Physiotherapy Exercises for Ankle Tendonitis

Introduction:

Tendons are present as cord-like fibers that will help connect muscles to the bones. They are strong, tough, and flexible enough, and they help muscles to move in the joints. Due to overuse or overstretching, tendonitis most commonly occurs. It can also occur due to injury and while playing sports.

What Are the Types of Tendonitis?

There are three common types of tendonitis,

1. Achilles Tendonitis: It commonly occurs due to sports injuries, especially in runners, and is characterized by heel pain that aggravates on running. In this condition, the tendon that has a connection with the calf muscles to the heel is affected.

2. Peroneal Tendonitis: Due to irritation and inflammation, there will be pain behind the ankle and instability of the ankle. The tendons extend outward down the lower leg bone, also called the fibula, and the one present behind the ankle’s outer side, along the foot length.

3. Posterior Tibial Tendonitis: This condition causes pain and instability of the foot to support the arching. The tendon affected in this condition attaches the foot to the back of the shinbone.

What Are the Symptoms?

• Pain and tenderness of the ankle.

• The pain increased with movement.

• Cracking sensation when the ankle is moved.

• A lump or overgrowth is felt on the tendon.

• Swelling may be present at times.

• Redness and heat in the area are seen.

How to Manage Ankle Tendonitis?

• RICE (rest, ice, compression, and elevation) protocol should be followed for any type of foot injury.

• The affected foot should be allowed to rest, and the movement of the individual should be restricted.

• Ice packs and cold application on the site of injury is a methods to relieve pain. A cloth can be used for applying cold to prevent skin injuries.

• Compression of the affected leg using bandages and slings is done to restrict movement. Restriction from movement can help heal faster.

• Elevating the affected leg using pillows will ease the pain.

• Ibuprofen, an anti-inflammatory medicine, will help reduce swelling and ease the pain.

• Certain stretching and strengthening exercises can be done to maintain the flexibility of the joint and improve the range of motion.

Stretching Exercises: Stretching exercises help in improving muscle fiber organization and collagen synthesis. These contribute to the healing of tendons and strengthen the muscles. Stretching also helps decrease pain and accelerate the healing process.

1. Towel Stretch: Sit straight and extend both feet. Wrap a towel around the feet until a stretch is felt at the lower leg and bottom of the feet. Hold for 30 seconds and repeat thrice.

2. Standing Calf Stretch: Stand straight near a wall, and the affected foot extended out, facing the wall. Extend the toes with toes facing the ceiling and gently lean forward while the back of the leg is stretched. Hold this position for 30 seconds and repeat thrice.

3. Standing Soleus Stretch: Stand before a wall with feet flat on the floor. Bring the unaffected leg forward and the affected leg behind. Now slightly bring the affected foot forwards while the other leg is slightly bent to touch the wall. A stretch will be felt, hold this for 30 seconds and repeat thrice.

4. Eversion and Inversion: Sit comfortably on a chair with crossed legs, the affected leg over the unaffected knee. Use the hands to hold the bottom of the affected foot and gently tilt toward the floor. Hold it for a few seconds and then pull it back while tilting it toward the body. Repeat this exercise ten times.

5. Heel Raises: Stand before a wall with feet flat on the floor. Rise on the toes and hold for a few seconds and then lower the heels gently. Repeat this exercise five to ten times.

Strengthening Exercises: Strengthening the muscles supporting the lower leg, foot, and ankle will help keep the ankle stable. It also helps in pain management and prevents further injuries.

1. Calf Raises: Stand behind a chair with the body weight distributed evenly on the floor. Hold the chair for balance and lift the unaffected foot off the floor. Now the body weight relies upon the affected foot. Now slowly raise the heel of the affected leg as high as possible from the floor. Hold onto a few seconds and lower the heel. Relax for a while and repeat the exercise ten times.

2. Marble Pick-Up: Place a bowl and 20 marbles spread on the floor near a chair. Sit on the chair with both feet flat on the floor. Slowly pick each marble from the floor using the affected foot and place it in the bowl that is kept nearby.

3. Towel Curls: Sit in a chair and place a towel nearby. Now slowly pick up the towel using the toes and curl it towards the chair. Relax for a few seconds and repeat this exercise.

4. Ankle Dorsiflexion and Plantarflexion: Sit comfortably on the floor with the legs extended straight. Slowly bend the affected ankle forward and backward as far as possible. Repeat this exercise ten times. An elastic band tied to a fixed surface can be used for stretching the legs if possible.

5. Ankle Range of Motion: Sit on a chair with the feet hanging loose. Now start writing alphabets on the floor using the foot leading with the big toe.

What Are the Benefits of Exercise in Treating Ankle Tendonitis?

• Exercise can help reduce pain and inflammation in the ankle.

• Blood circulation to that area is improved, which in turn, will accelerate the healing.

• Range of motion and flexibility is increased in the ankle.

• There will be increased strength and endurance if exercise is followed as a daily routine.

• Further injuries can be prevented if stretching and strengthening exercises are performed daily.

Conclusion:

Ankle tendonitis is a painful condition that interferes with the daily activities of the individual. Stretching and strengthening exercises in physiotherapy can help regain flexibility and improve the range of motion. Overall it improves the physical health of the patient and restores positivity to be independent to do daily activities.