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Ankle injuries are defined by the kind of tissue that is damaged, bone (fracture), ligament (sprain), or tendon (strain). We have covered sprains and fractures in previous articles, but when the tendons of the ankle are strained due to overuse or trauma, it may result in ankle tendinitis. More specifically ankle tendinitis (also referred to as tendonitis) is inflammation of the tendons that surround the ankle joints.
Conditions that Cause Ankle Tendinitis
- Overuse – The most common cause of tendonitis is overuse, which means a tendon is overly stretched and possibly experiencing a small degree of pulling apart or tearing. This occurs when there is an increase in activity, which can include anything from walking to participating in competitive sports.
- Abnormal foot structure – Problems such as flat feet or high arches can create muscular imbalances that put stress on one or more tendons.
- Trauma – A foot or ankle injury can cause tendonitis. This can occur with a sudden, powerful motion like jumping. Another form of trauma is chronic rubbing against a shoe, which most often occurs at the top of the foot or heel, resulting in tendonitis in those areas.
- Medical Conditions – Certain medical conditions that cause general inflammation can lead to tendonitis. Inflammatory conditions such as rheumatoid arthritis, gout and spondyloarthropathy can cause Achilles tendonitis or posterior tibial tendonitis.
Treatment of Ankle Tendinitis
When tendinitis symptoms occur, the first thing to do is R.I.C.E, which stands for rest, ice, compression and elevation.
- Rest: Rest your ankle by not walking on it. Limit weight bearing. Stay off the injured ankle so you do not injure it further.
- Ice: Apply an ice pack* to help slow or reduce the swelling within 48 hours of an injury, and repeat as needed. Don’t put ice directly on the skin and don’t ice more than 20 minutes at a time to avoid frost bite.
- Compression: Wrapping the injured ankle with an elastic ankle brace* or off-the-shelf compression wrap will help keep it immobile and supported. Be sure not to wrap the ankle too tightly.
- Elevate: Elevating the injured ankle to at least the level of your heart will reduce swelling and pain.
Over-the-counter medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve) can reduce inflammation in the tendon, leading to decreased pain and swelling with ankle tendinitis. Check with your doctor to be sure these medications are safe for you.
Gentle stretching exercises — such as ankle circles and stretching the calf muscle — may also be helpful. These exercises serve to strengthen the ankle joint while maintaining its flexibility and reducing stiffness. However, it’s important not to perform exercises that cause pain in your ankle, as this may further damage the inflamed tendon. Always ask your doctor first before doing any exercise.
If your ankle pain does not improve with home care, medication or exercise, see your healthcare provider for evaluation and treatment. Options include:
- Immobilization using a cast or splint
- Oral or injected anti-inflammatory drugs to reduce pain
- Physical therapy for range of motion, strength, and balance
- Surgery to repair the tendon or tendons and sometimes to repair the supporting structures of the foot
What you can do to prevent ankle injuries?
- Avoid exercising or playing sports when you are tired or in pain.
- Keep muscles strong by eating a well-balanced diet.
- Maintain a healthy weight.
- Try to avoid falling.
- Wear shoes that fit well and that are appropriate for the activity you are doing.
- Don’t wear shoes that have heels worn down on one side.
- Exercise regularly.
- Maintain the proper conditioning for whatever sport you are playing.
- Warm up and stretch before exercising or playing a sport.
- Wear the proper equipment for whatever sport you play.
- Run on flat surfaces.