Wednesday, December 6, 2023

Tendons In Ankle And Foot

Different Types Of Tendonitis

How to Treat Peroneal Tendonitis with Seattle Podiatrist Larry Huppin

Tendonitis can be a painful condition which is caused by inflammation or irritation of a tendon. It can occur anywhere in the body, but it most commonly occurs in the feet and ankles.

Overuse, repetitive movements, or overstretching can result in tendonitis. It can also be the result of an injury such as a sprained ankle. Most cases of tendonitis can be treated nonsurgically and with rest.

Physical Therapy Guide To Peroneal Tendinopathy

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Peroneal tendinopathy is an injury to the tendons of the foot and/or ankle. It often affects athletes like long-distance runners, basketball players, and dancers. People who have had ankle sprains, or those who have weak ankles, may also develop this condition. It commonly causes aching along the outside surface of the ankle that gets worse with activity, yet improves with rest. Physical therapists help people with peroneal tendinopathy reduce strain on the ankle and foot and strengthen their muscles.

Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.

Peroneal Tendon Injury Risk Factors

There are a few factors that can increase your chances of developing peroneal tendon injury, including:

  • People who participate in sports or work-related activities, especially running long distances, are at greater risk for peroneal tendon injury.
  • High arches. People with high foot arches are at greater risk for peroneal tendon injuries.
  • Tight calves. People who have tight calves are more likely to sustain peroneal tendon injuries.

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Nonsurgical Treatments For Ankle Sprains

Most ankle sprains dont need surgery.

You should be able to recover from a minor, first-time sprain relatively quickly with home care. This includes treatments known as RICE therapy:

  • Rest: Stay off your ankle until it doesnt hurt. Exercising before a sprain has fully healed may make it worse or increase your risk of re-injury.
  • Ice: Place a wet towel on your ankle, then cover it with a plastic bag full of ice . Apply the ice for 10-20 minutes, then remove it for 40 minutes. Repeat this as often as you can during the first 48-72 hours after your injury.
  • Compression: Wrap your ankle with an elastic bandage. This will help control swelling.
  • Elevation: Recline on a bed, sofa, or chair and use a pillow to raise your ankle slightly higher than your hips.

If you have a moderate to severe sprainor home care doesnt helpyou may need additional nonsurgical treatment. These therapies include:

  • Orthopedic devices: While you heal, certain medical equipment can help take pressure off your ankle or keep it stable. These include ankle braces, walking boots, and crutches.
  • Rehabilitation: Our physical therapists can teach you exercises to improve your ankle strength, ankle flexibility, and balance.

Treating An Achilles Tear

Strained Peroneal Tendon...?

Without proper healing of an Achilles tear, a persons ability to walk, jog, jump, and perform other high impact activity will be limited. A tear can be treated either with casting or with surgical repair. Cast treatment requires 6-8 weeks of non-weight bearing cast immobilization, followed by several weeks in a walking boot, to make sure the tendon is completely healed in proper position. Surgical repair of an Achilles can usually be performed through a small incision, and requires just 3-4 weeks non-weight bearing and an additional 2-3 weeks in a walking boot. Surgery results in a much quicker recovery and return to regular activities than non-operative treatment, and a slightly lower rate of re-rupturing the tendon. However, most studies show that at 1 year following the injury, functional results of cast treatment and surgical repair are about equal.

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What To Do If You Have Tendinitis Or Tendinosis Of The Feet

Tendinitis is the inflammation of a tendon. The American Podiatric Medical Association recommends treating tendinitis by icing the area and getting plenty of rest. If your foot tendinitis doesnt feel better after a week, its time to visit a podiatrist. You are more likely to get tendinitis again once youve gotten it already. Take proper precautions, such as stretching before exercise, getting used to exercise gradually. and wearing proper shoes, to prevent repeated cases of tendinitis.19

Tendinosis occurs when a tendons collagen degenerates over time, making the tendon weaker.20 This can happen as a result of chronic tendinitis. Treatment for tendinosis varies according to severity and may include surgery in severe cases.21 Your podiatrist can examine you to see if you have tendinosis and recommend treatment options.

Who Is Most At Risk Of A Peroneal Tendon Injury

  • People who play sports or do activates that involve repetitive ankle movements.
  • People who participate in activities such as running on uneven surfaces, racket sports, basketball, hiking, or skiing.
  • People with high arches in their foot.
  • People inaging populations, because our tendons lose elasticity and become brittle.

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Warning Signs Of Ankle Tendonitis And Tips For Prevention

Tendons are thick, fibrous cords of tissue that attach your muscles to your bones and help your joints move like they should. Whether youre involved in sports or just managing simple household chores, your tendons get a workout every day. When overused or misused, they can become inflamed, irritated, and painful. Doctors call that tendonitis.

Dr. Nickson is a gifted orthopedic specialist who wants to help keep your tendons, bones, and joints healthy. Hes happy to explain the warning signals your body sends regarding potential tendonitis and how you may be able to avoid this sometimes game-changing condition.

