Ankle pain and ankle injuries
The ankle is a stable joint formed by three joints, the shin bone (tibia), the fibula and the ankle bone (talus). It has a stable shape and strong ligaments but due to its position at the end of the body and the powerful forces produced by the legs it is often injured.
Physiotherapists routinely assess ankle pain and provide effective physical therapy for sprained ankles.
Ankle Ligament Sprains
Ankle ligament sprains and strains are the most common source of pain, usually from sports injuries or going over on the ankle whilst walking.
The anterior talofibular ligament is the most commonly injured in an ankle sprain. The ankle goes over on the edge of a kerb or piece of rough ground, stretching the ligament between the fibula and the talus until it tears or ruptures.
Care for a sprained or broken ankle
Damage to the ligament is a sprain, where some of the fibres are torn. Pain, swelling and difficulty weight bearing are in the initial problems. Treatment is ice, elevation, anti-inflammatory drugs, gentle movements and reduced weight bearing for a while.
A severe sprain can be difficult to tell from a fracture so if the person is suffering from high pain levels and cannot weight bear at all it is wise to seek medical advice.
Physical therapy for sprained ankle
How should a sprained ankle be medically treated? This depends on the severity and most ankle sprains settle without treatment, but some are more severe and need physiotherapy management to regain the movement, strength and joint position sense. In rare cases the ankle may need immobilization in a cast or splint or a stabilization operation.
The Achilles tendon is the largest tendon in the body and connects the major calf muscles to the heel bone. Near the heel bone insertion and for an inch or two above, the tendon can suffer from pain and inflammation.
Achilles tendonitis is usually an overuse syndrome, most common in runners who put abnormal and repetitive stresses on the tendon. It tends to come on slowly and may develop into a chronic case if you don’t heed the warnings. In chronic cases there may be little or no inflammation, making Achilles tendinosis a more accurate term.
Therapy is to reduce the stresses, perform local treatments and encourage eccentric muscle training. Physiotherapists are skilled in these areas and can advise on the best plan of management.
The ankle can also be affected in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, gout or reactive arthritis. These conditions need medical diagnosis and management, with physiotherapy an important part of subsequent treatment.
Tarsal tunnel syndrome
This problem occurs when nerves (the posterior tibial nerve) traveling down the leg over the ankle are compressed by the flexor retinaculum, a fibrous band around structures on the inside of the ankle. Rest, orthotics, physiotherapy and operation are treatment options.