Ankle Tendonitis

Tendonitis  around the ankle is a common condition in which the area surrounding tendon becomes irritated. Most common tendons involved are the Achilles tendon (behind the ankle) and the peroneal tendons (outside or lateral part of the ankle) . Many cases develop suddenly after increasing activity, and the inflammatory reaction involves the tissue surrounding the tendon but not within the tendon tissue itself.  This is contrasted from a conditions know as tendonosis in which the tendon tissue is damaged and becomes degenerative. Patients with tendonosis have more chronic symptoms and often the tendon itself is enlarged dramatically. In either case, most patients describe a sharp pain in the back or side of the ankle with activity. Motion is preserved, but painful.  I generally proceed with an MRI early to make sure there is no tendonosis or tearing of the tendon which is common in peroneal tendon injuries. Initial treatment includes activity modification, anti-inflammatory medication and physical therapy.  Corticosteroid injection for peroneal tendonitis is quite helpful but I do not inject Achilles tendons because of the risk of subsequent tendon rupture.  There is some evidence that tendon degeneration is more common is patients who have take fluoroquinolones (a type of antibiotic such a Cipro) so I you have taken these medications in the past, make sure you mention this at the time of the visit. Physical therapy, custom orthotics and anti-inflammatory medication are helpful to relieve tendon irritation. Surgery for peroneal tendon tears is done as an outpatient and requires patients to be in a cast for about 4 weeks after surgery.