Understanding Ankle Injuries: Causes, Symptoms, and Treatment Options
▫️Written by John Keller
✅ Reviewed by Dr. Jenny Hynes on JULY 2, 2023
Ankle injuries can have a significant impact on our daily lives, hindering our ability to walk, exercise, and carry out routine tasks. Whether you have personally experienced an ankle injury, suspect you may have one, or know someone dealing with such an injury, it is crucial to understand the causes, symptoms, and treatment options available. This comprehensive guide aims to shed light on the importance of comprehending ankle injuries, empowering individuals to recognize early signs, take preventive measures, and seek timely and effective treatment. By gaining a deeper understanding of ankle injuries, we can navigate the recovery process with confidence, regain mobility, and minimize the long-term consequences of such injuries.
Keilor Road Physio is a team of physiotherapists who are experts in their field. Book an appointment to see an ankle physio today.
What Are Ankle Injuries?
The ankle joint plays a pivotal role in providing support, stability, and mobility to the lower extremity. Understanding the anatomy of the ankle and its intricate workings is essential to grasp the nature of ankle injuries.
Anatomy and Function of the Ankle:
The ankle joint consists of the tibia, fibula, and talus bones. The tibia and fibula form the bony framework of the lower leg, while the talus bone connects the foot to the leg. The joint is further stabilized by several ligaments. The lateral ligaments, including the anterior talofibular, calcaneofibular, and posterior talofibular ligaments, prevent excessive inward rolling of the foot (inversion). On the inner side of the ankle, the medial deltoid ligament provides stability against outward rolling (eversion). These ligaments work together to maintain the integrity and proper alignment of the ankle joint.
Ankle Injuries
The ankle joint's movements are facilitated by a complex interplay of muscles and tendons. The calf muscles, including the gastrocnemius and soleus, are responsible for plantarflexion, which is the pointing downward of the foot. Dorsiflexion, the upward movement of the foot, is controlled by the anterior tibialis muscle. The peroneal muscles, situated on the outer side of the leg, aid in ankle eversion and stabilization.
Types of Ankle Injuries:
Ankle injuries encompass various conditions, including sprains, strains, fractures, and ligament tears. Specific types of ankle injuries include:
Achilles Tendinopathy: This condition involves irritation or damage to the Achilles tendon, which connects the calf muscles to the heel bone. It often arises due to repetitive stress, overuse, or degenerative changes (Maffulli, 2018).
Ankle Fracture: An ankle fracture refers to the breaking or cracking of one or more bones within the ankle joint. Trauma or excessive force is typically the cause (Court-Brown et al., 2017).
Ankle Sprain: An ankle sprain occurs when the ligaments supporting the ankle joint are stretched or torn. It often results from sudden twists or awkward foot placements (Waterman et al., 2010).
High Ankle Sprain (Syndesmosis): A high ankle sprain affects the ligaments above the ankle joint, resulting in prolonged healing times and instability. It commonly occurs due to excessive rotational forces or trauma (Hunt et al., 2013).
Posterior Ankle Impingement: This condition involves the compression of soft tissues at the back of the ankle joint, leading to pain and restricted range of motion. It is frequently associated with activities involving repetitive plantarflexion movements (van Dijk et al., 2000).
Common Causes of Ankle Injuries:
Ankle injuries can arise from various causes. Sports activities that involve sudden changes in direction, jumping, or contact can subject the ankle to excessive stress and increase the risk of injury. Accidents, such as falls or collisions, can also lead to ankle trauma. Additionally, overuse or repetitive strain on the ankle joint, often seen in occupations or activities that require prolonged standing or repetitive motions, can contribute to the development of ankle injuries (Fong et al., 2007).
By gaining a comprehensive understanding of ankle injuries and their underlying mechanisms, individuals can better recognize the signs, seek appropriate treatment, and take preventive measures. In the subsequent sections, we will explore each specific ankle injury in detail, covering their distinct characteristics, diagnostic considerations, and optimal management strategies.
Recognising Ankle Injuries
Identifying the signs and symptoms of ankle injuries is crucial for prompt intervention and appropriate medical care. By familiarizing ourselves with the common indicators, we can take proactive steps towards seeking timely treatment and preventing further damage. Here are the key signs and symptoms to watch out for:
Pain: Ankle injuries often manifest as localized pain, ranging from mild discomfort to severe and sharp sensations. The intensity may vary depending on the severity of the injury and the structures involved.
Swelling: Swelling around the ankle joint is a typical response to injury. It occurs due to the accumulation of fluid as a result of inflammation. Swelling can make the ankle appear visibly enlarged and tender to touch.
Bruising: Discoloration or bruising of the skin around the ankle is another common sign of injury. This occurs due to the rupture of blood vessels during the traumatic event, resulting in the leakage of blood under the skin.
Instability: An injured ankle may feel unstable or wobbly, making it difficult to bear weight or maintain balance. Instability can be indicative of ligamentous damage or fractures (Hertel, 2002).
Difficulty Walking: An ankle injury can significantly impact mobility, making walking a challenging task. Individuals may experience a limp or altered gait pattern due to pain and limited range of motion.
It is crucial to seek medical attention for suspected ankle injuries in various scenarios. Examples include severe pain that persists or worsens, inability to bear weight on the affected ankle, visible deformity, inability to move the ankle joint, or signs of a fracture (e.g., bone protrusion, bone crunching sound) (Murphy et al., 2016; Hootman et al., 2018). Additionally, individuals with chronic health conditions, such as diabetes or circulatory disorders, should promptly consult a healthcare professional for any ankle injury, as these conditions may impede proper healing (Khan et al., 2003).
