Tendonitis on the ankle
introduction
A tendon (Tendo) consists of connective tissue and represents the connection between muscles and bones. Tendons therefore transfer muscle power to the skeleton so that the body can perform movements. On the inner and outer ankles is the upper ankle, which allows the foot to move upward (Dorsiflexion) and below (Plantar flexion) can move. The tendons and ligaments that are needed to move the ankle joint can become inflamed, known as tendinitis (Tendinitis, tendinosis) or tendinitis (Tendovaginitis) referred to as. It can be next to the ankle (Malleolus) occur wherever there are tendons or tendon sheaths. Often an ankle tendinitis is caused by overstressing the ankle. This overload can be caused, for example, by too demanding sport or by uncomfortable footwear (for example, wearing high shoes). Depending on the degree of inflammation and injury to the tendon, the affected foot or ankle should be immobilized.
Read about this too: Tendinitis of the tibialis posterior tendon
causes
Tendonitis on the ankle is often caused by excessive stress. Such an overload can result, for example, from increasing sports units too quickly while jogging. Often, twisting the foot at the inner or outer ankle can also cause tendinitis. A congenital arched flat foot can also be the cause of recurring tendinitis on the ankle.
Find out more at: Pain in the outer ankle
Torn to torn tendons and degenerative and rheumatic changes to the tendons can also cause tendinitis in the ankle. Degenerative changes arise, for example, from previous inflammations or injuries to the ankle. Another cause of ankle tendinitis can be an infectious bacterial inflammation. However, this mainly occurs with open wounds, into which bacteria have to penetrate deep into the tissue, and is therefore rather rare.
Read more about this under Causes of tendinitis
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Pain after jogging
If there is pain and swelling on the inside or outside of the ankle after exercising, it may be due to tendinitis on the ankle. This is usually through a too heavy load caused by the tendons. However, you should also Running shoes check whether these meet the demands of the feet. Furthermore, misalignments of the foot can cause the tendons on the ankle to become inflamed after jogging. Here you can insoles help to put the foot in the right position so that tendinitis can be prevented.
If the tendinitis is currently present on the ankle, it should definitely a sports break inserted so that the muscles and tendons can recover. The resumption of training should then also take place slowly as a build-up training with light load, which can be slowly increased. A bandage can also help stabilize the joint and thus also the tendons and ligaments while jogging.
Symptoms
Depending on the degree of injury to the tendon, tendinitis will be accompanied by symptoms of varying severity. But in general the symptoms are the classic signs of inflammation: Swelling, redness, warmth, pain, and loss of function. The swelling can only occur on one side or it can affect both ankles. Pain occurs mainly when moving.
If the tendinitis is mild, caused by brief overload, it usually only occurs with repeated overload Stress pain (for example while jogging). If the structures are not only slightly irritated and inflamed, but have been torn, for example, by twisting the foot, normal walking or even walking is associated with pain. It can also become a local Tendernesswhere the inflamed tendon is located. In addition, tendinitis on the ankle can lead to so-called "palpable crepitationsThis means noticeable lumps on the changed and inflamed tendons, which cause a crunching noise when rubbing against each other.
diagnosis
A doctor should be consulted if the ankle pain and swelling persists and recurs. This can be done through a survey (anamnese) and by examining the swollen and / or painful foot, make the suspected diagnosis that there is tendinitis. It can also cause increased inflammation in the body Markers of inflammation be detected in the blood. An increased CRP value (C-reactive protein) or ESR value (Sedimentation rate) suggest the presence of inflammation.
A Ultrasound examination can cause tendon changes and tendinitis on the ankle display quickly and well. in the X-ray image is the representation of the tendons and ligaments not good possible. However, pathological changes in the bone, which may be responsible for swelling in the area of the ankle, can be determined or excluded. To accurately depict a change or inflammation in the tendon and the extent of the tendon injury, a MRI be made.
treatment
Treatment for tendinitis in the ankle depends on how severe the previous injury is. Treatment of the tendinitis is important, however, as persistent inflammatory processes can cause the tendons to become brittle and tear. In any case, the inflamed tendon should be immobilized. In addition, the affected ankle should be cooled. Until the swelling and pain in the affected ankle have disappeared, any sport that puts strain on the upper ankle or the foot should be avoided.
If the tendinitis persists for a long time and is accompanied by severe pain, so-called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen and diclofenac can be taken for a short time to relieve the inflammation and counteract the pain. However, since these drugs can cause stomach problems (for example, gastric mucosal inflammation) as a side effect, prolonged use of these drugs should be avoided.
In the case of severe inflammatory changes, glucocorticoids (cortisone) can also be injected near the inflamed tendon by the doctor. However, this should not be done repeatedly and also not directly into the inflamed tendon, since the administration of cortisone also poses a risk of degeneration for the tendon and the surrounding structures.
