Ankle Pain

Each year, over 3 million people are treated for ankle problems which include; sprains, strains, instability, contusions and fractures. The ankle is an extremely crucial joint and can become injured during even the most basic of activities like walking. The ankle joint is bound by numerous complex ligaments and tendons provides the body with flexible yet sturdy weight-bearing support. These ligaments help to stabilize the ankle and connect bone to bone while tendons provide motion and connect muscles in the lower leg to the bones of the ankle and foot.

Ankle Conditions & Treatments

Achilles Rupture: Characterized as a tear of the Achilles tendon. A rupture can be partial or complete. Usually ruptures occur just above the heel bone, but can occur 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. Early repair of the Achilles tendon offers a lower re-rupture rate, approximately 0% to 4%, and early range of motion out of casting. There is also a great chance of returning to sports and activities as well as greater strength and more endurance.

Arthritis: A general term for joint inflammation. Osteoarthritis is the most common form of the disease and affects almost 30 million Americans annually. Arthritis is defined as a condition that destroys the workings of a normal joints; as the cartilage, the cushioning between the bones, becomes damaged. Osteoarthritis, is considered a degenerative joint disease, reducing the elasticity and lubrication within the joints and weakening the muscles while loosening the ligaments. Age and wear are the 2 biggest risk factors for this condition, but this degeneration of cartilage can occur in any joints. Obesity, injury, nutritional factors, metabolic disorders and genetics also play a role.

Articular cartilage gradually wears away within our joints, 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, all natural and OTC anti-inflammatory medications and or cortisone injections. Arthritis is most common in the knees, hips, hands, neck, and lower back.

Chronic Instability: The development of repetitive ankle sprains and persistent, residual symptoms following an initial ankle sprain injury. Characterized by a recurring giving way of the outer or lateral side of the ankle. The progression of an acute lateral ankle sprain to chronic instability may be the result of insufficient or lack of treatment of the initial injury. About 60% of those suffering from acute ankle sprains do not treat the initial injury properly. The 2 primary contributing factors to ankle instability are both functional and mechanical instability. Instability will alter the joint’s movement and motor and neuromuscular control. Treatment may include the use of an all natural topical analgesic to reduce pain and inflammation and an effective conditioning program to improve structural and functional dysfunctions when they are present. Proper support and bracing is also recommended as it will reduce the joints natural instability, but if symptoms persist and the ligaments on the outside ankle are elongated or torn, a surgical intervention should be considered.

Contusions: Refer to a bruise of the soft connective tissue and underlying muscle fibers and commonly occur as a result of a direct blow to the ankle joint without breaking the skin. Symptoms include pain and swelling at the site as well as limited range of motion and weakness and stiffness. Most contusions are minor; rest, ice, compression and elevation is the normal treatment for such injuries as they will resolve naturally. More intensive or severe cases may require medication; typically NSAIDs or an all natural topical analgesic will reduce pain and inflammation associated with the soft tissue injury.

Fractures: An ankle fracture is a complete or incomplete break of one or both of the bones of the ankle. A temporary dislocation and rupture of ligaments of the ankle joint may also occur with this injury. When the foot is forcefully and externally rotated fractures commonly occur. Any one of the 3 bones; the inside bone or tibia, the outside bone or fibula or the large bone or talus which connects to the heel, that make up the ankle joint could break as a result of a misstep, fall or some form of trauma. A broken ankle may also involve damage to the ligaments, cartilage and or tendons. The number one clinical sign of fracture is tenderness over bone. Ice and elevation will help mitigate pain and inflammation 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 surgery may be recommended to realign the bones and prevent the development of arthritis.

Nerve Compression: Characterized by 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. Often, injuries and surgery to repair ankle problems can lead to scar tissue in the area of the nerve tunnels. Repeated sprains over a life time can also cause nerve compression, but the vast majority of neuropathy is a result, however, of diabetes.

Mild compression will lead to an ache that worsens with further compression until the nerve becomes non-functional, causing tingling, numbness, or loss of strength. Symptoms include burning an electrical shock are typically felt on the inside of the ankle and or bottom of the foot. They are brought on or aggravated by overuse such as in prolonged standing, walking, exercising or beginning a new fitness program. Treatment consists of corticosteroids, chemical destruction of the nerve and or surgery.