Tendinopathy refers to any injury and tissue damage to a tendon. The suffix “pathy” means suffering or disease, therefore tendinopathy is a general term that can describe any condition of a tendon. To be more specific about the type of injury that has occurred in a tendon, the terms tendonitis (also spelled tendinitis), tendinosis, and tenosynovitis are used.
The term tendinosis refers to the non-inflammatory, degeneration of the collagen fibers in a tendon. This tissue break down is often caused by repetitive stress on the tendon fibers and the failure for the fibers to heal. In fact, the rate of tissue damage exceeds the healing process and eventually the accumulation of damage to the tendon is not able to heal properly. The collagen fibers deteriorate to a point where the once straight, strong, flexible bundle is weakened by abnormally formed fibers that look more like a mess of strands.
Since there is no inflammation with tendinosis you will not experience swelling, heat or redness. However, you will experience pain, tenderness and stiffness in the area of the affected tendon in the foot or ankle where the tissue degeneration has occurred.
The suffix “itis” means something is inflamed, therefore, the term tendinitis (tendonitis) is used when a tendon becomes inflamed. Inflammation in a tendon in your ankle or foot is oftendue to irritation and/or micro-tearing of the collagen fibers. When the fibers tear, they become weaker, inflamed and swollen causing pain and tenderness in the area.
There are 2 types of tendonitis, acute and chronic. Acute tendonitis refers to inflammation that comes on suddenly, usually from a tendon strain or overloading during exercise. Chronic tendonitisoccurs over time and generally results from long term repetitive use of the tendon.
With both types of tendinitis, scar tissue develops on the tendon fibers as the tears begin to heal. This scar tissue mends the tears in an abnormal wayleaving the collagen fibers weaker and more prone to further injury. In the case of chronic tendinitis a node of scar tissue may form and/or the tendon may actually become thicker and inflexible with a build up of scar tissue over a long period of time.
People with tendon pain often call their injury tendonitis however, in reality,tendinitis is a rare occurrence, tendinosis is a more common injury.
Tenosynovitis, also called paratendonitis (or peritendinitis), is a term used to describe inflammation and degeneration of the tendon’s outer layer or sheath. Depending on the tendon, the sheath is also called the synovium or paratenon.
It is possible to suffer from tenosynovitis alone or in conjunction with the degeneration of the tendon (tendinosis). In either case, as your body tries to heal, scar tissue forms inside the sheath attaching the inner tissues of the tendon to its outer covering or surrounding tissue. This scar tissue limits the gliding movement of the tendon in the sheath, reducing the range of motion and causing pain, tenderness, redness and swelling.
Ankle Tendon Treatments
Allowing your ankle to rest is always recommended when you are suffering from tendinitis, tendon tear or bone dislocation. Avoid all activities that may have caused the injury or irritation and begin cold compression treatments as soon as possible. The peroneal and posterior tibial tendons are difficult to rest completely as they are essential tendons for walking and daily activities. During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your ankle until the pain and inflammation settle.
The trick with healing an ankle tendon injury is getting it to heal with minimal scar tissueformation. Even with optimum healing, there is always less elasticity in previously injured peroneal tendons. This will cause the tendons to hurt during daily activities and exercise. However, if you heal your ankle tendons efficiently and quickly, yourchance of re-injury later on is much lower than average.