Foot or Ankle injuries are one of the most common musculoskeletal injuries. When you have an ankle injury, it is very limiting because our ankles help us move and support our body weight. However, we often don’t take it seriously when we injure ourselves. Untreated ankle injuries can lead to severe complications like permanent immobility and deformity. To learn more about ankle injury, read this comprehensive guide.
Understanding Parts or Ankle Anatomy & Common Foot Injuries
Before discussing the treatment and rehabilitation of various ankle injuries, we first need to know how the ankle works.
The ankle is the joint located between the foot and the leg. Its rigidity helps maintain the body’s balance while allowing for smooth and flexible movement. It is so stable that it can hold 1.5 to 8 times your weight when you move.
What Are the List of Common Ankle Injuries?
Below are 4 different types of common ankle foot injuries. Cases are usually from sports, accidents around the house and outdoors.
1. Ankle Sprain
Among the various ankle injuries, the most common is an tendon ankle sprain. Sprains occur when a ligament stretches or breaks. Ligaments, along with tendons, are connective tissues that keeps the joints from moving too far from each other. You may sprain your ankles when you accidentally twist or turn your ankle out of its normal range of motion. While this is more common in contact sports, like football, any physical activity could also cause a sprain.
Some of the symptoms of an ankle sprain are
- redness of the joint,
- tenderness,
- inability to bear weight on the affected ankle,
- stiffness,
- bruising, and
- swelling.
Most cases of a sprain are minor and treatment from a simple rest and ice treatment. If the pain does not seem to improve, you must seek medical treatment right away. Otherwise, it might lead to worse and more painful injuries that may be difficult to treat. For example, recurring cases of an ankle sprain may soon lead to osteoarthritis.
2. Tendon Achilles Tendonitis & Rupture
The Achilles tendon is located in our ankles and is the largest tendon in the body. Primarily, it connects the calf muscles to the heel bones. The Achilles tendon may be injured by excessive and unguided exercise or by sudden trauma, resulting in Achilles tendonitis.
If you leave Achilles tendonitis unattended, you make yourself prone to a rupture or tear, which will require surgical repair. When the Achilles tendon ruptures, you will hear a popping sound or sensation followed by extreme heel pain after doing a certain activity.
3. Ankle Fracture Torn Ligament
Like connective tissues, our bones can also get injured. If one or more of the ankle bones break, an ankle fracture occurs and could even have torn ligament. Similar to the other ankle injuries, ankle fractures are usually due to sudden rotational movements, such as twisting or rolling the ankle, or direct trauma.
Stress fractures, specifically, are caused by repetitive stress or trauma to the ankles over time. Introducing a new strenuous foot activity to a person may cause a stress fracture. Examples of this are hiking, running, and field sports.
4. Ankle Arthritis
Out of the four common ankle injuries we mentioned, ankle arthritis is a longer-term condition that slowly progresses over time. Unlike other forms of arthritis, ankle arthritis is rare; nonetheless, the condition poses a significant challenge to mobility.
Arthritis is a type of degenerative disease that affects the joints, causing pain, swelling, deformity, and immobility. The type of arthritis that hits the ankle can be classified based on its causes.
- Osteoarthritis is caused by the deterioration of the joints.
- Rheumatoid arthritis is an inflammatory joint disease.
- Gout is the result of having excess uric acid.
- Reactive arthritis occurs when there is an infection in the body.
Ankle injuries are diagnosed through physical examination and radiologic test, such as
- X-rays to examine the bones and
- CT Scan or MRI to look at soft-tissue parts such as the tendon and ligament. It may also be used to scan a suspected ankle sprain.
Treatment Options for Ankle Injuries, Trauma & Pain
The cause, symptoms, and progression of ankle injuries will determine the appropriate treatment plan. One method may not fit another condition. That’s why a consultation with an orthopedic doctor is a must.
Both medication and surgical options are available for various ankle injuries. Your doctor will help you weigh the pros and cons of each method based on your condition. Furthermore, treatment for ankle injuries may be short-term or long-term. Usually, short-term treatments include interventions for mild ankle injuries, as well as first-aid solutions. On the other hand, long-term treatments include weeks or months of physical therapy and maintenance medication.
1. Short-Term Treatments
1.1 RICE Method
Rest, ice, compression, and elevation (RICE) protocol is a first-aid treatment for almost all ankle injuries, particularly Achilles tendonitis and ankle sprain, to relieve their symptoms.
First, you rest and immobilize the affected part to prevent more strain on the injury. Then, you put ice wrapped in a cloth on the injured ankle to slow down the inflammation or swelling. Next, compress the affected area with an elastic bandage. Finally, elevate your foot—above chest level, if possible—to keep the blood flow away from the injury and to reduce swelling.
Pros: RICE method is helpful right after the injury, and it is a noninvasive treatment you can do at home.
Cons: This may not work for more severe ankle injuries and could only serve as pain relief.
