How Do You Treat Tendonitis in the Ankle?

Ankle tendonitis is inflammation of the tendon of the ankle due to injury, repetitive movements or other issues. The best treatments for ankle tendonitis are rest, medication, home care, physical therapy and surgery.

Tendonitis in the ankle can occur due to an injury, repetitive movements, or underlying issues. Tendonitis causes many people to experience pain or swelling in one or both ankles. This pain may be worse after running, dancing, or working out. Tendonitis is a common cause of ankle pain that’s felt while working or exercising.

Tendons are the cords of tissue that attach your muscles to your bones. When a tendon gets inflamed, you experience tendonitis (also known as tendinitis). Repetitive movements and gradual overuse are common causes, but sometimes a sports injury may cause tendonitis. 

Tendonitis can occur anywhere you have tendons. Some common places are:

• Shoulders
• Hips
• Knees
• Elbows
• Base of the thumb
• Ankles 

The main symptom of ankle tendonitis is pain around the ankle joint, especially when you move the inflamed joint or put weight on it. You may also notice swelling on or around the ankle. The ankle is vulnerable to tendonitis and other injuries because it supports your body weight. Also, as a multi-directional joint, it allows you to point, lift, and rotate your foot.

There are a few common kinds of tendonitis that affect the ankles:

• Achilles tendonitis refers to inflammation of the Achilles tendon that connects the calf muscles to the ankle. This pain occurs along the back of the ankle. 
• If you feel pain along the outer side of your ankle, you may have peroneal tendonitis.
• Anterior tibialis tendonitis results in pain down the front of the shin.
• Posterior tibial tendonitis often presents as pain and swelling along the inner side of the ankle and foot.

Other common ankle ailments include sprains, fractures, and arthritis. Because some of these conditions may share similar symptoms with tendonitis, be sure to see a doctor for a diagnosis.

You may be at risk for developing tendonitis if you perform the same repetitive movements every day. For example, ankle tendonitis is a common issue for athletes like runners. As you age, the risk increases. People over age 40 are more likely to have tendonitis than younger people. 

Other risk factors that may be associated with tendonitis include a history of injuries or infection, gout, thyroid disease, diabetes, and arthritis. 

Before you receive ankle tendonitis treatment, you first need to confirm the diagnosis. Your doctor will likely want to discuss your lifestyle, symptoms, and the circumstances involved when you first noticed the pain. 

Your doctor may:

• Touch and examine your ankle for signs of swelling
• Perform a magnetic resonance imaging (MRI) scan 
• Order X-rays to check for other issues such as fractures, even though these tests do not show the tendons
• Remove some fluid from the swollen ankle to test for infection

Because tendonitis is most commonly the result of overuse, consider altering your work or workouts to be less repetitive and always use good form. Even after recovering from tendonitis, you’re still at risk for reinjury.

Because runners and other athletes are at risk for developing tendonitis, include preventive measures in your fitness routine. Thoroughly warm up before you exercise and allow recovery time between workouts. Consider incorporating strengthening exercises into your fitness routine to stabilize your joints.

Medications

Your doctor may suggest that you take a nonsteroidal anti-inflammatory drug (NSAID) like aspirin, ibuprofen, or naproxen (Aleve) to help reduce the swelling, pain, and inflammation.

Your doctor may also administer cortisone shots. Cortisone is a type of steroid that helps reduce inflammation. Your doctor will most likely limit the frequency of injections because they may be associated with joint damage over time.

Home care

Mild tendonitis may be effectively treated at home with RICE — which stands for rest, ice, compression, and elevation.

• Rest: Your ankle is a weight-bearing joint, so as much as possible, try to avoid standing, walking, or running when you first notice the pain. Also, avoid activities that may have contributed to the inflammation. So, if you are an avid runner, take a day or two off. 
• Ice: Apply ice to the inflamed area to help minimize the swelling. Apply ice once or twice a day for at least 10 to 15 minutes a session.
• Compression: Wear athletic tape, compression socks, or wraps to provide support and help reduce swelling.
• Elevation: Rest with your ankle propped up or elevated above your heart level to help reduce the swelling. 

Physical therapy

You may need to seek care from a physical therapist. Depending on your needs, your physical therapist might use ultrasound therapy, massage, or water therapy, or prescribe specialized exercises to build strength and mobility.

Surgery

Occasionally, surgery is used to treat severe tendonitis if it doesn’t respond to other treatments. If that is the case, your doctor would refer you to an orthopedic surgeon. 

While tendonitis may be effectively relieved with minimal risks, side effects of treatment do sometimes happen.

Cortisone injections have a range of possible side effects including allergic reactions, facial flushing, worsening joint pain, or bruising. Inform your doctor of any other medications you take, because some — like blood thinners — might increase the risk of side effects or have adverse interactions with the cortisone.

Allergic reactions are a possible side effect of many medications, including over-the-counter NSAIDs like aspirin and ibuprofen. You may develop allergies and sensitivities over time, so watch for symptoms such as hives, swelling, headaches, or even anaphylaxis (a life-threatening allergic reaction) in rare cases. 

Read your medication label for details on possible side effects and seek immediate care if you experience a severe reaction.