The ankle joint is the meeting of the bones of the leg and the foot and is responsible for the up and down motion of the foot. In popular usage, the ankle is often considered to be the ankle joint plus the surrounding anatomic region, including the lower end of the leg and the start of the flat part of the foot. Pain in the ankle can result from inflammation or injury to any of the structures in this region, including the bones, joint space, cartilage, ligaments, tendons, or muscles. Ankle pain can be associated with other symptoms including
- ankle swelling,
- numbness or tingling,
- burning pain,
- inability to bear weight on the affected ankle,
Achilles tendinitis implies an inflammatory response, but this is very limited because there is little blood supply to the Achilles tendon. More appropriate descriptions are inflammation of the surrounding sheath (paratenonitis), degeneration within the substance of the tendon (tendinosis) or a combination of the two.
What are the symptoms of Achilles tendinitis?
Paratenonitis presents in younger people. Symptoms start gradually and spontaneously. Aching and burning pain is noted especially with morning activity. It may improve slightly with initial activity, but becomes worse with further activity. It is aggravated by exercise. Over time less exercise is required to cause the pain.
The Achilles tendon is often enlarged, warm and tender approximately 1 to 4 inches above its heel insertion. Sometimes friction is noted with gentle palpation of the tendon during ankle motion.
Tendinosis presents similarly but typically in middle-aged people. If severe pain and limited walking ability are present, it may indicate a partial tear of the tendon.
Arthritis & Osteoarthritis
Arthritis is inflammation of one or more of your joints. It can cause pain and stiffness in any joint in the body, and is common in the small joints of the foot and ankle.
There are more than 100 forms of arthritis, many of which affect the foot and ankle. All types can make it difficult to walk and perform activities you enjoy.
Although there is no cure for arthritis, there are many treatment options available to slow the progress of the disease and relieve symptoms. With proper treatment, many people with arthritis are able to manage their pain, remain active, and lead fulfilling lives.
Osteoarthritis is a condition characterized by the breakdown and eventual loss of cartilage in one or more joints. Cartilage (the connective tissue found at the end of the bones in the joints) protects and cushions the bones during movement. When cartilage deteriorates or is lost, symptoms develop that can restrict one’s ability to easily perform daily activities.
Osteoarthritis appears at various joints throughout the body, including the hands, feet, spine, hips, and knees. In the foot, the disease most frequently occurs in the big toe, although it is also often found in the midfoot and ankle.
Fractures & Fracture Care
An ankle fracture is when 1 or more of the bones in your ankle break.
What causes an ankle fracture?
- A car accident
- A direct blow to the ankle
- Falling on your ankle
What are the signs and symptoms of an ankle fracture?
- You have pain, redness, and swelling.
- Your ankle feels warm when you touch it.
- You have trouble moving your ankle or foot.
- You cannot put weight on your injured ankle.
- Your foot feels weak, achy, or numb.
- You see parts of the bone coming out of the skin.
How is an ankle fracture diagnosed?
Your healthcare provider will ask about your injury and examine you. You may need any of the following tests:
- X-ray: This is a picture of your ankle fracture. You may be given dye as a shot into your joint before the x-ray. This dye will help your joint show up better on the x-ray. A joint x-ray with dye is called an arthrogram.
- CT scan: This is also called a CAT scan. An x-ray machine uses a computer to take pictures of your ankle. Healthcare providers check for a fracture and tissue damage. You may be given dye in your IV to help your healthcare providers see the images better. Tell the healthcare provider if you are allergic to dye, iodine, or seafood.
- MRI: This scan uses powerful magnets and a computer to take pictures of your ankle. An MRI is used to look for ligament tears or other injuries. You may be given dye in your IV to help your healthcare providers see the images better. Remove all jewelry, and tell healthcare providers if you have any metal in or on your body. Metal can cause serious injury. Tell healthcare providers if you cannot lie still or are anxious or afraid of closed spaces.
Loose Bodies in the Ankle
Loose bodies are small fragments of cartilage or bone that can form in joints; particularly the hip, knee and elbow, but also in the ankle joint and the joint below.
Loose bodies don’t have to cause problems and they can often be stable and fixed within the joint space. If they are free in the joint they may become trapped between the bony joint surfaces where they may give rise to twinges of pain, locking of the joint or blocked or ‘springy’ movements.
A loose body in the ankle and foot causes twinges of pain, swelling and the sensation of giving way. There may also be the sensation of locking but that usually passes quite quickly.
Physiotherapy can help by applying a special technique that stretches through the affected joint to give the loose body room to move, and then applying a few sharp flicks to jolt the loose body into a more comfortable position.
Sprains & Strains
Most people have twisted an ankle at some point in their life. But if your ankle gets swollen and painful after you twist it, you have most likely sprained it. This means you have stretched and possibly torn the ligaments in your ankle.
Even though ankle sprains are common, they are not always minor injuries. Some people with repeated or severe sprains can develop long-term joint pain and weakness. Treating a sprained ankle can help prevent ongoing ankle problems.
What causes ankle sprains?
Most types of ankle sprains happen when you make a rapid shifting movement with your foot planted, such as when you play soccer or get tackled in football. Often the ankle rolls outward and the foot turns inward. This causes the ligaments on the outside of the ankle to stretch and tear. Less often, the ankle rolls inward and the foot turns outward. This damages the ligaments on the inside of the ankle.