of your heel

• Need to be held in place

• Slide off if you move

HurtSkurt® is a reusable gel hot/cold pack inside a soft, stretchy sleeve that:

• Slides on like a sock or sleeve

• Delivers 360° cold compression around the Achilles, ankle, and lower calf

• Stays put while you walk around the house, stretch lightly, or recover after workouts

• Can be frozen for cold therapy or warmed for gentle heat therapy (when appropriate)

Add a SkurtStrap™ and you have cold therapy + compression that actually stays put—no dripping bags, no tape, no hassle.

Common guidance is 15–20 minutes of ice, several times per day, with at least long enough between sessions for your skin to return to normal temperature. 

General safety tips:

• Always use a barrier (sock or cloth) between your skin and the cold source.

• Stop if your skin becomes numb, white, or painful.

• If you have circulation issues, diabetes, or nerve problems, check with your healthcare provider before using any cold therapy.

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Achilles tendonitis needs three things: smart rest, progressive strengthening, and pain-management tools that keep you consistent. Cold therapy is your go-to early on, and a wearable hot/cold pack like HurtSkurt® turns that into something you can actually stick with—hands-free, mess-free, and sized to fit your Achilles, not just your freezer.

Use this guide to dial in your hot/cold routine, then let your rehab plan and good recovery habits do the rest.