Ankle pain

There are many causes of ankle pain. According to the U.S. National Library of Medicine and the National Institutes of Health, ankle pain involves discomfort in one or both ankles and may be accompanied by swelling and bruising of the ankles, along with the inability to support a person's body weight.

[ 1 ], [ 2 ], [ 3 ]

Dislocations and subluxations of the ankle joint

Usually, both subluxations and dislocations of the ankle are supplemented by fractures of the ankles. Most often, dislocations and subluxations occur in the place where the talus bone connects to the calcaneus. This is called a subtalar dislocation of the foot. Then the ankle becomes significantly thicker, deformed, and the heel area is also deformed. The heel, instead of being turned outward, turns inward.

When the foot is compressed, dislocations and subluxations of the tarsal bones or metatarsal bones also occur. They provoke deformation of the foot, then the dislocated bones protrude to the sides or to the back of the heel. A large hematoma is visible on the foot (on its back part).

People who are obese or have weak ligaments suffer most from ankle injuries, dislocations and subluxations. When a person walks, with the slightest uncomfortable movement, he or she turns the foot inward, and swelling of the joint occurs, which is called traumatic swelling.

With proper treatment and a gentle schedule, it goes away in three weeks. If, apart from this injury, nothing else was damaged, the ankle joint can fully perform its functions after 1-2 months.

[ 4 ], [ 5 ], [ 6 ]

Causes and symptoms

Forced movement of a joint beyond normal limits usually results in deformation of the joints and ligaments. Although ankle pain is often a result of injury, it sometimes occurs as a result of a disease affecting the musculoskeletal system. During injuries, ligaments and joint capsules, which are vital structures for supporting the bone, are torn. After a dislocation, the affected bones of the affected limb may be in an abnormal position; fractures are also a problem with serious impairments.

An important factor in diagnosing a dislocation or subluxation is the force of the fall or impact, in particular, the loss of function of a certain part of the limb. Immediately after a dislocation, the site of the injury almost always swells greatly, and painful sensations are felt when pressing on the ankle area.

If the joint trauma, including a torn ligament or subluxation, is severe, small bone chips may be pulled out along with the supporting structures of the foot. Chronic recurrent dislocations may occur without significant pain due to the laxity of the surrounding muscles and other bone-supporting tissues.

Risk factors that may increase susceptibility to recurrent dislocation, subluxation of small joints include prenatal (congenital) joint surfaces and/or other diseases of the ligaments and tissues around the joint. Some infants are born with hip dislocations. Both sexes and all ages are affected.

[ 7 ], [ 8 ]

Diagnostics

Having a detailed medical history and a physical examination by a doctor is the first step in correctly diagnosing ankle dislocations and subluxations. The first diagnostic method is an X-ray.

[ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ], [ 15 ]

Treatment

Immediately after an ankle sprain, ice application is helpful in reducing swelling and pain. If the patient needs to be transported, it is important to reduce ankle motion to zero (immobilization). For the time being, a cast or splint may be used to immobilize and ensure proper alignment of the ankle bones.

Treating and realigning the bone after a dislocation is the doctor's first priority. This may involve simple maneuvers that are designed to reposition the bones or surgical procedures to restore the joints to their normal alignment.

General or local anesthesia may be used to help the joints contract, possibly by relaxing the muscles that are in spasm. Acetaminophen or aspirin are sometimes used to manage pain, and other medications may be prescribed by your doctor if the pain is severe. Recurrent joint dislocations may require surgical reconstruction or replacement. Trying to reduce a joint dislocation on your own is not recommended.

Prevention

When a person is involved in strenuous sports or other heavy work, the areas where the ankle joints connect may be protected with elastic wraps, tapes, knee and shoulder pads, or special support stockings.

Maintaining the muscles surrounding the joint will also help prevent them from breaking down and atrophying. Long-term problems with ankle sprains can also be prevented by allowing the injured joint enough time to rest and heal before resuming full activity.

Features of ankle pain

Ankle pain due to injury can affect the ankles, tendons, cartilage, or blood vessels near the ankle. Ankle pain can radiate to the knee and shin.

There are many sports enthusiasts who understand the essence of ankle pain. Popular sports such as tennis, hockey, field hockey, football, soccer, baseball and softball require constant reliance on the feet. It would be more accurate to say, on the joints of the legs. After all, sports are daily tasks that many people perform on a regular basis. The ankle joints perform essential functions that are stopped due to pain. So what causes ankle pain?

