Ankle tendinitis is a general term for inflammation in any of the tendons near the ankle. Common sites of ankle tendinitis are the heel, or Achilles tendonitis; inside of the ankle, or posterior tibial tendonitis; and outside of the ankle, or peroneal tendinitis. Treatment is typically nonoperative for all types of ankle tendinitis.
RICE
The acronym RICE refers to rest, ice, compression and elevation. Rest involves not performing activities that cause pain or discomfort to the ankle. Dr. Pierre Rouzier, a team physician for UMASS-Amherst, advocates for icing the ankle for 20 to 30 minutes every three to four hours for two or three days or until the pain goes away.
An elastic bandage can be used to apply compression to the ankle to decrease the swelling. It is important not to wrap the bandage too tight around the ankle, as this can make swelling worse or decrease blood flow to the area.
Elevating the ankle is important to help decrease the swelling. Lying down with the ankle above the level of the heart, which is approximately on top of two to three pillows, can help remove some of the swelling.
Anti-Inflammatory Medications
Anti-inflammatory medications such as ibuprofen, or Motrin and Advil, and naproxen, or Aleve, can be helpful to decrease inflammation and swelling. Ibuprofen and naproxen are both over-the-counter medications, meaning they can be bought without a prescription from a physician. A physician can prescribe other types of anti-inflammatory medications that require a prescription.
Physical Therapy
Physical therapy can either be done with home exercises or by going to see a physical therapist. Stretching and strengthening exercises are important to regain function and decrease pain. A resistance band can be helpful to strengthen the ankle. A physical therapist may try other modalities also, including ultrasound and electrical stimulation to help promote quicker healing.
Immobilization/Orthotics
A stirrup splint called an Aircast or Gelcast or a lace-up ankle brace may be prescribed by a physician. Some patients prefer to use crutches to not put weight on the affected lower extremity. These devices are not always prescribed for tendinitis.
Heel cups for the shoes may be helpful for Achilles tendinitis. Special arch inserts known as orthotics may be helpful for posterior tibial tendinitis. A physician will tell patients what is appropriate for their particular type of tendinitis.
