Ankle tendonitis is an inflammation or irritation of the tendons surrounding the ankle joint. Tendons are the fibrous tissues that connect muscles to bones, and when they become overused or injured, they can swell, leading to pain and discomfort. This condition can affect various tendons in the ankle, with the most common being the Achilles tendon, which connects the calf muscles to the heel.
For this reason, we will look into what causes ankle tendonitis, symptoms and the best solutions to help you recover.
What is Ankle Tendonitis
Ankle tendonitis is inflammation of the tendons in the ankle, primarily the peroneal and posterior tibial tendon. Peroneal tendonitis affects the tendons on the outer ankle and causes peroneal tendon pain, while posterior tibial tendonitis affects the tendon that supports the arch of the foot. These tendons are the stabilizers and supporters of the foot so their health is crucial for mobility.
When these tendons get inflamed due to overuse, injury or poor foot mechanics the condition can hinder movement and cause a lot of pain.
Causes of Ankle Tendonitis
Overuse is one of the main causes of ankle tendonitis especially among active people and athletes. Activities that involve repetitive movements like running or jumping puts prolonged stress on the tendons and can lead to inflammation and tendon injuries. This repetitive stress can be exacerbated by poor foot mechanics especially among people with flat feet or high arches.
Sports that require quick direction changes like basketball or soccer also increases the risk of ankle tendonitis. The constant pivoting and sudden stops puts additional stress on the tendons making them more prone to injury. Ankle sprains can also contribute to the development of tendonitis by weakening the tendons and making them more inflamed.
Ankle tendonitis can be caused by several common factors. These factors may be overuse or injury.
1. Overuse and Repetitive Motion
Frequent running, jumping, or walking on uneven surfaces can strain the tendons, leading to inflammation.
2. Poor Footwear
Wearing unsupportive shoes, especially during physical activity, can increase stress on your ankle tendons.
3. Sudden Increase in Activity
Rapidly increasing exercise intensity or duration can overload the tendons and cause irritation.
4. Improper Form or Biomechanics
Flat feet, high arches, or poor walking/running posture can put extra strain on the tendons.
5. Previous Injuries
Sprains or untreated injuries can weaken the tendons, making them more susceptible to inflammation.
6. Aging and Degeneration
As you age, tendons naturally lose elasticity, increasing the risk of tendonitis.
7. Medical Conditions
Conditions like arthritis, diabetes, or inflammatory diseases can contribute to tendon irritation.
8. Tight or Weak Muscles
Lack of flexibility or strength in the surrounding muscles can put extra pressure on the ankle tendons.
9. Excess Weight
Carrying extra weight increases stress on your ankles, leading to inflammation.
10. Improper Warm-Up or Cool-Down
Skipping stretching before or after workouts can lead to tightness and tendon strain.
Ankle Tendonitis Symptoms
Common symptoms are pain, swelling and reduced mobility in the affected area. Pain on the tendon on the outside of the ankle is peroneal tendonitis. This pain worsens with activity and is often accompanied by feeling of instability in the ankle.
Other symptoms of peroneal tendon injuries:
- Swelling and warmth around the tendon
- Weakness and instability in the ankle
- Pain at the outer ankle bone
- Snapping or popping sensation
Types of Ankle Tendonitis
Ankle tendonitis refers to inflammation of the tendons around the ankle joint. There are several types of ankle tendonitis, each affecting different tendons. Here are the most common types:
This is the most common form of ankle tendonitis, affecting the Achilles tendon, which connects the calf muscles to the heel bone. It often results from overuse, leading to pain and stiffness in the back of the ankle.
This condition affects the posterior tibial tendon, which supports the arch of the foot. It often leads to pain and swelling on the inside of the ankle and can contribute to flatfoot deformity if untreated.
This type involves inflammation of the peroneal tendons, which run along the outside of the ankle. It can cause pain on the outer side of the ankle and may result from repetitive ankle motion or ankle sprains.
This affects the anterior tibial tendon, which helps with dorsiflexion (lifting the foot). Pain may occur at the front of the ankle, especially during activities like walking or running.
This involves inflammation of the tendon that flexes the big toe. Pain is typically felt on the inside of the ankle and may worsen with activities that require pushing off the toe.
Inflammation of the tibialis anterior tendon can cause pain and swelling at the front of the ankle and may affect walking or running.
This affects the soleus muscle, located beneath the gastrocnemius muscle in the calf. Pain may occur in the lower part of the calf and can affect ankle mobility.
