Ankle Pain - Ankle Pain Causes and Treatment

Pain on the ankle

Ankle pain is a common complaint due to the tremendous strain on the ankle in everyday life and exercise. The ankle forms the upper part of the ankle, ie the transition between leg and foot. It is divided into the outer knuckle at the lower end of the fibula and the inner ankle at the lower end of the tibia.

contents

• Pain on the ankle
• definition
• Symptom ankle pain
• Causes of ankle pain
• diagnosis
• Treatment for ankle pain
• Holistic treatment approaches
• Prevent pain on the ankle

definition

Pain in the ankle is restricted to the area of ​​the upper ankle from a medical-anatomical point of view, but in common usage they describe all painful discomfort in the area between lower leg and foot. These can occur both in the upper ankle joint (OSG) and in the lower ankle joint (USG). In addition to joint pain, pain in the surrounding ligaments and muscles is also perceived as ankle pain.

Ankle pain is often accompanied by swelling and redness in this area. (Image: Csaba Deli / fotolia.com)

Symptom ankle pain

The ankles are exposed to extreme stress during sports such as basketball, football, tennis or hockey. Correspondingly, athletes often suffer from painful sprains, ligament strains or even fractures in the area between foot and leg. Depending on whether the bones, muscles or ligaments are the cause of the complaints, they can be observed in a different intensity and localization.

Impairments at the transition between bones and ligaments, for example, are perceived as punctate pain, while the pain in ruptures of the inner or outer bands rather spread more flat on the respective side of the foot. Because torn ligaments and ligamentous expansions are accompanied by a massive swelling that presses on the surrounding tissue and causes pain here as well.

Ankle pain is more commonly associated with swelling, redness, and bruising around the ankle.

Irrespective of whether the symptoms are punctual or flat, they usually increase with pressure and strain. When standing, walking and running, the ankle pain is usually significantly increased and external pressure, such as palpation, leads to increased sensation of pain.

Not infrequently, an instability in the ankle shows concomitantly. Patients easily fold when climbing stairs, curbs or on uneven terrain. This further increases the risk of ligament strains, tears and ankle fractures. The foot can theoretically bend inward or outward, but in most cases, those affected bend their feet inwards. Accordingly, they tend to damage the outer bands. The buckling can also affect the bones of the ankle, which also causes ankle pain.

The ankle is stabilized by numerous ligaments and so-called syndesmoses (band-like connective tissue connections). In the area of ​​the ankle, here are the ligament tibiofibulare interosseum, ligamentum tibiofibulare anterius (anterior syndesmotic ligament), the ligament tibiofibulare posterius (posterior syndesmotic ligament) and the ligamentum tibiofibulare transversum. They give the upper ankle stability, but are exposed to correspondingly high loads.

Other ligaments that hold the ankle together are the deltoid ligament (so-called delta ligament) and the collateral ligament ligament (outer ligament). In the back area between the foot and lower leg sits the strongest band of the human body, the Achilles tendon. All these bands can be damaged in their structure or even tear and thus cause corresponding ankle pain. Most common, however, are strains, strains and ruptures of the outer bands.

Ankle pain is often associated with instability in the joint, greatly increasing the risk of kinking. (Image: auremar / fotolia.com)

Causes of ankle pain

Possible causes of pain in the ankle area are damage to the surrounding ligaments. These may in turn be due to chronic overuse, trauma injury due to kinking or congenital ligament weakness.

Athletes often experience signs of wear and tear in the joint, which may also lead to ankle arthrosis, given the high level of stress the ankle is exposed to during exercise. In this case, the cartilaginous layer disappears in the joint, the resilience goes back significantly and those affected complain of pulling pain inside the ankle. In the long term, the ankle completely loses its functionality and becomes stiff.

Violent kinking of the foot can cause a fracture of the ankle, which in turn causes massive ankle pain. Such an ankle fracture is usually associated with stretching or rupture of the ligaments. Another trigger is the so-called Os-trigonum syndrome. The os trigonum is a small bone at the posterior end of the ankle bone. If the surrounding ligamentous structures (ligamentum fibulotalare posterius and ligamentum deltoideum) are heavily stressed, irritation may occur at the level of the os trigonum, leading to persistent pain behind the lateral malleolus.

Since ligament tears or stretch marks as well as ankle fractures are usually associated with massive swelling and bruising, healing of the tissue may result in healing of the tissue, which can lead to painful blockages in the ankle area. The mobility of the ankle is clearly limited and in certain positions shows an extreme painful pulling.

diagnosis

In addition to scanning the ankle, imaging techniques such as x-rays and magnetic resonance imaging are well suited for diagnosis. With them, ligaments, muscles, cartilage and bones can be represented in their structure and clearly recognize ankle fractures, torn ligaments or arthritis diseases. Os trigonum syndrome is also diagnosed using imaging techniques. Finally, the diagnosis of ankle pain is usually not a problem. The treatment of the causes, however, is often much more difficult.

An x-ray of the ankle makes it easy to detect fractures, torn ligaments or joint wear. (Image: stockdevil / fotolia.com)

Treatment for ankle pain

Basically, the therapy for a sore ankle depends on the particular causes of the condition. For example, in the case of torn ligaments, there is no way to avoid a splint until today, an ankle fracture usually requires a plaster and sprains are fixed with a bandage. Accompanying the immobilization, the cooling and raising against the swelling should help.

If torn ligaments do not reassemble despite splinting, surgery may be required to either reconnect or replace existing ligaments. Surgery may also be required for ankle osteoarthritis and os trigonum syndrome.

With the minimally invasive procedure of so-called ankle arthroscopy (reflection of the ankle), bone fragments released after an ankle fracture, which threaten to block the joint, can be detected and removed. This method can also be used to stop the arthritis-related shrinkage of the cartilaginous layer.

In any case, physiotherapy is an elemental component in the treatment of ankle pain. Physiotherapy is intended to avoid stress, stabilize the joints and remedy the pain in the long term. Physiotherapy also attempts to eliminate existing movement impairments.

Holistic treatment approaches

Massages can also help relieve the symptoms. In addition, the so-called Rolfing and osteopathy offer possible treatment approaches to therapy. According to their holistic approach, these methods consider other complaints of the patients, such as knee pain, patellar pain, difficulty walking, back pain, back pain or even neck tension in the treatment of ankle pain. Although the relationship between the symptoms may not be apparent to outsiders at first glance, success often proves this holistic approach to treatment.

Prevent pain on the ankle

To minimize the risk of ankle pain, it is important to wear suitable footwear, especially in sports. In addition, stretching exercises may help against existing problems while providing a preventative effect on ankle problems.

Physiotherapy also plays a prominent role in prevention. Because, for example, following a ligament tear or a ligament strain, the ligaments are not sufficiently stabilized by appropriate training threatens a permanent instability and the risk of renewed injuries increases. Taping the ankle during exercise or a stabilizing support stocking can eliminate the susceptibility to buckling, but these tools can not replace the fully resilient and functional structure of the bands. (fp, last updated on 15.1.2018)