[ 16 ], [ 17 ]

Ankle fractures

According to the American College of Foot and Foot Associations (ACFAS), an ankle fracture is a partial or complete break in the ankle that is associated with bone injuries. The ankle is one of the most common sites for fractures, and ankle fractures are often caused by rapid, forceful inward or outward movements of the foot. It is difficult for a person to distinguish between a broken ankle and a bruise, but they are still noticeably different.

If a person has suffered an ankle injury, it is important to have it diagnosed as soon as possible. A diagnosis from a qualified health professional can lead to the need for proper treatment, which in turn can speed up the recovery process. The ACFAS notes that ankle fractures and ankle sprains sometimes occur together.

Common symptoms associated with ankle fractures include pain at the fracture sites, inability to walk, and significant diffuse or localized swelling around the areas of injury.

Tunnel syndrome (tarsal)

Tarsal tunnel syndrome is a compression injury to the nerves of the ankle, including the posterior tibial nerve and its branches. The tunnel is located just below the bony prominences on the inside of the ankle.

Tarsal tunnel syndrome is a neuropathy in which the posterior tibial nerve of the ankle becomes compressed as if passing through a tunnel. This syndrome can be caused by many factors, including ankle osteoarthritis, diabetes, tendovaginitis, and ankle trauma.

Common symptoms associated with tarsal tunnel syndrome include the following: pain and tingling in and around the ankle, feet causing swelling of the feet, hot and cold sensations in the feet, and ankle pain when standing or for long periods of time.

Tendinitis

According to the National Institutes of Health, tendinitis is inflammation, irritation, and swelling of the Achilles tendon. These are the thick tendons in the heel bone that connect the bones to the calf muscles. The Achilles tendon becomes inflamed and is often the cause of repeated tendon tears or inflammation or arthritis, which can lead to ankle injury or infection.

Runners, basketball players, and athletes – as well as other sports that require a person to run and jump vigorously – are at higher risk of developing Achilles tendonitis. Arthritis associated with Achilles tendonitis is more common in middle-aged and older adults. Common signs and symptoms associated with Achilles tendonitis include pain when walking or running that radiates into the Achilles tendon, and pain and swelling in the ankle joint.

Gout

Ankle pain is a common problem for people as they get older. Ligaments and tendons are no longer as good at supporting knees, elbows, and ankles as they used to be when people were younger. In addition, inflammation caused by overuse or age-related diseases increases the risk of chronic joint pain. The ankle can be very painful and raises many questions about its treatment.

A common condition that can affect the ankle in the middle of the night is called gout. You may wake up with sharp pains that radiate to your big toe, ankle, or other joints, such as your ankles and knees. Although the pain may last for a few days and subside, it can recur at any time in the future.

More than 2 million people in the United States alone suffer from gout, which affects men more often than women. The disease usually develops in men after their 30s and in women after they have gone through menopause. Men are more likely to suffer from gout if they are overweight and if they have problems with high blood pressure.

Gout can be a consequence of hereditary arthritis, other diseases. The body tries to compensate for deposits in the joints, which cause inflammation and severe pain in the ankles, knees and other areas of the legs. If you suffer from gout and joint pain, diet can be one of the factors that can help you stay in shape.

Fracture of the calcaneus

The heel bone at the bottom of the foot is commonly called the calcaneus. This bone helps support the foot, and is important for normal walking movements. The heel bone is responsible for turning the foot inward and outward.

How does a heel bone fracture occur?

Calcaneal fractures are almost always the result of trauma. They usually occur as a result of a fall from a height, such as falling down a ladder. Other causes of calcaneal fractures include car accidents and sports injuries.

Heel bone problems as a source of ankle pain are common in long-distance runners. Ankle cracks are a variety of injuries due to traumatic fractures and their treatment should be discussed with your doctor.

What are the symptoms of a heel bone fracture?

Fractures of the calcaneus can cause significant swelling and pain in the foot and shin. Symptoms of a calcaneus fracture include:

• Inability to walk
• Swelling of the legs
• Bruises on the leg
• Severe pain in the heels

Most calcaneus fractures are closed, with the skin intact. When the skin around a calcaneus fracture tears, it may be an open fracture. An open fracture requires surgery.

What is the treatment for a calcaneus fracture?

Calcaneal fractures may require a cast after surgery. Non-operative treatment for ankle pain is also recommended for patients who suffer from poor circulation or diabetes; these patients are at risk for complications after foot surgery.

Patients who smoke also have a very high risk of complications associated with surgery after a calcaneus fracture. Surgery must be carefully considered for these patients, and some doctors will refuse surgery unless the patient agrees to quit smoking.

Surgical treatment for heel bone fractures usually involves making an incision on the outside of the foot and inserting a metal plate or screws into the broken bone. The doctor will try to restore the bone to its normal position and restore the cartilage surface as close to normal as possible.

