Ankle Conditions

Ankle Conditions: Sprains & Achilles Tendinitis

Ankle injuries, though relatievly common, are surprisingly complex. They can take various forms and, depending on the severity, treatment can dramatically vary.

Table of Contents

Ankle Sprain

Causes

Generally, an ankle sprain is the result of a traumatic injury or fall.

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

Ankle sprains are likely among the most common injuries, and unfortunately, they’re also commonly misdiagnosed.

There are two major types of sprained ankles:

  • high ankle sprains (less common)
  • lateral ankle sprains

These often look the same the same, although they affect entirely different ligaments.

Symptoms

Reduced motion, pain, swelling, and bruising in the entire ankle region. This can occur in both high ankle sprains and lateral ankle sprains. Occasionally, there will also be bruising of the foot.

Treatment

Treatment varies by severity. If a sprain is just that, typically it can be treated by following the P.R.I.C.E (protection, rest, ice, compression and elevation) procedure.

However, more serious sprains (such as the aforementioned high ankle sprain) may require focused medical treatment such as physical therapy, custom foot brace, or surgery (albeit rarely).

In order for us to properly diagnose a sprain, we need to understand how it happened. For example: did the foot turn inwards or outward?

If you can’t put weight on your foot or you see bruising, it’s best to make an appointment with a health provider.

Prevention

Most commonly ankle sprains occur during rigorous physical activity. We realistically can’t suggest you to stop exercising! However, we will suggest you:

  • Warm up prior to doing any rigorous physical activity.
  • Be wary of uneven surfaces.
  • Choose proper-fitting shoes and replace worn out shoes ASAP (we even wrote an article about this!)

Achilles Tendinitis

illustration showing achilles tendon

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. This type of injury is often mistaken for an ankle sprain – especially if it has not ruptured.

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.

Causes

Achilles tendonitis can be caused by:

  1. Overuse of the Achilles tendon
  2. Tight calf muscles
  3. Tight Achilles tendon
  4. Lots of uphill running
  5. Increasing the amount or intensity of sports training, sometimes along with switching to racing flats, which are racing shoes with less heel lift
  6. Over-pronation, a problem where your feet roll inward and flatten out more than normal when you walk or run
  7. Wearing high heels at work and then switching to lower-heeled shoes for exercise.
  8. An Achilles tendon may tear during sudden activity. For example the tendon might tear when you jump or start springing.

Symptoms

Achilles tendinitis 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

  1. 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.
  2. Elevate your lower leg on a pillow when you are lying down.
  3. Take anti-inflammatory medication as prescribed by your healthcare provider.
  4. 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.
  5. 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.
  6. Do any exercises your health care provider gives you to stretch and strengthen your Achilles tendon.
  7. If you over-pronate, your health care provider may prescribe custom-made shoe inserts, called orthotics, which help keep your foot stable.
  8. In some severe cases of Achilles tendonitis, your foot may be put in a cast for several weeks.
  9. 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.

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