Ankle Pain

Your ankle is a complex network of muscles, bones, ligaments, and tendons. There can be many reasons for why they are painful.

When combined together, they form a network that is strong enough to support your body weight, while allowing you to move.

Ankles can be prone to pain and injury.

Ankle pain comes in the form of discomfort along the Achilles tendon or outside the ankle. The Achilles tendon connects the lower leg muscles to the heel bone. Therefore, when one part of this network is affected, it affects the whole ankle component, leading to inflammation, pain, and discomfort.

Ankle pain affects individuals regardless of the age. However, it is more common to men involved in sports. It can occur due to various reasons, to an extent of preventing movement.

Causes of Ankle Pain

Ankle pain can be caused by injuries such as strains and sprains from sports. It can also be caused by conditions and diseases like gout, and rheumatoid arthritis. Overusing the calf muscles can also lead to ankle pain.

Ankle Sprains

This is the most popular ankle injury. It occurs when the ligaments supporting the ankle are stretched to exceed their normal range. This can be due to foot rolls and twists, due to a misstep or being stuck inside an unseen hole. Sprains are graded on a scale of 1 to 3. The grading is based on the extent of the damage. One represents light damage on the ligaments while 3 represents severe damage. Sprains can occur either on the outer or inner portions of the ankle. They are more common when there is a history of ankle injuries or as a result of muscle weakness on that section of the ankle area.

Ankle Fractures

A broken or fractured ankle, mostly involves a break occurring on one of bones that support the ankle. In severe cases, it might involve several broken bones in the ankle. Ankle fractures mostly occur when you roll or twist your ankle when running, walking, using stairs or playing certain sports that involve gliding like baseball. It can also occur due to falling or tripping or as a result of a car accident. A broken or fractured ankle can pose the same symptoms as a sprained ankle, which includes bruising, swelling and tender to touch. Therefore, it can be hard to differentiate between the two, unless you see a specialist. In rare cases, a fracture can occur when tears and then pulls a part of the bone with it. This condition is known as avulsion fracture.

Tendinitis

Also called tendonitis, tendinitis is an inflammation of the tendons. Ankle tendinitis may be due to Achilles tendon, the peroneal tendon or the posterior tibial tendon. Ankle tendinitis does not occur frequently as compared to the other ankle injuries. It usually happens when the ankles have been exposed to sudden trauma or overuse injury such as running. It can also be caused by underlying inflammatory illnesses and diseases such as rheumatoid arthritis, ankylosing spondylitis and reactive arthritis. All variations of tendonitis cause pain and discomfort, as well as swelling and inflammation on the tendon area affected.

Osteoarthritis

This is the most popular form of arthritis. It is a chronic condition characterized by breakdown of cartilage cushioning the end of the bones, where bones meet to form joints. Due to the cartilage breakdown, bones rub against each other leading to pain, stiffness and limited movement in the joints. The big foot is the most affected by this condition. It can also affect the bones and joints on the ankles, causing pain during movement.

Rheumatoid Arthritis

This inflammatory condition mainly affects the joints. It occurs when the body’s immune system attacks the synovium, which is a thin membrane lining the joints. This leads to joint damage, swelling, inflammation, loss of function and even disability in severe cases. More than 90% of people suffering from this condition have reported painful ankles.

Reactive Arthritis

This is another form or arthritis, which occurs mostly after an infection to the gastrointestinal, urinary or genital systems. It is characterized by swelling and inflammation of the joints, eyes, as well as structures found in the genitourinary or gastrointestinal tracts such as bladder, kidneys and intestines. The knees, ankles and joints in the feet are always the first to be affected by this condition. This form of arthritis can also lead to inflammation of the tendons, which includes the Achilles tendon located behind the ankle.

Patients whose immune systems are impaired, like those suffering from AIDS, are at a higher risk of developing infections in the joints, which includes the ankles. Moreover, patients suffering from diabetes as well as those taking cortisone medications are at a greater risk of bacterial infections to the joints. When bacterial infections occur to the joints, they might require extensive treatment methods such as joint fluid drainage and intravenous injections.

Diagnosis of Ankle Pain

As noted earlier, the ankle is a network of bones, muscles, ligaments and tendons. Therefore, whenever you have ankle pain, it can be hard to point out the exact cause of the problem. You should see a doctor if your joint appears disfigured, if there is intense pain at the ankles when moving or putting weight, when the ankles produce a popping sound during movement or when your ankles are swollen. When you visit a doctor, the first question you will be asked is how you suffered the injury. The doctor can then use that information to examine the ankle while noting the amount of bruising and swelling.

You might experience some pain during the physical examination since the physician has to move the ankle, to assess the swelling and pain. That evaluation will form the basis of a proper diagnosis. Apart from the physical examination, the doctor may see it necessary to conduct an ankle X-ray. This will be used to establish whether there are broken bones. Apart from the X-ray, your doctor may also ask you to undergo X-rays of the foot and leg, to establish whether there are other injuries. If the physician feels you might be having a stress fracture, an imaging scan like an MRI scan will be done. An MRI will reveal more detail with regard to the injury. A stress test may also be carried out when there is a fracture. This helps the physician to determine the best treatment method.