If there are serious changes to the tendons, an operation may be necessary to remove any thickenings on the tendons. Sometimes, however, a complete renewal of the tendon is necessary. In the case of severe tendinitis on the ankle and after an operation, physiotherapy (after adequate immobilization), physiotherapy with shock wave therapy and slow training of the affected muscles should be carried out.
Read also: Home remedies for tendinitis
Homeopathy for tendinitis
If you want to alleviate the tendinitis on the ankle with homeopathic remedies, regardless of the medicine to be taken, depending on the symptoms, five globules should be taken twice a day for two to three weeks. In addition, it should be borne in mind that homeopathic treatment is only recommended as an accompanying therapy in the event of excessive stress, during which the tendons have not been further injured or torn.
Causticum C7 can be taken if the patient is stiff and painful during movement. Ledum palustre C5 is particularly recommended for tendinitis on the ankle or ankle. Taking Arnica montana can also help relieve the discomfort of tendinitis in the ankle. If the cause of the tendinitis is a sprain, taking ruta graveolens can help heal it.
Read more on the topic: Arnica
Duration
Since the severity of the tendinitis in the ankle depends on the previous injury to the tendon, the duration of the tendinitis also varies. In the case of tendinitis that was triggered by brief overload, this can be resolved by cooling and appropriate immobilization some days be gone again. However, you should still be careful not to put too much strain on the tendon right away.
If the tendon is torn or torn, the period of time until freedom from pain and inflammation can be increased several months drag on. In some cases, a tendon will be painful again and again if it is overloaded.In any case, one should make sure that the affected tendon is only stressed without pain and that it is possible to switch to sports that do not strain the joints and thus the tendons too much. If an operation is necessary, the foot will stay open for at least two weeks after the operation in plaster. If it is a serious operation, it may be necessary to wear the cast for up to six weeks. After the operation, it can take up to twelve months before the tendon can be fully exercised again.
Anatomical orientation for tendon complaints
Outer ankle
If there is pain in the rear outer ankle, it is usually one Peroneal tendonitis. This affects the tendons of the so-called peroneal muscles, which are located on the outside of the Fibula and ensures that the foot remains in the correct position while walking. If tendinitis occurs on the outside of the ankle, this is usually a gradual process with a long-lasting one Overload owed (incorrect footwear or excessive sporting activity).
Since the tendons on the outer ankle are affected, the pain and swelling will also appear there. In most cases, those affected also have pain when lifting the foot to the outside or inside, as the tendons are stretched or compressed. Can also be a Varus deformity the heel could be the cause of tendinitis on the outer ankle. Here the heel is bent outwards, which over a longer period of time ensures that the tendons and the joint change, which can lead to tendinitis.
Inner ankle
The tendon of the tibialis posterior muscle is usually responsible for tendinitis on the medial malleolus. This tendon runs behind the inner ankle towards the underside of the foot and is responsible for the arching of the foot. Therefore, pain can also occur on the underside of the foot, among other things. Here, too, tendinitis is usually caused by excessive stress (e.g. overweight). If the inflammation of the tendon is accompanied by degeneration and change, a so-called flat foot can develop after a long period of time, as the tendon of the tibialis posterior muscle can no longer fulfill its task. Therefore, early therapy is very important. For example, the formation of flat feet should be counteracted by wearing insoles.
Read more about this under Pain in the inner ankle
Above the ankle
If the pain and swelling occur above the ankle, only the upper part of the tendon is affected. Depending on whether the pain is described on the inner or outer ankle, it is the tendons of the respective muscles. If the upper outer ankle is affected, it is the tendons of the M. peroneus longus or brevis. These can easily ignite when overloaded or twisted. The tendon of the M. tibialis posterior affected, which pulls from above the ankle further down to the bottom of the foot. Since tendinitis rarely causes discomfort in isolation above the ankle, the pain can also be felt below the ankle when walking, for example. Here, too, it is advisable to relieve the foot so that the affected tendons can recover.
Below the ankle
Pain and swelling below the ankle can also be triggered by tendinitis in the ankle. Again, either the tendons of the outer or inner lower leg muscles can be the cause. The tendons of the peroneus longus and peroneus brevis muscles run behind and below the outer malleolus. If both or one of the tendons is overloaded, they can become inflamed and cause discomfort. On the inside below the ankle, the tendons of the tibialis posterior and the tendons of the Flexor hallucis longus muscle and Flexor digitorum longus along. If these tendons are injured by excessive stress or twisting or twisting, these tendons can become inflamed and cause corresponding complaints such as pain when going down stairs. Here, too, as with any tendonitis on the ankle, you should rest and possibly take anti-inflammatory painkillers such as ibuprofen or diclofenac. In the event of persistent or recurring symptoms, a doctor should be consulted, as this is also the case Malpositions of the foot or other injuries (for example in the joint or on the nerves).
