Ankle Pain

Ankle Tendon Problems

• Achilles tendinitis is a painful inflammatory condition of the Achilles tendon, which connects the calf muscle to the back of the heel. It occurs mainly due to overuse and due to the continuous load the Achilles tendon is subjected to, be it in everyday life or in most sports, can lead to swelling and small tears in the tendon. The first treatment approach is the reduction of pain and swelling with rest, ice, compression and elevation (RICE) of the affected area. NSAIDs are the first choice in pharmacological treatments. Gentle stretching to avoid stiffness is helpful as is  avoiding further loads on the tendon until the tendon is healed. A corticosteroid injection into the tendon sheath with ultrasound guidance is helpful to reduce tendon inflammation when more conservative treatments do not help the pain.

• Achilles tendinopathy is a painful long-term degenerative condition of the Achilles tendon that occurs when the healing rate is less than the injury rate. There is a loss of the elasticity (collagen) within the tendon due to repetitive overloading. This condition does not respond  well to anti-inflammatory treatments and is best treated with functional rehabilitation, especially eccentric physical therapy (strengthening while stretching the tendon). Treatments for tendinopathy that does not respond to physical therapy include dry needling of the tendon or platelet-rich plasma injections.

• Achilles tendon rupture can occur if there is a sudden overload or trauma to the Achilles tendon strong enough to tear it. Achilles tendon ruptures occur most often to athletes or to those who lift heavy objects for a living. A tendon rupture is a risk of a steroid injection into the body of the tendon. If the tendon is completely torn, surgery may be needed.