|The ankle is a mortise joint comprise of three bones, the tibia, the fibula, and the talus. It is held together by many important ligaments that maintain the stability of the ankle joint. Behind the ankle joint is an important tendon known as the Achilles tendon, which helps flex the foot. There are several other ligaments around the ankle that are involved in complex foot and toe movement.|
An ankle sprain is a very common condition in which the ankle twists or is turned in a particular direction, causing injury to the stabilizing ligaments of the ankle. Ankle sprains most commonly affect the lateral ankle ligaments but can often involved the medial ankle ligaments as well. A “high ankle sprain” occurs when a different higher ankle ligament is involved in the injury. Ankle sprains can lead to pain, difficulty walking, swelling, and discoloration of the ankle.
Ankle sprains are initially treated with rice, elevation, and compression. Also, a stabilizing brace, a walking boot, or a cast is often recommended by the doctor, depending on the extent of the sprain. Sometimes, specific types of ankle sprains require surgery.
Ankle fractures usually occur with a twisting type injury to the foot. Depending on the mechanism of injury, the fibula, the tibia, or both can fracture. Patients with an ankle fracture have pain, swelling, discoloration, and difficulty bearing weight on the leg. X-rays are used to diagnose ankle fractures.
Ankle fractures can be treated with either a boot, a cast, or surgery, depending on the type and extent of the fracture. After initial treatment, physical therapy is helpful in regaining ankle range of motion and strength.
The Achilles tendon is a critical tendon behind the ankle that helps flex the ankle. Achilles tendonitis is a common condition in which this tendon becomes irritated and can develop tiny tears in its substance. This can cause chronic pain in the tendon and difficulty walking or running. Sometimes, chronic Achilles tendonitis can lead to rupture of the tendon itself.
Achilles tendoninits is initially treated with initial rest and anti-inflammatory medications. Physical therapy is then begun to strengthen the tendon. If this is unsuccessful, the tendon can be injected with a new “healing” injection known as PRP (platelet rich plasma). This injection can help heal the tiny tears in the tendon and improve symptoms.
The Achilles tendon can rupture from chronic tendonitis or from one acute injury. The patient usually feels a “pop” in the back of the ankle and difficulty walking thereafter. Patients will also have pain and difficulty bending their ankle. Achilles rupture is diagnosed with a clinical examination and MRI study of the ankle.
Achilles rupture can be treated in a special brace, a cast, or by surgery. Your doctor will discuss the pros and cons to each treatment. After treatment, physical therapy is required to regain flexibility, strength, and function of the ankle.
The plantar fascia is a stout ligament near the sole of the foot that helps support the foot and contributes to the arch definition of the foot. Plantar fasciitis is a condition in which the plantar fascia has small degenerative tearing. Symptoms of plantar fasciitis included pain near the heel of the foot, morning stiffness, and limitation of physical activity. Plantar fasciitis is diagnosed by a thorough history and clinical examination. X-rays of the foot can demonstrate a bone spur in the calcaneous bone.
Plantar fasciitis can be treated with anti-inflammatory medications, orthotics, physical therapy, platelet rich plasma injections, or with surgery.