The ankle is aching and swollen
Home ?? Surgery? Oboloniya of the joints ?? Pain and swelling at the ankle, increases with bending of the foot, walking on the toes and other symptoms of tendinitis
Tendonitis of the tendon of the posterior tibial muscle is accompanied by severe pain in the posterior part of the foot and may resemble the damage of the medial deltoid ligament and the lesion of the middle part of the foot.
Tendonitis of the tendon of the posterior tibial musclemost often occurs against a background of moderate physical exertion in the elderly with complaints of pain in the joints. This is one of the most frequent syndromes of overwork in young people and in persons with excessive pronation of the foot.
The posterior tibialis muscle is the main antagonistshort fibular muscle that provides supination of the foot and when walking restricts pronation in the subtalar joint and the transverse tarsal joint. If the foot is penetrated, its biomechanics is disrupted and the tract of the posterior tibial muscle becomes less effective. To compensate for pronation, the muscle is constantly in a reduced state, which leads to its overload and chronic tendinitis. The result can be a degeneration of the tendon and a partial or complete rupture (with the development of flat feet).
Symptoms of tendonitis are pain and small swelling under themedial ankle, where the tendon passes before attaching to the scaphoid and wedge-shaped bones. Pain increases with supination and flexion of the foot, especially when walking on toes. With a complete rupture of the tendon, pain usually does not. There is a unilateral flat feet; standing on tiptoe, the patient does not turn out the foot. When the patient is standing, the foot is sharply diverted, especially well seen from the back.
Pain in chronic tendonitis is worse during exercise. Day after day the pain gradually increases, and in severe cases the patient can no longer walk.
The basis of treatment of tendinitis is rest,restriction of pronation of foot and anti-inflammatory drugs. There are enough immobilizing bandages and tight bandaging of the lower leg, but sometimes only the cast and the crutches can relieve the pain. A long-term intake of NSAIDs is required, and physiotherapy is often prescribed. To introduce glucocorticoids is not recommended, as this can lead to degeneration and rupture of the tendon.
To limit the pronation of the foot and weakentension of the tendon of the posterior tibial muscle, orthoses are needed. Rigid orthoses are preferable, but if the patient is difficult to walk with them, you can use a semi-rigid and soft.
The excision of necrotic areas of the tendon or the stitching and lengthening of the ruptured tendon is only indicated if there is constant severe pain and impairment of the supporting function of the leg.
In the elderly after the operation, a prolonged immobilization of the foot is required, therefore, surgical treatment is shown only in the most severe cases.
"Pain and swelling at the ankle, worse with flexion of the foot, walking on the toes and other symptoms of tendonitis," and other articles from the section Joint Diseases