At North Austin Foot & Ankle Institute, we treat patients for a wide range of lower limb conditions. A big reason there are so many different issues is this simple fact: feet and ankles contain numerous moving parts.
The anatomical components that enable movement are your muscles and tendons. Tendons are connective tissues that attach muscles to bones. When a muscle contracts, a tendon will pull on a specific bone.
An easy example of this is the largest tendon in your body – your Achilles tendon. This tissue connects the bottom of the calf muscle to the back of the heel bone (calcaneus). When you contract your calf muscle, it pulls on the back of the calcaneus, which causes you to point your foot downward.
When strong and healthy, these soft tissues simply do their job while going unnoticed. Unfortunately, they are susceptible to injury, and particularly when they must endure excessive strain or are stretched beyond their normal limits.
With regard to muscle injuries in feet, a vast majority are cramps. These usually happen on account of dehydration and can be resolved with rest, stretching, and consuming plenty of fluids.
The most typical tendon injury is tendonitis (also spelled tendinitis, depending on the condition), so let’s look at some of the more prevalent forms seen in feet and ankles.
Achilles tendinitis is a common overuse injury. The problem develops when the Achilles tendon becomes irritated and inflamed in response to excessive strain. This strain can happen for two distinct reasons:
- Increased activity levels. Some most at risk for Achilles tendinitis are individuals starting a new workout program and attempting to do too much, too soon. Others have been working out for a while (especially runners) and decide to suddenly “ramp up” their workouts.
- Tight calf muscles. The Achilles tendon connects the calf muscle to the heel bone. When the calf muscle is loose and limber, there is less tension on the tendon. If the calf muscle is tight and contracted, there is increased tension. This can lead to tiny tears, which results in inflammation as the body attempts to heal them.
It is important to note that those two causes are not mutually exclusive and it is possible to develop the injury from both.
In addition to these causes, sometimes the condition develops when a bone spur is formed between the heel bone and the Achilles. Bone spurs are calcium deposits that build up over time on bone tissue, causing bony bumps that can aggravate soft tissues (like tendons).
The Achilles tendon is incredibly strong and durable, but it begins to wear down over time. As such, middle-aged individuals—particularly those who suddenly become active—are at increased risk for this common overuse injury.
Posterior Tibial Tendonitis
The posterior tibial tendon attaches the calf muscle to the bones on the inside of your foot, supports the arch, and assists with pronation – the natural inward rolling motion performed by your foot with every step you take.
When this valuable tissue becomes inflamed, you will likely need professional medical attention.
Symptoms of posterior tibial tendonitis can include pain, especially along the inside of the ankle and foot that is worse with activity. In some cases, there is also pain on the outside of the ankle, due to the heel bone shifting and extra pressure being placed on the outer edge of the ankle bone.
Other signs of this particular tendonitis are foot arch collapse, swelling on the inside of the foot, limited flexibility, and seeing too many toes when looking at the foot from behind (an indication the foot is pointed outward).
Your peroneal tendons run down, along the outer side of your ankle and then across your foot. When they become inflamed, you will likely experience pain in the back and outer side of your ankle and/or foot. This pain is typically strongest when you push off the ground with your foot (when walking), but can also be experienced when you are simply standing.
Overuse is the most common cause of this condition, but you may also develop peroneal tendon problems if you suffer from recurrent ankle sprains – something that can happen if you don’t allow a sprained ankle to heal completely before resuming normal activities.
Other contributing factors and causes include abnormal foot position (high foot arches) and muscle imbalance between the calf and peroneal muscles.
Extensor tendonitis is a condition that develops when the extensor tendons running the length of the top of the foot become inflamed. These tendons are responsible for straightening your toes, and you use them every time you step.
The extensor tendons can become inflamed from overuse, changes in training levels or methods, or even shoes that fit poorly or are laced too tightly.
Treating Tendon Injuries in Feet and Ankles
Conservative treatment for tendonitis includes:
- Rest – After being certain that you are dealing with tendonitis—remember, you should have the injury professionally diagnosed—you need to back off from training and physical activity. We will work with you so you know how long that might entail, along with which alternative exercises you can do until the problem is resolved.
- Medication – Our office might prescribe anti-inflammatory medication, or even steroid injections for long-term problems.
- Cold therapy – Icing can be used for relieving pain and keeping swelling to a minimum. When you ice an injured area, be sure to wrap the ice or cold pack in a thin towel to protect your skin from damage.
- Physical therapy – After the pain has been addressed, physical therapy—including stretching and strengthening exercises—can help you achieve a complete recovery from the injury.
- Surgery – In very rare cases, surgical procedures are necessary to completely treat this condition (but we will exhaust conservative options before getting to that point).
The nature of your specific treatment plan will depend, naturally, on an array of different factors.
We will start by diagnosing the condition and determining the extent of injury, and then work on creating your customized plan. In doing so, we may incorporate any of the aforementioned elements, but our goal will be to resolve the issue while avoiding surgery.
Professional Foot and Ankle Care for the Greater Austin Community
Issues like these can keep you away from your favorite activities. As such, it might be tempting to try and “push through” them, but—even though we understand—this can be a big mistake. Doing so can lead to greater damage and increase the odds you might need surgical intervention.
Instead, come see us here at North Austin Foot & Ankle Institute as soon as you become aware of a problem.
We will provide you with a professional diagnosis and then create a customized treatment plan so you can return to those favorite activities at the earliest possible opportunity!
For more information, simply contact us online or give our office a call at (512) 593-2949. We will be happy to help.