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Ankle Conditions and Treatments to Alleviate Your Ankle Pain

Ankle pain can be debilitating and adversely affect your mobility. However, it is important to know your opponent! So we want to share some important information with you about the causes of ankle pain and the possible solutions in each case. 

  • Ankle Instability
  • Anterior Ankle Impingement
  • Posterior Ankle Pain

Categories of Ankle Conditions

There are a number of conditions that can lead to ankle pain. This is a special joint surrounded by cartilage, ligaments, and tendons that are vital for your ability to walk, run, and move about. 

There are four main classifications of ankle conditions. The first is related to injuries or traumatic episodes. Sprains of ankle ligaments and ankle fractures are the two most common forms of these injuries. Such injuries are often sports-related.  

The second category refers to injuries that occur from overuse of the joints. So injuries such as tendonitis, joint inflammation, and stress fractures would all fall into this category. 

Degenerative ankle conditions would fall into the third category. These degenerative conditions develop over a number of years and are generally preceded by traumatic injuries. These previous injuries may include previous fractures, repetitive ankle injuries, and degenerative ankle arthritis.

The fourth category consists of metabolic or inflammatory conditions. These include gout and rheumatoid (or inflammatory) ankle arthritis.

Now let’s consider a few types of ankle conditions, and the possible treatment options available in each case.

Ankle Instability

Ankle instability arises when ligaments are permanently damaged and joint stability is compromised. 

Chronic ankle instability (also called weak ankles) arises from recurrent injuries and persistent ankle degeneration. This diagnosis is often done using stress radiographs and MRI in order to evaluate joints, cartilage, ligaments, and the accompanying tendons. So, any changes in these structures can give way to ankle instability.   

Treatment Options for Ankle Instability

Some of the strategies used to treat ankle instability include functional bracing when doing physical activities (such as sports). The brace works to support the ankle for improved functionality and to reduce the risk of injury. 

Ankle surgery is also quite effective at repairing the ligaments and restoring stability and ease of movement. However, you don’t have to worry about invasive surgery. Such procedures are often done with a minimally invasive arthroscopically guided operation. 

The estimated recovery time from such a surgery is typically two weeks. During that time, one would need to immobilize the leg and rest. After the rest time is complete, then sutures are removed. Physical therapy and rehabilitation then begins and may last from 6-8 weeks. It all depends on the patient as well as the surgical conditions that were addressed. The goal of ligament surgery is to get patients back to their pre-injury functionality and to discontinue the use of bracing. 


Anterior Ankle Impingement

When there’s an ankle pain in the front of the joint, then this is often due to anterior ankle impingement. This is a common problem that manifests in more pain when walking uphill or upstairs (or whenever the foot is bent inwards). 

Ankle impingement occurs when there are bone spur formations along the front of the ankle joints. So, when the ankle moves up and down, the bone spurs create friction between them, which then results in pain, swelling, and difficulty in walking. Ankle impingement may also be due to degenerative arthritis, scar tissue formation, inflammation, or sports injuries.

Anterior impingement generates symptoms that are common among linemen and running backs in football. This is due to the mechanical nature of the activities and the risks of repetitive injuries. Athletes may also develop impingement after recurrent ankle sprains or chronic ankle instability that is untreated. 

Treatment Options for Anterior Ankle Impingement

Anterior ankle impingement is often diagnosed from a thorough physical examination, and x-rays of the joint. Sometimes, an MRI is also used to assess other aspects of the ankle’s structure. 

The treatment options may include physical therapy to improve the range of motion and resolve scar tissue. Anti-inflammatory medications can also alleviate pain and swelling. The ultimate intervention is surgery to remove the tissue or bone spurs that are causing friction and pain. Oftentimes, the procedure that is done is ankle arthroscopy, which uses fiber-optic cameras and tiny surgical tools within tiny incisions around the joint. This type of surgery easily removes ankle debris and results in a quick recovery and easy return to all of the usual physical activities- minus the ankle pain. 

Posterior Ankle Pain

Posterior (or back of) ankle pain occurs due to several possible problems. Usually, patients experience pain deep in the back of the ankle. This pain is worsened when the ankle moves downward, such as when walking downhill, or downstairs. Sports that involve kicking your feet (for example swimming and jumping) can also make the pain worse.

This type of ankle pain may develop in the wake of chronic complications from ankle sprains. In this instance, patients can develop a medical condition called OS Trigonum Syndrome. Any injury to the back of the ankle that is left untreated can result in this painful condition. These injuries may also include bone fractures or joint instability that results in chronic irritation and pain. The good news is that there may be limited swelling and bruising with this condition.

Treatment Options for Posterior Ankle Pain

OS Trigonum Syndrome or Stieda process fracture (fracture of the posterior talus bone in the ankle) will cause pain whenever the ankle moves your foot downwards. Generally, this pain occurs at the end of the particular range of motion. 

Your doctor will do a physical exam to assess your ankle pain. This can be done by having you stand on your toes, or they may manipulate the ankle to see the symptoms that result. This condition is further diagnosed via ankle radiographs (or x-rays), an MRI can be used as well. The MRI is useful to see if there are any other causes of the present ankle pain. It can also show signs of swelling in the irritated region of the ankle. 

The treatment for posterior ankle pain includes interventions to reduce inflammation. Applying ice for 20-30 minutes every two to four hours can reduce pain and swelling. Using a compression bandage, Tubigrip compression stockings or kinesiology supportive taping will also support your ankle and minimize excessive swelling. You will need to elevate your ankle for best results. 

Sometimes, you may need physical therapy as well. A cast or walking boot may also be used to limit the motion and also support your ankle. However, surgical intervention may be necessary to resolve the source of this ankle pain. Your surgeon will discuss all the possible treatments that are suitable for your case. 

Get Treatment for Ankle Conditions and Relieve Your Ankle Pain

We’ve discussed a variety of ankle conditions and their corresponding treatment options. Contact us at the offices of our expert surgeon, Dr. Shannon Rush, to set your consultation appointment. Let’s get you on the path to independence, freedom of mobility, and freedom from ankle pain.