Sometimes, if two large pieces of the heel bone are broken (versus many small pieces), this surgery can be performed using small incisions. Your doctor can recommend the appropriate treatment based on your specific needs.

After severe calcaneal fractures, the foot may be damaged all the way to the bones above the heel. In these situations, the possibility of restoring the cartilage tissue of the foot is unlikely.

All patients with a calcaneus fracture should also be protected from other types of injury in the future. Studies have shown that a large number of patients who have a calcaneus fracture are also at risk of suffering a lumbar spine fracture (10 to 15%). Other injuries are common in patients who have suffered a calcaneus fracture, including head, neck, and other extremity injuries.

What are the complications of calcaneus fractures?

Calcaneal fractures are usually quite serious injuries and often lead to permanent foot and ankle problems. Complications of calcaneal fractures can be divided into early complications and late complications.

Early complications of calcaneal fractures are most often due to the significant swelling of the bone that can occur after these injuries. Patients who have had surgery to treat a calcaneal fracture may develop swelling. As mentioned, patients with diabetes, smokers, and people with poor circulation are particularly susceptible to developing this complication.

Late complications from a calcaneus fracture are most often due to chronic foot pain and arthritis. Ankle pain due to arthritis may be chronic after a patient has sustained a calcaneus fracture. The risk of developing arthritis from a calcaneus fracture is usually related to the severity of the fracture.

Patients often experience problems with chronic leg pain, difficulty wearing certain types of shoes, and pain associated with walking, running, and standing in one place for long periods of time.

What is heel bone fracture recovery?

The recovery period after a calcaneus fracture is an important aspect in determining how quickly a patient will return to their pre-injury activity level. Patients will be required to control weight bearing for as long as three months. Another critical aspect of treatment is controlling swelling in the ankle, especially in patients who have had surgery. The best ways to control swelling include immobilization, rest, and ice.

Deforming arthrosis of the ankle joint

Degenerative diseases of the ankle joint occur less frequently than arthrosis of the hip joint or arthrosis of the shin. Deforming arthrosis always manifests itself on the basis of disorders of the ankle joint, legs, or parts of the legs.

These disorders occur as a result of heredity, congenital features and development of deformation of the ankle joint structure. Thus, a systemic disease occurs that leads to the destruction of the ankle joint cartilage. As in other joints, trauma or the development of arthrosis leads to the destruction of the cartilaginous tissue of the ends of the joints.

Arthrosis manifests itself as pain in the ankle joint with a limitation of its range of motion. The need for surgical treatment is determined depending on the limitations in movement, pain and complaints expressed by the patient.

The type of surgical treatment is determined by the previously planned goal. For ankle arthrosis, a number of measures are diversified. The extreme measure of surgical intervention is arthroscopic removal of free and half-free parts of the leg, cutting out the overgrown part of the synovial membrane from the inside of the part and joints.

[ 18 ]

Prospects

In addition, a medical examination in this case allows us to determine the size and extent of the ankle lesion and a plan for more distant treatment prospects. Until recently, immobilization was the only and decisive way to solve the problem of ankle pain due to arthrosis. However, this led to restrictions in movement that are irreparable and could lead to secondary changes in adjacent joints.

Recent years of research have made it possible to preserve ankle movements even in advanced forms of degenerative diseases. As with other large joints, there is now the possibility of ankle and ankle alloplasty. Not all medical orthopedic centers are yet capable of ankle joint restoration using prosthetics.

The first ankle joint prosthetic plastic surgeries were performed back in the seventies of the last century. The results were surprisingly weak regardless of the types of prostheses used. These failures led to the search for new forms and methods of fixation of the next generation of ankle joint prostheses.

Currently, treatment methods associated with the use of prostheses have become popular. The average percentage of good and very good indicators after 14 years of observation is 72%. Indications for ankle alloplasty are the results of ankle lesions that develop on the basis of rheumatic diseases or arthropathy in the course of other systemic diseases. This also includes post-traumatic arthrosis in elderly people with a small range of motor activity.

This type of treatment is contraindicated for young and active individuals, for ankle joints after bacterial infections, for legs with muscle dysfunction, with tibia deformities and after multiple injectable steroid use. The decision on the treatment method should be considered very carefully.

A healthy lifestyle and diet can be a major factor in reducing the risk of chronic ankle pain. Exercise is also a factor in strengthening joints and muscles, lowering blood pressure, and can be used to combat age-related conditions such as gout. Gentle exercise can be used early in recovery from an ankle injury, and as the joints become more mobile and strong, more physical activity can be allowed.