Treatment of Ankle Pain

The majority of ankle injuries can be treated using over-the-counter medication like acetaminophen as well as other non-steroidal anti-inflammatory like ibuprofen. The treatment method prescribed depends on the extent and nature of the injury.

Treatment of Fractures

Ankle fractures can be treated via surgical and non-surgical procedures. Non-surgical methods like ankle immobilization can be used in a situation where only one ankle bone is broken. Additionally, if the ankle bones are properly positioned and the ankle is stable, the doctor will not perform surgery. The doctor will recommend a brace or a cast, to keep your ankle supported, while minimizing movements. This allows the broken bone and the torn tendons and ligaments to recover with minimal interference.

However, if your ankle is not stable, the doctor will resort to surgery. The ankle will be stabilized with the use of screws or metal plates to secure the bones in position. After the surgery, the ankle is provided with additional protection using a splint. The splint remains in place until the swelling minimizes. After that, a cast is used for the rest of the recovery process. Bones take around 6 weeks to heal. During this period, you will be asked to minimize exerting weight on the affected bone so that they can heal in proper alignment.

Tendons and ligaments take much longer to heal after treatment. It can take you up to two years, before you can recover fully and resume full motion. However, most people are able to go back to their daily routines and lifestyles, after 3 to 4 months. After you resume normal ankle movements, you might require physical therapy. This will provide you with balance, gait training and strengthening. A home program can be used to help you regain your normal function and go back to your normal lifestyle. It will take you several months before you can be able to walk without limping.

Treatment of Sprains

The treatment procedure applied for sprains depends on the extent of the injury. Sprains are graded as severe, moderate and mild. Surgery is only applied in situations of severe damage, mostly those involving damage to several ligaments. Surgical procedures are also used when other treatment options have proved ineffective. Mild sprains are called grade 1. These are managed using the RICE procedure for several days until swelling and pain improves. If you just have a mild sprain, a cast or a splint will not be necessary. In fact, your doctor will advise you to put weight on the affected ankle as soon as possible.

A maximum of 3 days is all you need to recover fully from a mild sprain. You will also be advised to engage in a range of motion exercises such as stretching, as long as you can tolerate them. If you have a grade 2 sprain, your physician will still apply the RICE approach. However, you will be requested to give the ankle or affected area more healing and recovery time. you may also be given a boot or special splint to minimize movements on the ankle. The doctor will also prescribe a range of exercises that you can do, to improve the motion range while strengthening the ankle.

Physical therapy may also be prescribed to allow you regain full use of the ankle. Grade 3 sprains are characterized by severe damage such as complete rupture or tear of the ligaments. Such an injury takes quite some time to heal. These are treated through joint immobilization, followed by physical therapy, strength building and stretching. If the injury does not heal within the expected period, surgery might be recommended to reconstruct the damaged and torn ligaments. The normal treatment for a sprain, which includes resting and ankle protection should not take more than a week. Once the swelling goes down, you can engage in light exercises, which will help to restore flexibility, strength, and range of motion. Full recovery and mobility might take up to a month.

Treatment of Tendon Injuries

Tendon injuries are treated in a similar manner to sprains. Some of the available options include; immobilization using casts, bracing to support movement, physical therapy to improve range of motion, strength and balance, injected or oral anti-inflammatory drugs to minimize pain and surgical procedures to repair torn and damaged tendons.

Preventing Ankle Pain

Ankle pain resulting from medical conditions like arthritis is not easy to prevent. However, fractures and sprains are easy to prevent. The following steps can be used to minimize ankle sprains and fractures, and prevent ankle pain.

1. Avoid high-heeled shoes. If you walk on high heels, you have reduced stability. This puts you at a higher risk of twisting your ankles. On top of that, if you have weak ankles due to osteoarthritis, you should wear shoes with flared, low and wide heels. Alternatively, you can choose shoes with lateral posts such as running shoes.

2. Avoid complete flats. Most flip-flops and sandals have minimal safety features. When you are wearing a flat shoe, you lost substantial amount of arch support. Most people suffering from ankle arthritis also suffer from pronation, which is inward rolling of the foot. If you are wearing a flat shoe, you are exposing your feet even further to this condition.

3. Maintain a healthy weight. Most overweight people tend to complain from aching ankles and feet. This problem can be corrected simply by cutting down the excess weight. Once you lose the unnecessary weight, you relieve the pressure from the ankle joints.

4. Condition your ankles. If you strengthen your paroneal muscles with the help of resistance exercises, you will add stability to your ankles and keep them injury-free.

Bottom Line

Ankles are among the most injured joints in the body. They can be easily treated using various home remedies. However, it is advisable to see a doctor specialized in foot conditions, so that the exact problem can be identified and treated. You also need to make sure that you give proper care to your ankles, to prevent the common ankle injuries.

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