The Achilles tendon: Dealing with ankle tendonitis

Ankle tendonitis is the inflammation of tendons around the ankle joint. To better understand why these injuries occur, it’s important to know what tendons are and how they work.

How your tendons work

Tendons are the connectors that connect muscle to bone. They enable muscles to exert their force across the joints that separate bones.

There are various tendons in the foot, ankle and toes, each with their specific functions. There are tendons in:

• the anterior part of the ankle
• the extensor tendons of the toes
• the big toe
• the tibialis anterior tendon
• the Achilles tendon (Achilles heel)
• the flexor tendon of the big toe
• the flexor of the toes
• the posterior tibial
• two peroneal tendons

Causes of tendonitis

The overloading of a tendon causes tendonitis.

The overloading of the tendon can be caused:

• By excesses, especially in sports when there is a poor adaptation or progression program.
• Because the foot, toes or ankle work in poor biomechanical conditions as a result of poor support, a previous lesion in the ligaments, a previous fracture, or osteoarthritis.

How is ankle tendonitis different from a sprain?

Ankle tendonitis is frequently mistaken for a ligament injury.

Ankle tendonitis is a result of an overload of one of the tendons. Tendonitis can be a consequence of:

• An alteration in the function.
• By excess.
• Alterations in the musculoskeletal system of the patient which cause an inadequate functioning of the tendon. These alterations include ankle sprains and ligament damage. Strains or ligament sprains can lead to additional tendonitis if they are not adequately resolved.

How can you treat ankle tendonitis?

First of all, the cause must be identified.

If it is a sports overload, the factors involved should be corrected. Factors include excess weight, poor hydration, poor sequencing of exercises of workout, inadequate progression plan, poor physical condition for the type of training, poor footwear, unsuitable terrain…

When a patient has tendonitis, it is highly recommended to rest the Achilles tendon, and take medication for the inflammation and pain. When the spasms and pain subside, a progressive stretching plan should be implemented and followed, and then the strengthening exercises can be performed.

All this must follow a well-established medical and physiotherapeutic plan to avoid any worsening or relapse.

What precautions should we take to prevent tendonitis?

Ankle tendonitis mostly occurs when there is little or poorly-controlled physical activity.

It is very important that before starting a sports activity or preparing for a relatively new discipline, the patient has a thorough medical check-up in order to assess their fitness and overall health. By doing this, the doctor will be able to recommend a suitable regime, which may include a controlled diet, physiotherapeutic treatment, orthopaedic treatment, and certain exercises to strengthen the ankle tendon.

For patients who already practice sports, muscle stretching routines before and after training programs are essential to avoid tendon overloads. Obviously, for each sport, some stretching should be done depending on the tendons being worked. In the case of sports that put a lot of pressure on the ankle tendons, in order to avoid ankle tendonitis, it's a good idea to stretch and warm up the ankle tendons.