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Ankle Pain

Ankle Tendonitis

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Posted 2 years ago


Last updated: 03/12/2022


by James McCormack

James McCormack
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What are the different types of Ankle Tendonitis?

Ankle Tendonitis is the most common type of Tendonitis due to the high levels of force that pass through the ankle joint when walking and running. A tendon connects a muscle to a bone, and some of the largest tendons in the body are found in the ankle. If these tendons become overloaded and inflamed, it results in Ankle Tendonitis.

Ankle Tednonitis Diagram

The most common Ankle Tendonitis are as follows:

Outer Ankle Tendonitis – Peroneal Tendonitis

Inner Ankle Tendonitis – Posterior Tibial Tendonitis

Back of Ankle Tendonitis – Achilles Tendonitis – Insertional Achilles TendonitisPlantaris Tendonitis

Front of Ankle Tendonitis – Anterior Tibial Tendonitis

What causes Ankle Tendonitis?

As a principle, all forms of tendonitis can be caused by an overload or overuse. In the instances of overload, this is caused by a sudden increase in the use of a tendon. Depending on an individual’s baseline activity, an overland can be as simple as a sudden increase in step count. Clinically we see this a lot in patients who go on a city break and have a sudden increase in steps or in individuals who have a sudden increase in their running volume or intensity.

Overuse as a cause of ankle tendonitis is usually the result of a biomechanical overload of a tendon. For example, poor pronation control can overload the Posterior Tibial Tendon or overstriding when running can overload the Achilles Tendon. In each form of Ankle Tendonitis, we have individual articles to discuss the causes in greater detail.

Ankle Tendonitis Symptoms

All Ankle Tendonitis have the same symptoms. They are often stiff first thing in the morning, worse at the beginning of an activity such as running, improve during the activity and are worse afterwards. There is often minimal swelling, and the tendon is often sore to the touch.

  • Peroneal Tendonitis – Pain on the outer ankle around the lateral malleolus
  • Posterior Tibial Tendonitis – Pain on the inner ankle and down to the arch of the foot.
  • Achilles Tendonitis – Pain on the back of the ankle above the heel bone
  • Insertional Achilles Tendonitis – Pain on the back of the heel bone
  • Plantaris Tendonitis – Pain on the inner aspect of the Achilles Tendon only.
  • Anterior Tibial Tendonitis – Pain on the front of the ankle

How to diagnose Ankle Tendonitis?

Ankle tendonitis can be diagnosed following a clinical examination by a Physical Therapist based on a patient’s symptoms, the pattern of pain, and clinical tests. If the clinician is unsure of the diagnosis or wants to rule out other conditions in the area, an ultrasound or MRI may be requested. Both of these scans can identify pathological changes within the tendon and inflammation of the tendon.

Ankle Tendonitis Treatment

Treatment for Ankle Tendonitis is best guided by a Physical Therapist who can provide a specific strengthening and rehabilitation protocol. For each form of ankle tendonitis, strengthening exercises are the most effective form of treatment. Still, other considerations are helpful such as insoles, changes in footwear, shockwave therapy and exercise medication.

Steroid injections are not recommended for ankle tendonitis as they can decondition the tendon, while GTN patches work well as most tendons are superficial.

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Physiotherapy with James McCormack

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.

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