All About Ankle and Foot Tendinitis: A Common Ailment Among Hurdlers

by Melinda Burris

This article is devoted to a common sports injury experienced by hurdlers—ankle tendinitis. Athletes who compete in sports that require a lot of repetitive motion and forceful exertion, such as hurdlers who must run quickly between hurdles attempting to jump the hurdle without breaking stride. The exact definition, symptoms, preventative measures that can and should be taken, as well as treatment options for ankle and foot tendinitis, are explored below.
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What is Ankle Tendinitis

Tendinitis is the medical term for inflammation of tendons, which are  “the thick fibrous cords that attach muscle to bone.”1  Tendinitis is characterized by tenderness and pain in the area “just outside the joint.”1 Tendinitis most often affects knees, heels, shoulders, and elbows. The ankle is also often affected, as repetitive motions are frequently required of this area. The term “jumper’s knee” refers to tendinitis that occurs in the tendons surrounding the knee and is also common among hurdlers and track athletes.1

Frequently, ankle tendinitis (also spelled tendonitis) is caused by repetitive motion performed in a manner that is not ergonomically correct and thus places unsustainable pressure on the ankle joint and tendon, causing the surrounding tissue to become inflamed.2,3  

Posterior tibial tendonitis (PTTD), which affects the inner area of the ankle, right below the bone, can cause the arches to fall and can lead to flat feet. PTTD is caused by damage to the tendon that leaves it unable to properly support the arch, and when the arch falls due to weakness of the tendon, the feet become flat, a condition that can range from mild discomfort to intense pain as the body ages and requires more support from the feet for proper posture, balance, and perhaps most notably, the ability to remain on one’s feet for an extended amount of time.4

In medical terms, tendinitis is classified as a musculoskeletal disorder. Here are some known risk factors for the condition:3

• Repetitive motion/overuse
• Forceful exertion
• Awkward, improper posture
• Extremes in Climate Conditions or vibrations
• In ankle tendinitis, ill-fitting footwear is often a factor

What Causes Ankle Tendonitis?

According to the Mayo Clinic, ankle tendinitis “can be caused by a sudden injury, [but] the condition is much more likely to stem from the repetition of a particular movement over time.”1 For this reason, it is imperative that you listen to your coach and employ the correct techniques for jumping and running, two repetitive movements that can be hard on the ankles and other joints. Correct techniques emphasize the importance of proper shoe support, good posture, and ergonomics to avoid fatigue and the eventual overuse of the tendon.1,2

Foot and ankle tendonitis do have other causes, including medical conditions such as arthritis and gout.1 (This may be one reason people over the age of 40 have an increased susceptibility to developing tendinitis.)2

Other causes of foot and ankle tendonitis include infection and even another foot and ankle injury—sprain—yet another common ailment among high-endurance athletes.2

Other Risk Factors Associated With tendonitis of the Ankle or Foot

It has been noted that men are more prone to suffer from tendonitis of the ankle or foot, although no literature seems to pinpoint why this is the case. People who weigh more are more apt to suffer from tendinitis of the foot or ankle, as are athletes with a history of tendon injuries in the ankle or foot.2

You must always train and compete in shoes with adequate structure and support for your arches. Failure to keep your footwear up to proper standards substantially increases your risk of developing ankle and foot tendinitis.2

To comprehend the importance of this, it helps to understand that while our feet only make up 2% of our body, they support and carry the other 98% of the body. When you fail to take proper care of your feet, your performance suffers, and you open yourself up to an increased risk of repeat injuries that can lead to even more serious damage down the line.

As you grow older, the injuries incurred to these major joints (ankles, elbows, knees, etc.,) all of which we all use in repetitive motions to perform daily tasks such as walking, or bending over, can and will catch up to you in uncomfortable and at times, painful ways, including having your arches fall, becoming flat-footed, and having no support to aid in maintaining your balance and preserving your comfort.

Symptoms of Ankle or Foot Tendinitis

Tendinitis of the ankle and foot first presents as localized pain at the site of the joint, characterized by swelling of the surrounding tendon. Stiffness is also a prevalent symptom associated with the condition. Tendinitis pain is intermittent; it will alleviate after time and rest, but the discomfort tends to return when you stand and put pressure on the foot and ankle for any length of time.2

Diagnosis of Tendinitis of the Ankle or Foot

Tendinitis of the foot or ankle is generally easy to diagnose, and a visit to your primary healthcare provider, a podiatrist, orthopedist, or sports medicine doctor will confirm the diagnosis once your physician does a full exam and documents your medical history. Generally, tendinitis can be determined or ruled out with a physical exam. However, if your physician suspects more extensive damage has been done, an MRI or x-ray may be taken to determine the severity of the injury.2

Preventative Measures

Thankfully, there are numerous precautions you can take to prevent the development of tendinitis:1

Ø  Whenever possible, avoid repetitive motions, particularly performing them for extended periods. Listen to your body and when you feel fatigue set in or a sensation of pain while engaging in a specific exercise, stop, rest, and consider whether you should change up your routine to avoid aggravating the situation.

Ø  Embrace cross-training. You can build up the muscles and endurance you need in more ways than constantly pounding your feet against hard asphalt or jumping hurdles. Mix in other forms of exercise such as swimming, a low-impact aerobic activity. Run on grass occasionally so your body isn’t constantly absorbing the vibrations and stress of running on a hard surface.

Ø  Follow your coach or trainer’s instructions on proper technique. This will teach you the correct way to use training equipment and how to carry your body so that you can perform at your optimal level without placing undue pressure on your tendons.

Ø  Remember to do your cool-down stretches. This will help your joints by increasing your range of motion. This additional flexibility reduces the chances of your suffering multiple, repeat injuries that can lead to serious harm.

Treatment                                                                                                   

Tendinitis is usually a mild to moderate injury and self-care measures including rest and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen will prove sufficient. Physical therapy may be needed depending on the severity of the injury and how long it persists. If the injury does not heal within a few days with home care, you should see your physician again to make sure the injury has not developed into something more serious.

References

1.Mayo Clinic. (n.d.). Tendinitis.

2. MercyHealth (2020). Tendinitis of the Ankle or Foot.
3. Electro Kinetic Technologies. (2020). What are Musculoskeletal Disorders and How Do They Happen?
4. FootHealthFacts.org (n.d.). Posterior Tibial Tendon Dysfunction (PTTD): What is PTTD?

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