1.2 Pain Medication & Walking Aid
A few days to a week after the injury, the area may still be painful. Thus, you should not strain it until the symptoms die down. For pain management, physicians prescribe anti-inflammatory medication, such as aspirin and ibuprofen, only as needed.
As you slowly try to walk on your own, you might want to get a brace, a walking cane, or any assistive device to prevent putting too much weight on your ankle. Physicians also recommend that you stay away from doing strenuous activities or sports before the rehabilitation process.
Pros: It is a noninvasive method you can do at home. The canes also facilitate self-healing and rehabilitation.
Cons: If you solely rely on pain medications without addressing the root causes, you may be at risk of drug codependence. In other words, your body may get too used to it that the medication no longer gives you any relief.
2. Surgical Procedures
2.1 Arthroscopy
Ankle arthroscopy is a minimally invasive surgical operation to repair the tissue in your ankle. The procedure involves inserting a tiny camera, called an arthroscope, through a small incision on your ankle for assessment. After inspecting the tissues, the doctor will make up to three more small incisions to remove the damaged tissue.
This surgery may treat ankle arthritis, ankle fractures, ankle instability, and ankle sprains.
Pros: Minimally invasive, less risk of infection, quick healing, and less bleeding
Cons: May be a bit expensive, costing around thousands of dollars
2.2 Ligament Ankle Reconstruction
Ligament ankle reconstruction surgery is the most commonly performed outpatient surgery for ankle injuries because of its minimally invasive nature. The procedure strengthens your ligaments by tightening them up on the outside of your ankle.
If you had an ankle sprain several times already, your sprain is likely to damage your ligaments even further. You might want to consider and talk about ankle reconstruction with your doctor for precautionary measures.
Apart from a sprain, reconstruction surgery can also treat other ankle injuries, such as chronic ankle instability.
Pros: It can help solve chronic pain from walking and recurrent ankle sprain.
Cons: As with other surgical procedures, it can have complications. These can include excessive bleeding, blood clot, and stiffness in your ankle joints. Consult your doctor immediately if you show symptoms of complications from the anesthesia administration to post-surgery.
3. Long-Term Treatment & Rehabilitation
Rehabilitation and long-term treatment are important not only to a post-ankle surgery patient but also to nonoperative patients. These programs and treatment plans will help strengthen your joints and teach you how to efficiently move. This way, you can prevent injuries from recurring in the future.
According to data, nonsurgical management ankle injury patients usually return to activity within six weeks. However, 10 to 40% of these patients will still experience recurrent sprains and ankle pains.
3.1 Ankle Sprains & Physical Therapy
You may undergo physical therapy after a surgical treatment or depending on your condition. Therapy may include exercises to widen the range of motion, progressive weight bearing, and proprioceptive training or enhancing the body organ localization ability. Through proprioceptive training, the coordination of your ankle’s position in space and the firing of muscle commands are more in sync, preventing injuries.
These methods are a series of gradual progression, meaning, your therapist will slowly increase the stress on the joint as the pain and other symptoms decrease. You should only be allowed to do a full activity when the following are cleared:
- Your injured areas have a complete range of motion.
- Your injured areas have regained 80 to 90% of pre-injury strength.
- You can walk, run, and change direction without much trouble.
Pros: Can be completed at your own pace and time.
Cons: The adaptation time and pain level threshold may not be in sync all the time.
3.2 Achilles Tendonitis Rehabilitation
After the first few sessions of physical therapy, the pain will gradually alleviate as you climb uphill or increase your sprints. Healing Achilles tendonitis is a relatively slow process.
At first, your doctor may advise you to wear a heel cup to lessen the stress on your ankle. The first stage is all rest and activity modification to heal the injury. Later on, they will introduce stretching and strengthening exercises, depending on how much you can tolerate. It can be as simple as towel stretching or toe raises.
The end of the rehabilitation process will be determined by your foot structure and gait mechanics. By the time you achieve the normal range of motion, you should slowly start doing exercises that aim to increase the stress capability of your Achilles tendon. You can start doing walking and jogging exercises on a progressive basis. Remember to do your workouts on a flat surface as much as possible.
3.3 Maintenance Medication
Long-term medications are usually prescribed for ankle injuries due to arthritis. Doctors may prescribe nonsteroidal anti-inflammatory drugs, corticosteroids for pain and inflammation, colchicine, and pain relievers.
Pros: May work faster because the medication directly goes into your system
Cons: Not all ankle injuries can be treated with maintenance medication. It only offers pain relief and management.
Final Thoughts on Ankle Injuries
The Achilles tendon isn’t named after the Greek mythological figure Achilles for no reason. Our ankles are as strong as the legendary hero. They keep us standing tall and freely moving. However, when left unattended, they can have problems that can cost us our mobility and overall well-being.
Start taking precautionary measures to prevent ankle injuries. If you already have ankle injuries, seek help from an orthopedic doctor as soon as possible so that you can return to battle in no time.
