What is Ankle Joint Tendonitis or Ankle Joint Tendinitis?
Many tendons support ankle joint. Inflammation of tendon around ankle joint is known as Ankle Joint Tendonitis.
What is Tendon?
Tendon is bundle of tough fibrous tissue shaped like a rope. One end of tendon is attached to muscles and the other end is attached to bone. When muscle contracts tendon pulls the bone.
What is Tendonitis?
Tendonitis is an inflammation of tendon. Tendonitis of ankle joint tendon is often associated with tendon injury.
What Are The Tendon Injuries Associated With Ankle Joint Tendonitis or Ankle Joint Tendinitis?
Tendon injury could be tendon laceration, partial tear or complete tear leading to Ankle Joint Tendonitis or Ankle Joint Tendinitis.
Is there Any Difference Between Ankle Joint Tendonitis and Ankle Joint Tendinitis?
Tendonitis is also known as tendinitis. Ankle Joint Tendonitis or Ankle Joint Tendinitis are one and the same thing.
Is Ankle Joint Tendonitis or Ankle Joint Tendinitis a Common Illness Causing Pain in Ankles?
Ankle joint pain is a very common disease. Several conditions cause ankle join pain. Ankle Joint Sprain and Ankle Joint Tendonitis are most common illnesses resulting in Ankle Joint Pain.
Describe The Ankle Joint?
Ankle joint is a cartilaginous and hinged joint. Ankle joint is made up of three joints as follows-
- Tibio-Talar Joint- The tibiotalar joint is a link between lower end of shinbone (tibia) and upper flat surface of talus bone.
- Subtalar Joint or Talo-Calcaneal Joint- The subtalar joint is a link between lower flat surface of talus and upper flat surface of calcaneal bone.
- Tibio-Fibular Joint- The lower end of tibia is link with lower end of fibula.
What is Cartilaginous Hinged Joint?
In cartilaginous joint the surface of the bone within the joint is covered by smooth cartilage. The ankle joint is a link between foot and lower leg. Foot is placed at 90-degree angle to lower leg. The joint is known as hinged joint since foot moves like a hinge of a door in two direction upward (dorsiflexion) and downward (planter flexion).
List All The Tendons Around The Ankle Joint?
Tendons are continuation of muscles of lower leg. Muscles of lower leg are placed in anterior and posterior compartment of lower leg around shinbone and fibula. Tendons around ankle joint are divided into anterior and posterior compartment as follows-
Tendons Placed Anterior To Ankle Joint Are:
- Tibialis Anterior
- Extensor Digitorum Longus
- Extensor Hallucis Longus
- Peroneus Longus.
Tendons Placed Posterior to Ankle Joint
- Tibialis Posterior
- Peroneous Longus
- Peroneus Brevis
- Peroneus Tertius
- Flexor Hallucis Longus
- Flexor Digitorium Longus.
Which Ankle Joint Tendons Are Most Likely To Be Affected By Trauma And Injury?
Following Tendons of the Ankle Joint Are Most Often Inflamed And Injured-
- Achilles Tendon.
- Posterior Tibial Tendon.
- Peroneal Tendon.
What Can Cause Ankle Joint Tendonitis or Ankle Joint Tendinitis?
Body weight is continuously transferred to ground through ankle joint during walking and standing. Wrong twist and turn causes overstretching of the ankle joint and ankle tendons resulting in injury of the tendon followed by inflammation. Repeated actions like jogging or cycling causes continuous contraction of muscles and pulling of tendon resulting in inflammation of the tendon leading to Ankle Joint Tendonitis or Ankle Joint Tendinitis.
Ankle Joint Tendonitis or Ankle Joint Tendinitis Can Result From the Following:
- Ankle Joint Tendonitis or Ankle Joint Tendinitis Caused Due To Trauma
- Auto Accident
- Work Accident
- Slip and fall.
- Ankle Joint Tendonitis or Ankle Joint Tendinitis Caused Due To Arthritis
- Rheumatoid Arthritis
- Psoriatic Arthritis
- Ankle Joint Tendonitis or Ankle Joint Tendinitis Caused Due To Metabolic Disease
- Ankle Joint Tendonitis or Ankle Joint Tendinitis Caused Due To Sport Injury
- Contact Sports- Football, Soccer, wresting, and basketball.
- Repeat Injury- Tennis and Cycling.
What are the Symptoms of Ankle Joint Tendonitis or Ankle Joint Tendinitis?
Following Symptoms Are Observed In Ankle Joint Tendonitis or Ankle Joint Tendinitis-
- Chronic Pain in the Ankle- Tendon is the continuation of muscle. Muscle contraction causes severe pain along the inflamed tendon, which is attached to the contracting muscle. Ankle pain of less than 3 months duration is known as acute ankle pain and pain in the ankles lasting more than 3 to 6 months is known as chronic ankle pain. Injury or inflammation of the ankle tendon causes severe intractable pain.
- Ankle Joint Swelling- Ankle joint swelling is often associated with Ankle Joint Tendonitis or Ankle Joint Tendinitis. Ankle joint swelling is seen when ankle joint tendonitis is caused by Rheumatoid Arthritis, Gout, Pseudogout or traumatic injury of ankle joint.
