Definitive Guide on Tenosynovitis Ankle Physiotherapy

An unusual pain in your ankle, especially on the outer side, could be a symptom of ankle tenosynovitis. This common condition affects the tendons and their surrounding tissues in the ankle. While tenosynovitis can occur in various parts of the body, like the wrist (De Quervain tenosynovitis) or elbow (tennis and golfer's elbow), this guide focuses specifically on tenosynovitis in the ankle or peroneal tendonitis.

First, let's define tenosynovitis, its causes, symptoms, and diagnosis. We'll also explore how to treat ankle tenosynovitis and how physical therapy helps.

What is Tenosynovitis?

Tenosynovitis is essentially an inflammation of the tendon sheath, a lubricating sac surrounding your tendons. These sheaths allow tendons to glide smoothly as you move your muscles. When it gets inflamed, it can irritate the tendon itself, leading to pain and restricted movement.

There are two main types of tenosynovitis: acute and chronic. Acute tenosynovitis develops suddenly, often following a specific injury like a sprain or a fall. Symptoms can be intense and appear quickly. On the other hand, chronic tenosynovitis develops gradually over time due to repetitive stress on the peroneal tendon. The pain may be dull and persistent, often worsening with activity.

Tenosynovitis is common in the hands, feet, and wrists, but the ankles are particularly susceptible due to the constant stress placed on them during daily activities. Ankle pains and injuries being the most common orthopaedic conditions 1 in 4 Singaporeans suffer from, calls for preventive measures.

What Causes Ankle Tenosynovitis?

Ankle tenosynovitis often develops due to overuse or repetitive strain on the peroneal tendons, located on the outer side of your ankle.

Activities like running, jumping, or even walking long distances with the feet flat can put excessive stress on these tendons, causing inflammation. Other potential causes include:

• Injuries like ankle sprains
• Rheumatoid arthritis, an autoimmune disease that can affect the synovial sheath
• Certain footwear that doesn't provide sufficient support

Symptoms of Tenosynovitis

The specific symptoms of tenosynovitis will vary depending on the location of the inflammation. General signs of ankle tenosynovitis include the following symptoms:

• Pain and tenderness around the affected area
• Swelling
• Tenderness to the touch
• Difficulty flexing or pointing your foot
• Creaking or snapping sensation with movement
• Redness or warmth (more common in acute cases)

How to Diagnose Tenosynovitis?

A physical therapist or doctor will typically diagnose tenosynovitis based on your symptoms and a comprehensive assessment of your ankle joint. A physical examination will assess your range of motion in the ankle joint, strength of surrounding muscles, gait analysis (how you walk), and any swelling or tenderness present.

In some cases, they incorporate imaging tests like an X-ray or MRI scan to rule out other potential causes of your pain, such as a fracture or arthritis.

How to Treat Tenosynovitis?

Tenosynovitis typically responds well to conservative treatment methods, and surgery is rarely necessary. In Singapore, physical therapy emerges as a leading treatment and rehabilitation program in treating ankle pain and injuries, including ankle sprain physiotherapy and ankle fracture physiotherapy treatment.

Other than this, you can manage ankle tenosynovitis with the following efforts:

• Rest: Reducing activities that aggravate the condition is crucial for allowing the inflammation to subside.
• Medication: Anti-inflammatory medications like ibuprofen can help reduce pain and swelling.
• Devices: Braces or supportive footwear may be recommended to limit lower leg movement and provide stability.

How Does Physiotherapy Help with Tenosynovitis?

Experienced physiotherapists at Phoenix Rehab are trained to treat musculoskeletal conditions like tenosynovitis. Based on the findings, your therapist will develop a specialised treatment plan tailored to your specific needs and goals. Here's what physical therapy treatment for ankle tenosynovitis may look like.

Pain and Inflammation Management

This helps to loosen tight muscles and improve blood flow to the affected area, promoting healing. Initial sessions may include the following techniques:

• Ice therapy
• Manual therapy and soft tissue massage
• Modalities ultrasound or electrical stimulation

Regaining Mobility

As the pain subsides, your therapist will guide you through gentle range-of-motion exercises to restore full mobility in your ankle joint. These exercises will likely involve:

• Ankle circles
• Alphabet with toes
• Calf stretches

Strengthening Exercises

Once you have regained some mobility, your therapist will introduce specific exercises to strengthen the muscles around your ankle joint. Stronger muscles provide better support and stability to the ankle, reducing stress on the tendons and preventing future recurrence.

You can use techniques like towel stretch to gently pull on the muscles and tendons. Balance exercises also help, enhancing proprioception and ankle stability.

Functional Activities and Gait Training

As your strength and mobility improve, your therapist will gradually progress your exercises to mimic real-life activities. This may involve exercises like walking on uneven surfaces, stair climbing, or lunges.

Gait training can help correct any walking abnormalities that may be contributing to stress on the tendons.

Tips for When You're at Home

While undergoing physiotherapy treatment, you can also take steps at home to aid your recovery. Below are some actionable tips to get your ankle back to health.

• Avoid activities that cause pain and allow your ankle ample time to heal.
• Apply ice packs to the affected area for short periods to reduce inflammation and pain.
• Elevate your foot above your heart when resting to help reduce swelling.
• Ensure you wear well-fitting shoes with proper arch support to prevent further strain on your ankles.

Conclusion

Ankle tenosynovitis can be a painful condition. Physiotherapy for ankle pain caused by tenosynovitis can help you achieve a full recovery and get back to enjoying activities without foot pain. Seek early diagnosis and a personalised treatment plan to regain strength, flexibility, and prevent peroneal tendonitis recurrences. Finally, listen to your body and incorporate a healthy everyday routine. This can go a long way in keeping your ankles healthy.