Does Stretching Help Foot Pain And Ankle Pain

Peroneal Tendonitis Stretches & Exercises Ask Doctor Jo

By using gentle stretches for ankle tendonitis and stretches to relieve foot pain both to prevent and recover from injuries you can avoid downtime and recover more quickly should an injury occur. The key is to make stretching before, after, and between workouts a habit.

If you suffer an injury to a tendon in your ankle or foot, our orthopedic and sports science experts can do an exam and prescribe treatment as needed. Search our online provider directory if you dont yet have a Baptist Health provider.

Next Steps and Useful Resources

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How Do You Stretch Ankle Tendons

Use these stretches to increase flexibility and range of motion in your ankle tendons.

Ankle circles

  • Sit in a chair and set your right lower calf on your left thigh.
  • Turn your right ankle in clockwise circles for approximately 10 rotations and then in counterclockwise circles for 10 rotations. Be sure to keep your leg still and only move your ankle and foot.
  • Switch ankles and repeat.
  • Instead of completing circles, you may want to trace the letters of the alphabet in the air with the big toe of each foot, doing two sets for each ankle.
  • Towel stretch

  • Sit on the floor with your legs together and straight in front of you.
  • Holding one end of a towel in each hand, loop the middle around the balls of both feet together.
  • Pull the towel toward you gently until you feel a good stretch on the bottoms of your foot and the backs of your legs.
  • Hold the stretch for 30 seconds and repeat 3-5 times.
  • Cross-legged ankle stretch

  • Sit in a chair and put your right lower calf on your left thigh.
  • Grasp the top of your right foot and your toes with your left hand.
  • Gently pull down as if youre pointing the toes of that foot
  • Hold for 30 seconds, repeat 2-3 times, then switch sides and repeat.
  • Achilles tendon stretch

  • Stand with a wall or chair in front of you for support.
  • Place your right foot a step behind your left foot.
  • Keep your right heel on the floor and bend your left knee until you feel a food stretch in your right leg.
  • Hold the stretch for 20-30 seconds and repeat 2-4 times for each leg.
  • Why Is This Surgery Performed

    The tendons in your feet and ankles may become injured or torn due to disease , overuse, structural abnormalities, or a sports injury. When the tendons are injured or torn, you will usually have swelling and intense pain, and the outside of the ankle may feel unstable. When non-surgical methods are not able to remedy your condition, you may need tendon repair or reconstruction.

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    What Are The Ankle Tendons

    The ankle joint consists of the talus bone, tibia and fibula bones and they are surrounded by ligaments and tendons. A ligament attaches a bone to a bone while a tendon attaches a muscle to a bone and this article will cover all of the tendons that cross over the ankle including their attachment points and their action.

    Key Points About Peroneal Tendon Injury

    Tendons of the Foot
    • Peroneal tendon injuries are common in athletes, including runners, who participate in sports that require repetitive ankle motion.
    • Peroneal tendon injuries can be acute, meaning the injury occurred suddenly, or chronic, meaning that damage occurred over time.
    • Symptoms of peroneal tendon injuries can include pain and swelling, weakness in the foot or ankle, warmth to the touch, and a popping sound at the time of injury.
    • Many patients do not need surgical treatment for peroneal tendon injuries. Many can find relief of symptoms with rest, immobilization with a bandage or brace, exercise and/or stretching, and other self-care measures.

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    The First Two Weeks After Ligament Tear Surgery

    If you work, be sure to inform your employer that you might be out for a week or two. The first two weeks will be the most critical time in your recovery process, since this is when your body is beginning to heal and is, therefore, most vulnerable.

    During this period, you will likely experience pain in the affected joint, the adjacent muscles, and even in some nearby tissues. There might also be a buildup of fluid on the joint.

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    What Is Peroneal Tendinopathy

    Peroneal tendinopathy is a tendon injury that causes pain on the outside of the ankle. Tendons are connective tissues in the body that attach muscles to bones. The muscles and tendons involved in peroneal tendinopathy move the foot in an outward direction and help point the foot and ankle downward. These muscles and tendons work together to balance the foot and ankle and keep them stable.

    The condition often develops over time as a result of overuse. The peroneal muscle-tendon complex can be overworked. If your foot doesn’t hit the ground in a good position when walking or running, it creates more stress on the tendon. For example, if your foot hits the ground more on the outside, the muscles and tendons must work harder to keep the foot and ankle stable. With overuse, tendons can become enlarged, thickened, and possibly swollen. Peroneal tendinopathy also can develop following an untreated ankle sprain.

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    Risk Factors For Tendonitis Of The Ankle Or Foot

    Risk factors for tendonitis in the foot or ankle include:

    • Sports that require repetitive movement
    • Sports that may lead to overuse of the ankle such as running
    • People over 40 are more likely to have tendonitis in the foot or ankle
    • Men are more likely to develop tendonitis in the foot or ankle
    • People who are overweight are more likely to develop tendonitis in the foot or ankle
    • People who wear worn out shoes that do not support the feet are more likely to develop tendonitis in the foot or ankle
    • Previous injuries to the tendons in the foot or ankle

    Types Of Tendonitis Of The Foot Or Ankle

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    • Peroneal tendonitis pain and inflammation along the outer edge of the heel.
    • Achilles tendonitis causes heel and calf pain, typically felt when walking or running, extending all the way up to the middle of the calf.
    • Extensor tendonitis causes pain on the top of the foot, a very rare type of ankle tendonitis.
    • Anterior tibial tendonitis causes pain on the front of your foot, typically felt when walking down stairs or on sloped surfaces.
    • Posterior tibial tendonitis pain and inflammation on the inner portion of the ankle , can contribute to flat foot.

