Ankle Pain

Disorders and Injuries of the Ankle

The ankle joint is comprised of the lower leg bones, the tibia and the fibula, meeting with the talus bone of the foot. The ankle joint is considered a "hinged joint" and moves primarily in two directions, toward and away from the body, with very little side to side movement. Surrounding the joint are ligaments, which serve to connect the lower leg bones to the ankle bone, providing support and stabilization. The ankle is moved by muscles and tendons.

Sprains and fractures are the most common problems associated with the ankle joint and are usually a result of a sport injury. When a ligament is injured, it is known as a sprain. Ankle sprains can take as long as months or a short as weeks to heal properly. When the bone is broken, it is a fracture, described as simple or compound, and may need to be manipulated by a medical professional before healing will begin. Injuries to other parts of the ankle joints, such as cartilage can also occur which affects the cushioning and lubrication between the bones of the ankle joint. Injury to the tendons is know as tendonitis, which affects the muscles surrounding the ankle joint.

What are the main causes of ankle pain?

When a ligament is suddenly stretched, the result is either a partial or complete tear, known as ankle sprain. An ankle sprain can happen to either or both sets of inner and outer ligaments surrounding the ankle joint. Ankle sprains are more likely to occur if there has been a previous ankle injury or a preexisting muscle weakness in the ankle. Ankle sprains can occur from participation in a vigorous physical activity known as a sport injury or something as mild as stepping onto an uneven surface. The ankle can be twisted and results in the ligaments stretching suddenly, causing an ankle sprain. Patients often describe a ankle sprain as a popping sensation when the ligament is torn. Following the popping sensation onset swelling and pain occurs in the ankle. Swelling is caused by the blood vessels that have been injured leaking fluid into the surrounding tissues. Ankle sprains have three categories for the severity of the ligament tears, graded from I to III, I being a partial tear and III being a complete tear. For ankle sprains that are in the III category it is usually suggested that ankle surgery is performed, especially for patients that want to participate in athletic activity in the future. Ankle sprains that are more severe are sometimes accompanied by a fracture of the ankle bone. Fractures can be repaired with a cast to keep the ankle joint immobile for proper healing. Ankle fractures can also require surgery to repair damage, depending on the severity of the break in the ankle bones.

Inflammation of tendons can also cause ankle pain and is commonly known as tendonitis. There are three main tendons in the ankle, the Achilles tendon, the peroneal tendon, and the posterior tibial tendon. Tendonitis usually occurs from trauma to the tendons in the ankle, but can also stem from unknown, previously occuring inflammatory diseases. In either case, all forms of tendonitis cause swelling, tenderness and ankle pain. Sometimes the onset swelling and pain may be rapid, like ankle sprains involving physical activity, that need immediate treatment which includes elevation, immobilization, a cold compress or ice being applied to the area, and use of anti-inflammatory drugs to calm the swelling.

Ankle pain can also be caused by different types of arthritis, which is inflammation of the associated joint. Reactive arthritis, gouty arthritis, rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis are the main types of arthritis associated with ankle pain and inflammation of the ankle joint. Arthritis is not caused by a single incident or injury to the ankle joint, but develops slowly over time. The symptoms of these types of arthritis cause ankle pain including swelling, stiffness, warmth in the area, and redness.

Another condition that causes ankle pain is tarsal tunnel syndrome which results from the compression of nerves in the ankle joint as it passes under the flexor retinaculum, the supportive band surrounding the ankle joint.

While infections of the ankle joints are rare, bacteria can be introduced into the ankle joints through trauma, compound fractures or open wounds. Antibiotics are used to treat infections of the ankle joint, but patients with weak immune systems or diabetics are more likely to have bacterial infections in their joints.

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