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About Common Ankle Conditions and Injuries

Achilles Tendonitis



The Achilles tendon is a band of tissue that connects the heel of the bone to the calf muscle of the leg.  Injury to the tendon may cause it to become inflamed or torn.

  Achilles tendonitis is the term used when the tendon is inflamed.  The inflammation causes pain at the back of your leg near the heel.  A tear of the tendon is called a rupture.  It also causes pain near your heel.

Cause:

Achilles tendonitis can be caused by:

  • Overuse of the Achilles tendon

  • Tight calf muscles

  • Tight Achilles tendon

  • Lots of uphill running

  • Increasing the amount or intensity of sports training, sometimes along with switching to racing flats, which are racing shoes with less heel lift

  • Over-pronation, a problem where your feet roll inward and flatten out more than normal when you walk or run

  • Wearing high heels at work and then switching to lower-heeled shoes for exercise.

An Achilles tendon may tear during sudden activity.  For example the tendon might tear when you jump or start springing.

Symptoms:

Achilles tendonitis causes pain and may cause swelling over the Achilles tendon.  The tendon is tender and may be swollen.  You will have pain when you rise up on your toes and pain when you stretch the tendon.  The range of motion of your ankle may be limited.

   When the tendon tears or ruptures, you may feel a pop.  If there is a complete tear, you will be unable to lift your heel off the ground or point your toes.

Treatment:

  • Put ice packs on the Achilles tendon for 10 minutes on, 10 minutes off and then 10 minutes on again.  Repeat every 2 to 3 hours for the first 2 or 3 days or until the pain goes away.

  • Elevate your lower leg on a pillow when you are lying down.

  • Take anti-inflammatory medication as prescribed by your health care provider.

  • A heel lift insert for your shoe, wear it at least until your tendon heals and possibly longer.  The lift prevents extra stretching of your Achilles tendon.

   While you are recovering from your injury, change your sport or activity to one that does not make your condition worse.  For example, you may need to swim instead of run.

   Do any exercises your health care provider gives you to stretch and strengthen your Achilles tendon.

   If you over-pronate, your health care provider may prescribe custom-made shoe inserts, called orthotics, which help keep your foot stable.

   In some severe cases of Achilles tendonitis, your foot may be put in a cast for several weeks.

   A tear of the tendon may require surgery.  Or your foot may be put in a cast for 6 to 10 weeks.

Prevention:

The best way to prevent tendon injury is to stretch your calf muscle and Achilles tendon before exercise.  If you have tight Achilles tendons or calf muscles, stretch them twice a day whether or not you are doing any sports activities that day.

   If you have a tendency to get Achilles tendonitis, avoid running uphill a lot.


Ankle Sprain  

A lengthening or tearing of the ligaments that hold the ankle joint in place on the outside part of the ankle.  The ankle becomes swollen, painful and it may be difficult to put weight on it

Cause: Generally, is the result of a traumatic injury or fall. 

Symptoms: Pain and swelling on the inside or outside of the involved ankle. Occasional bruising of the foot.    

Treatment: P.R.I.C.E. (protection, rest, ice, compression and elevation). Physical therapy. Custom ankle brace. Occasionally surgical treatment is needed.


Posterior Tibial Tendonitis

Posterior tibial tendonitis causes pain along the inner side of the lower leg, ankle or foot.  Tendons are strong bands of connective tissue which attach muscles to bones.  The posterior tibial tendon helps point the foot down and in.  Tendonitis is inflammation of a tendon.

Cause:

Posterior tibial tendonitis occurs from overuse of the tendon.  This tendon attaches to a bone in the foot called the navicular and helps stabilize your arch.  If your arch flattens out more than normal when you walk or run it is called over-pronation.  When you over-pronate you strain your tendon and are more likely to get posterior tibial tendonitis.

Symptoms include:

  • Pain or tenderness on the inner side of the shin, ankle or foot

  • Pain with lifting up your foot

  • Pain walking or running

Treatment may include:

  • Applying ice packs to your foot for 10 minutes on, 10 minutes off and then 10 minutes on again every 3 to 4 hours for the first 2 to 3 days or until the pain goes away.  Thereafter, ice your foot at least once a day until the other symptoms are gone.

  • Doing ice massage.  Freeze water in a cup and then peel back the top of the cup.  Massage the ice into the painful tendon for 5 to 10 minutes.

  • Elevating your lower leg and foot by placing a pillow underneath it.  Try to keep your foot above the level of your heart.

  • Your provider may recommend special arch supports or inserts for your shoes called orthotics, either custom-made or off the shelf.

  • Taping your foot to give extra support to your arch, the navicular bone and the attachment of the posterior tibial tendon.

  • Sometimes a cast is needed for a few weeks until the pain and inflammation go away.

  • Using crutches until you can walk without pain.

  • Taking anti-inflammatory medication or other pain medication prescribed by your provider.

  • Doing exercises will help you return to your normal activity or sports.

Capsulitis

Inflammation of a capsule (joint)

Cause:

Overwork or strain of any joint-including sprains (partial tears). Certain medications and or joint diseases-such as rheumatoid or osteo arthritis

Symptoms:

Stiffness in the morning or after a period of inactivity. Tightness & soreness of joint or instability (excess movement) of joint.

Treatment:

Protect joint.  RICE (rest, ice, compression, elevation) treatment for the first 2-3 days after injury-then you may apply heat for soreness. Oral anti-inflammatories such as Advil or Tylenol for one to two weeks. Physical therapy  Biomechanical  analysis and/or computerized orthotics. Brace or surgery for unstable or badly sprained joint.  Early treatment prevents arthritis of the joint.


Myositis

Inflammation of muscle tissue
Symptoms:
Stiffness in the morning or after a period of inactivity. Tightness & soreness of muscle
Cause:
Overwork or strain of any muscle. Direct physical damage. Certain medications and or diseases (chronic fatigue syndrome, rheumatoid arthritis)
Treatment:
Stop or modify the activity that is causing the problem. RICE (rest, ice, compression, elevation) treatment for the first 2-3 days after injury-then you may apply heat for soreness. Oral anti-inflammatories such as Advil or Tylenol for one to two weeks. Physical therapy. Biomechanical analysis and/or computerized orthotics. Special stretching and or muscle activation techniques.


Gout

Uric acid in joint caused by too much protein in the diet. Example: meat, sardines. Certain high blood pressure medications. Kidney disease

Symptoms:
Hot, very painful joint-usually the big toe-but can also affect the ankle or knee and the elbow

Treatment:
Change diet, drink lots & lots of water. Avoid alcohol. Have your doctor evaluate you for possible meds and or treatment (we offer immediate pain relief treatments) 

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The definitions and treatments listed above are for informational purposes only and should not be considered diagnosis of your particular problem. 

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