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    Diagnosis Of Tendonitis Of The Ankle Or Foot

    Foot or ankle tendonitis is diagnosed under the care of your primary care provider, podiatrist, orthopedist or sports medicine physician. The physician will do a full physical exam and take your medical history.

    Your physician may order an x-ray or MRI to determine if the injury is more severe. Fractures, tendon ruptures and calcifications require alternative treatments.

    Peroneal Tendon Injury Treatment

    Peroneal tendon injuries can generally be treated with nonsurgical treatments. Many people experience symptom relief within two to four weeks, with rest and medication.

    If your pain is affecting your ability to perform your daily activities, your doctor may recommend a nonsurgical treatment such as:

    • Staying off the affected foot and pausing strenuous exercise is imperative during rehabilitation.
    • Heat and ice. Alternating ice and heat can help relieve pain and make movement easier.
    • A cast or splint to immobilize the foot and ankle
    • Physical therapy. Physical therapy is key, first to reduce pain and swelling and then to increase strength and improve range of motion
    • Keep your ankle and foot elevated with a pillow when youre sitting or lying.
    • OTC medications. Over-the-counter pain relievers such as ibuprofen or naproxen can relieve pain caused by peroneal tendon injuries
    • Injected pain relievers. Your doctor may inject an anti-inflammatory medication such as cortisone into the affected area.

    In some cases, peroneal tendon injuries require surgical treatment. The goal of surgery is to repair the injured tendons. Rehabilitation after surgery often includes physical therapy.

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    Recovery Process From A Ligament Tear

    Ligament tears are common when performing in sports or just when stepping awkwardly. These injuries occur when an individuals joint is stretched out beyond the normal range, causing the ligament to partially or fully tear.

    If the ligament is only partially torn, you will likely be told by your doctor to follow the RICE method: rest, ice, compression, and elevation of your joint that was affected. However, if it is fully torn, you may need to have surgery to repair the ligament tear.

    Although surgery to fix a torn ligament is usually performed as an outpatient procedure, the recovery process will take a while. You will likely undergo rehabilitation for about six months, but the length of time will depend on the severity of your injury.

    Below is the general timeline and what you can expect during ligament tear recovery.

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    When Is An Ankle Sprain More Than An Ankle Sprain

    What Is Peroneal Tendonitis?

    Close consultation with an orthopedic specialist is important, as other injuries often occur along with a strained ankle. A sprain might mask something more serious, like a fracture, stretched or torn tendons, torn ligaments, or a cartilage injury.

    If you are experiencing any of the following symptoms, then the first step is to consult with an orthopedic physician who specializes in the foot and ankle:

    • Persistent swelling
    • Weakness in the ankle
    • General discomfort

    If these symptoms sound familiar, then you may be suffering from something more than an ankle sprain. If the sprain is not getting better, It is always best to be proactive. Untreated conditions can worsen into chronic ankle sprains and instability, which can be debilitating in the long term. This may make arthritis of the ankle more likely, especially if the ankle is allowed to continue to deteriorate.

    Treating Serious Ankle Injuries

    Diagnostic imaging is the next step in determining the best method to treat your ankle. With an MRI, an orthopedic provider can work with you on an approach to treat any underlying conditions or extensive injuries.

    Sometimes, surgery is necessary, explains Dr. Viens. The procedure can be anything from minimally-invasive arthroscopy to a ligament tightening procedure. Chronic ankle instability occurs when ligaments and tissue arent sufficient to stabilize the ankle.

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    The Recovery Time For Torn Tendon In Foot

    The recovery time for torn tendon in foot can be quite long and drawn out. A grade 2 moderate tendon injury has a four week average recovery time, and a grade three injury to the tendon can take considerably longer to heal and even longer to return to normal function. There are three main stages to any torn tendon recovery the first is the prevention of any further damage to the foot, the second is a reduction in the swelling and stiffness while the third stage is the regaining of normal function and movement. Physiotherapy can be extremely beneficial in helping the patient to reach stage three more rapidly.

    Do Ankle Sprains Heal On Their Own

    Most sprains heal on their own, but rebuilding strength in your ankle can help prevent future injuries. If you dont allow your ankle ligaments time to heal, you may have long-lasting instability or repeat ankle sprains. If your symptoms continue for more than four to six weeks after injury and you still feel weakness when walking on your foot, you may have a chronic ankle sprain.

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    What Is Peroneal Tendonitis

    Peroneal tendonitis is inflammation in the tendons that run along your outer ankle bone and the side of your foot. These tough bands of tissue connect the muscles in your lower leg to the bones in your foot. They help stabilize and balance your foot and ankle, protecting them from injuries.

    This type of foot tendonitis is usually the result of overuse, but it can also happen suddenly if you fall or injure your foot.

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