- Ankle Joint Tenderness- Touch or pressure over injured tendon of the ankle causes severe pain.
- Restricted Ankle Joint Movement- Patients suffering from Ankle Joint Tendonitis or Ankle Joint Tendinitis voluntarily restricts ankle joint movement to prevent sudden intense pain. Contraction of muscles pulls the tendon, which is attached to one of the anchoring bone of the joint. Patient avoids muscle contraction to prevent pull or movement of inflamed tendon, which is attached to muscles.
- Ankle Joint Stiffness- Joint stiffness associated with Ankle Joint Tendonitis or Ankle Joint Tendinitis is secondary to pain and voluntary restriction of joint movements. Lack of ankle joint movements for prolonged period causes joint stiffness.
- Tender Muscles- Pain from inflamed ankle tendon is referred to muscles. Palpation or examination of muscle provokes pain in the ankles.
- Muscle Spasm- Some of the joint muscles contracts involuntarily to prevent painful joint movement. Continuous contraction results in muscle spasm.
Why Does Ankle Joint Tendonitis or Ankle Joint Tendinitis Cause Swelling in Ankles?
- Synovial Fluid- Ankle joint swelling is observed secondary to excessive synovial fluid secretion as seen in Rheumatoid arthritis and synovitis associated with ankle joint tendonitis.
- Synovial Membrane Thickness- Generalized ankle joint swelling may be secondary to synovial membrane thickness as seen in Rheumatoid arthritis and psoriatic arthritis.
- Hematoma (bleeding) – Tendonitis caused by trauma is associated with bleeding in ankle joint. Bleeding results in blood clot and tissue swelling.
- Infection and Abscess- Ankle joint infection may be associated with ankle joint tendonitis. Abscess as a result of infection causes soft tissue swelling around ankle joint.
How is Ankle Joint Tendonitis or Ankle Joint Tendinitis Diagnosed?
Diagnostic test such as X-ray, CAT scan and MRI are done to rule out fracture of ankle bone or dislocation of the ankle joint. Ultrasound test is performed to diagnose ankle joint abscess, dislocation and tendon rupture. Blood examination is performed to rule out septic ankle joint arthritis, rheumatoid arthritis and psoriatic arthritis.
How Can Ankle Joint Tendonitis or Ankle Joint Tendinitis Be Treated?
Following are the Treatment Options for Ankle Joint Tendonitis or Ankle Joint Tendinitis:
Conservative Treatment For Ankle Joint Tendonitis or Ankle Joint Tendinitis
Following initial diagnosis patient is treated with conservative treatment. Patient is considered for alternative treatment if conservative treatment fails. Conservative treatment used is as follows-
- Icing and Cold Treatment.
- Restriction of Joint Activities- Ace or crape bandage wrapped around the joint.
- Use crutches for ambulation.
- Keep the affected leg elevated as much as possible.
Medications to Treat Ankle Joint Tendonitis or Ankle Joint Tendinitis:
NSAIDs- Tendon inflammation of ankle joint and pain is treated with NSAIDs. Most common NSAIDs used are Motrin, Naproxen and Celebrex.
Opioids- Chronic ankle pain due to Ankle Joint Tendonitis or Ankle Joint Tendinitis not responding to NSAIDs is treated with Opioids.
- Short Acting Opioids- Prescribed for acute ankle pain lasting less than 3 months.
- Long Acting Opioids- Prescribed for chronic ankle pain lasting more than 3 to 6 months.
Muscle Relaxants- Muscle spasm of the ankle joint is treated with muscle relaxants. Most common muscle relaxant used for Ankle Joint Tendonitis or Ankle Joint Tendinitis is as follows-
Antianxiety Medications- Severe pain of the ankle is often associated with anxiety. Anxiety is treated with Valium, Ativan or Clonazepam.
Antibiotics- If the Ankle Joint Tendonitis or Ankle Joint Tendinitis is associated with infection, then the infection is treated with antibiotics. Antibiotic is selected after blood test and bacterial sensitivity test.
Physical Therapy for Ankle Joint Tendonitis or Ankle Joint Tendinitis
Physical therapy is prescribed for following conditions-
- Muscle Spasm of the ankle joint.
- Restricted Ankle Joint Movement.
- Ankle Joint Stiffness.
- Reduced Inflammation.
Interventional Pain Therapy for Ankle Joint Tendonitis or Ankle Joint Tendinitis
Indications for cortisone and local anesthetics injection-
- Inflammation- Corticosteroid injection is performed to treat ankle tendon inflammation.
- Pain- Corticosteroid mixed with local anesthetics is used to treat inflammation and pain of ankle joints.
- Ankle Joint Function- Reduction in pain and ankle joint swelling following cortisone injection results in improvement of ankle joint movements.
- Assist Physical Therapy- Injection is performed to reduce pain so patient can perform aggressive physical therapy for early from Ankle Joint Tendonitis or Ankle Joint Tendinitis.
Surgical Option for Ankle Joint Tendonitis or Ankle Joint Tendinitis:
Tendon Reconstruction Surgery.