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Ankle Injuries: General Info

The ankle joint is formed where the tibia and fibula of the lower leg meet the talus bone in the foot. The bones are connected to each other by ligaments, which are strong bands of connective tissue. The ligaments stabilize and support the joint, preventing the bones slipping out of position. Tendons attach the leg and foot muscles to the bones, enabling movement of the foot within certain limits.

Ankle injuries fall into three main categories: strains, sprains, and fractures.

A strain is damage to a muscle or tendon. Overstretching or excessive pulling can cause tears to the microscopic muscle or tendon fibers. Overuse or trauma make the peroneal tendons particularly susceptible to damage. Without proper treatment, tendon tears can accumulate over a period of time (sometimes years), leading to condition called tendonosis.

The usual cause of a strain is twisting the ankle by walking or running on an uneven surface. Wearing poorly fitting or high-heeled footwear can increase the likelihood of twisting the ankle. Sudden trauma such as a sports injury or car accident can also result in a strain.

Treatment usually includes resting the ankle to allow the fibers to heal, taking anti-inflammatory medication, doing physical therapy to regain range of motion, flexibility, and strength, and supporting the ankle during activity by wearing a brace. If the strain is severe enough, surgery might be necessary. Post-surgery the ankle would be immobilized in a cast or splint for a period of time.

A sprain describes injury to one or more ligaments, again as a result of being stretched beyond their normal limit, causing tearing of some or all of the microscopic fibers that make up the ligament band. When all the fibers have been torn, it is known as a complete rupture.

Sprains are graded according to severity: the mildest is a Grade 1, a moderate sprain is a Grade 2, and a severe sprain is Grade 3.

Grade 1 sprains are generally treated with rest, ice, compression, and elevation.

Grade 2 sprains may require a boot or splint to prevent movement of the ankle while the ligaments heal.

Grade 3 sprains describe a complete rupture of the ligament. The ankle needs to be completely immobilized for a time, then a longer time spent undergoing physical therapy to increase range of motion and strength.

A fracture is when an anklebone has been broken.

If the bones are in place, the ankle joint is stable, and only one bone has been broken, treatment of a fracture may consist of bracing the ankle in a cast or splint while healing takes place. An unstable ankle might need surgery, following which a splint would be worn for a period of time (until any swelling has gone down), and then wearing a cast until the bones heal. Ligaments and tendons damaged at the time of fracture can take much longer to heal than the bones, sometimes up to two years for a complete return to pre-injury status.

Whatever the final diagnosis, it is important to keep weight off an injured ankle until it has been medically assessed. Failing to properly address a sprain or fracture can lead to chronic ankle problems.

To reduce the risk of hurting your ankle,

· maintain strength and flexibility by regular exercise;

· maintain a healthy weight;

· use properly-fitting, reasonably new footwear (to prevent uneven heel depth);

· warm up before exercising; and

· exercise on even surfaces.