The ankle provides the body with flexible yet sturdy weight-bearing support. As such, ankle injuries are very common. Each year, approximately two million patients are treated for ankle sprains, strains and fractures. This very important joint can become injured even during the simplest of activities like walking or running. The ankle joint is bound by numerous complex ligaments and tendons; the ligaments help to stabilize the joint and connect bone to bone while tendons provide motion and connect muscles in the lower leg to the bones of the ankle and foot.
Conditions & Treatments Include:
Achilles Rupture: A tear of the Achilles tendon. A rupture can be partial or complete. Usually ruptures occur just above the heel bone, but can happen anywhere along the tendon. Common symptoms include popping or snapping sounds, sharp pain in the back of the ankle, pain and swelling near the heel, and inability to bend the foot downward or walk normally. This usually occurs from overuse or a sudden motion. Immobilization and surgery are common treatments as the ruptured tendon must be reattached to its normal position.
Arthritis: A broad term for a number of conditions that destroy the workings of a normal joint as the cartilage, the cushioning between the bones, becomes damaged. Articular cartilage gradually wears away within the joint, causing pain and swelling when standing or walking. When arthritis becomes severe, pain is experienced even when resting. Arthritis can be treated non-surgically in a variety of ways such as modifications to shoes, weight loss, anti-inflammatory medications and/or cortisone injections. Generally, surgery for arthritis may consist of re-aligning, stiffening or replacing a joint. If diagnosed early, sometimes removal of bone spurs around an arthritic joint can also help.
Chronic Instability: Characterized by a recurring "giving way" of the outer or lateral side of the ankle. Commonly due to tendon or ligament weakness and often occurs in 10 to 20% of people after an acute lateral ankle sprain. Subsequent sprains will lead to further weakening or stretching of the ligaments, resulting in greater instability. Initial treatment is conservative, either with bracing or physiotherapy, but if symptoms persist and the ligaments on the outside ankle are elongated or torn, a surgical intervention is usually considered.
Contusions: Refers to a bruise of the soft tissue and commonly occurs as a result of a direct blow to the joint. Common symptoms include pain and swelling at the site. RICE is the common treatment: rest, ice, compression and elevation. Severe cases may require medication, typically NSAIDs (non-steroidal anti-inflammatory drugs).
Fractures: Any one of the three bones (tibia, fibula or talus) that make up the ankle joint could break as a result of a fall or some other trauma to the ankle. A broken ankle may also involve damage to the ligaments, cartilage or tendons. The number one clinical sign of fracture is tenderness over bone. Ice and elevation will help control the pain from an ankle fracture and minimize the damage to the surrounding tissues. Some stable or minimally displaced fractures can be treated with a leg cast or brace. However, if a fracture is displaced or unstable, orthopedic/podiatric surgeons may recommend surgery to realign the bones and prevent the development of arthritis.
Nerve Compression: Pain that radiates along the path of the nerve or at the site where the nerve senses its signals. There may often be no pain at the site of the compression itself. Mild compression leads to an ache that worsens with compression until the nerve becomes non-functional, causing tingling, numbness, or loss of strength. Common symptoms such as burning or a sensation similar to an electrical shock are typically felt on the inside of the ankle and/or on the bottom of the foot. Often they are brought on or aggravated by overuse of the foot, such as in prolonged standing, walking, exercising, or beginning a new fitness program. Treatment can consist of cortisone injections, orthotics, chemical destruction of the nerve, and/or surgery.
Sprains: A wrenching or twisting of the ankle joint. Stretching and or tearing to the ligaments of the ankle may also occur, causing injury. The ankle is often sprained when it is "folded" over on itself. Common symptoms include tenderness and swelling to the lateral aspect of the ankle joint. Pain and difficulty with ankle motion usually increases in severity after several hours. Again, RICE is the common treatment: rest, ice, compression and elevation. While 85% of ankle sprains will heal without complications, 10 to 15% of people do experience ongoing problems.
Strains: Inflammation to a muscle or tendon connecting muscles to bones within the ankle; it is often caused by overuse, force or stretching. Strains frequently result from excessive exercise, heavy lifting, repetitive motion or minor impacts. Pain and swelling are common symptoms. Tendonitis can develop if gone untreated. Treat with RICE: rest, ice, compression and elevation. The second stage of treating a strain is rehabilitation to restore normal function. Most ankle strains heal in two to six weeks, with proper treatment.
Tendonitis: Irritation and inflammation of the large tendon in the back of the ankle. This can lead to small tears within the tendon and make it susceptible to rupture. This band of connective tissue that anchors muscle to bone and attaches the calf muscles to the calcaneus is very important because it provides thrust when walking. It is a common overuse injury that tends to occur in middle-aged recreational athletes. Pain and swelling are also common symptoms. Rest is the first treatment. Medication is typically NSAIDs (nonsteroidal anti-inflammatory drugs). Massage, ultrasound and exercises that stretch the calf muscles may be recommended by a podiatrist once the acute stage of inflammation has subsided. Surgery is usually considered when non-surgical methods have failed.