Each type of ankle tendonitis may require specific treatments, including rest, ice, physical therapy, and sometimes surgical intervention. If you’re experiencing symptoms, consulting a healthcare professional for a proper diagnosis and treatment plan is essential.
How is Ankle Tendonitis Diagnosed
Ankle tendonitis is diagnosed through physical exams and imaging tests. In a physical exam a healthcare professional will check the affected area for inflammation, tenderness and instability. They will also check for snapping or popping sensation which can worsen tendon issues if left untreated.
As you can see, ultrasound, MRI and CT scans are used to diagnose ankle tendonitis. Ultrasound is particularly good for ankle tendon conditions because it can provide real time imaging and dynamic evaluation. It can help differentiate peroneal tendon subluxation from normal tendon position during ankle movement.
Color Doppler ultrasound can also be used to assess tendon vascularity to evaluate inflammatory conditions.
Conservative Treatment for Ankle Tendonitis
Conservative treatment is usually the first line of treatment for ankle tendonitis. The RICE method, Rest, Ice, Compression and Elevation is the foundation of ankle tendonitis management.
- Rest the affected ankle to avoid further strain.
- Apply ice to reduce swelling and pain.
- Compression bandage to reduce swelling.
- Elevation to promote healing.
NSAIDs can help manage pain and inflammation associated with ankle tendonitis. Supportive shoes reduces stress on the ankle and aid in tendonitis recovery. Physical therapy is often recommended to strengthen ankle muscles and improve flexibility after initial treatment.
Bracing may also be used during recovery from ankle tendonitis. These can help improve symptoms and prevent worsening of the condition so you can get back to normal activities.
Stretching Options
Stretching and exercises are part of managing ankle tendonitis. Ankle circles increases flexibility by moving the ankle in rotational motion. Towel stretch targets the underside of the foot and back of the legs to relieve.
Cross legged ankle stretch is done by gently pulling the foot down. Achilles tendonitis stretch is done by placing one foot behind the other with heel on the ground. These flexibility exercises can help reduce pain associated with ankle tendonitis.
Do these stretches and exercises to prevent peroneal tendonitis by maintaining peroneal tendons and muscles flexibility and strength.
Ankle Tendonitis Exercises
In addition to stretching, specific exercises can strengthen the ankle and improve flexibility to reduce tendon injury. Ankle pumps flex and point your toes to improve circulation and mobility. Towel stretch is another exercise: sit with your legs straight, loop a towel around the ball of your foot and gently pull to stretch the calf muscle.
Other exercises to do are calf raises, eccentric heel drops and resistance band exercises. These exercises target different muscle groups and tendons to improve ankle stability and function.
- Ankle Pumps
- Towel Stretch
- Calf Raises
- Eccentric Heel Drops
- Resistance Band Dorsiflexion and Plantarflexion
Do these exercises regularly to manage symptoms and prevent future ankle tendonitis. Consult a healthcare professional or physical therapist to do it correctly.
When to Consider Surgery for Ankle Tendonitis
Surgery may be needed if conservative treatment doesn’t work. Decision to undergo surgery depends on the severity of the tendon injury and the individual’s activity level. High impact sports may require surgery sooner than low impact activities.
An orthopedic specialist can assess the condition and recommend the best treatment, physical therapy or surgical repair. Surgery usually aims to repair the torn tendon and get back to normal function so you can fully recover.
Recovery and Prevention Tips
Recovery from ankle tendonitis requires rest, proper care and gradual return to activity. Rest is key to healing as it prevents further strain to the affected area. Compression bandage can help reduce swelling and aid in recovery.
- Rest: Avoid activities that aggravate the pain.
- Ice: 15-20 minutes every few hours
- Compression: elastic bandage or compression wrap
- Elevation: elevate ankle above heart level
To prevent future occurrences, use proper technique during exercises and sports, invest in good fitting supportive shoes and listen to your body.
Bottom Line : Quick Facts
Ankle tendonitis is important to understand for anyone who is prone to tendon injuries.
- Ankle tendonitis is caused by overuse, poor foot mechanics and high impact sports which causes inflammation of the peroneal and posterior tibial tendons.
- Knowing the symptoms like pain, swelling and weakness will help in early diagnosis and treatment to prevent further damage.
- Solutions include RICE, physical therapy and specific exercises and surgery as a last resort if conservative methods don’t work.