To assess the severity of an acute ankle injury, self-assessment techniques can provide preliminary guidance. The POLICE method (Protection, Optimal Loading, Ice, Compression, Elevation) can be implemented immediately after the injury to reduce pain and swelling (Bleakley et al., 2019). However, it is important to note that self-assessment is not a substitute for a professional evaluation. If in doubt or if symptoms persist, seeking medical advice is always recommended for an accurate diagnosis and appropriate treatment plan (Grossman et al., 2020; Hopkins et al., 2021).
Diagnosing Ankle Injuries
As a Keilor Road Physiotherapist, our primary goal is to accurately diagnose ankle injuries to provide appropriate and effective treatment. Our skilled physiotherapists employ a comprehensive diagnostic process that combines subjective examination, physical assessments, and, if necessary, diagnostic imaging.
The initial step in diagnosing an ankle injury involves a detailed subjective examination. We gather information about the individual's medical history, the mechanism of injury, and the onset and progression of symptoms. This helps us understand the nature and potential causes of the injury, as well as any pre-existing conditions that may influence the treatment plan.
Following the subjective examination, a thorough physical examination is conducted to assess the affected ankle. We examine the range of motion, strength, stability, and any abnormalities such as swelling, tenderness, or deformity. Specific tests, such as the anterior drawer test for ligament stability or the Thompson test for Achilles tendon rupture, may be performed to further evaluate the injury.
In certain cases, diagnostic imaging may be necessary to confirm the diagnosis and assess the extent of the injury. X-rays are commonly used to evaluate fractures or bony abnormalities, while MRI scans provide detailed images of soft tissues such as ligaments, tendons, and cartilage. In some instances, additional diagnostic tests, such as ultrasound or CT scans, may be necessary to gather more information about the injury and aid in the diagnosis.
At Keilor Road Physiotherapy, we emphasize the importance of consulting a healthcare professional for an accurate diagnosis. Self-diagnosis or reliance on online resources can lead to misinterpretation or inadequate treatment. Our team of experienced physiotherapists has the expertise and knowledge to assess and diagnose ankle injuries effectively, ensuring that the treatment plan is tailored to the individual's specific needs.
Our physiotherapists possess the expertise and knowledge to perform a comprehensive evaluation, interpret imaging results, and provide an individualized treatment plan. Proper diagnosis ensures that the appropriate treatment strategies are implemented, facilitating a faster and more successful recovery.
Ankle Injuries
Treatment Options for Ankle Injuries
As a Keilor Road Physiotherapist, we offer a range of treatment options for ankle injuries, tailored to each individual's specific condition and needs. Prompt medical care and early intervention play a crucial role in effectively managing ankle injuries and promoting optimal recovery. Here are some key treatment options we provide:
The POLICE (Protection, Optimal Loading, Ice, Compression, Elevation) method is an updated approach for managing acute ankle injuries (Bleakley et al., 2012). It involves protecting the ankle, promoting early mobilization with controlled exercises, applying ice for pain and swelling reduction, using compression to control swelling, and elevating the ankle to reduce fluid accumulation. Implementing the POLICE method can contribute to optimal recovery and improved outcomes in acute ankle injuries (Bleakley et al., 2012).
Physiotherapy: Physiotherapy plays a crucial role in the management of ankle injuries, as it offers personalized treatment plans designed by experienced physiotherapists (Vuurberg et al., 2018). Our experienced physiotherapists design personalised plans that may include manual therapy techniques, such as joint mobilization and soft tissue massage, which help reduce pain and improve joint mobility (Vuurberg et al., 2018). Physiotherapists also guide patients through exercises that target strength, flexibility, and range of motion in the ankle, aiding in the restoration of optimal functionality (Vuurberg et al., 2018).
Bracing and supports are recommended based on the severity and type of ankle injury (Hupperets et al., 2015). Ankle braces or supports provide stability, protect injured structures, and minimize the risk of further damage during the healing process (Hupperets et al., 2015).
In some cases, non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to manage pain and reduce inflammation; however, it is crucial to consult a healthcare professional before initiating any medication (Bleakley et al., 2012).
Early intervention and prompt medical care offer numerous benefits in ankle injury management. Timely treatment can alleviate pain, swelling, and inflammation, facilitate faster healing, and reduce the likelihood of complications or long-term issues. It also enables the implementation of appropriate rehabilitation strategies at the optimal time.
Rehabilitation exercises are a fundamental component of ankle injury recovery, focusing on strengthening the ankle, foot, and lower leg muscles to restore stability and prevent future injuries (Vuurberg et al., 2018). These exercises may include calf raises, ankle circles, resistance band exercises, and balance training to enhance proprioception and overall ankle function (Vuurberg et al., 2018). Stretching exercises are also incorporated to improve flexibility and restore the ankle joint's range of motion. This comprehensive rehabilitation program aims to promote healing, regain full functionality, and mitigate the risk of re-injury (Vuurberg et al., 2018).
In addition to strengthening exercises, stretching exercises are an integral part of the comprehensive rehabilitation program for ankle injuries. These exercises specifically target improving flexibility and restoring the range of motion in the ankle joint (Vuurberg et al., 2018). By incorporating stretching exercises into the rehabilitation plan, the goal is to promote healing, regain full functionality of the ankle, and reduce the risk of re-injury (Vuurberg et al., 2018).
At Keilor Road Physiotherapy, our team is dedicated to providing individualized treatment plans and ongoing support throughout the recovery process. We strive to empower patients with the knowledge and tools necessary to regain mobility, prevent future injuries, and resume their active lifestyles.
Preventing Ankle Injuries
At Keilor Road Physiotherapy, we are committed to educating individuals on injury prevention and promoting overall foot and ankle health. By implementing these strategies and seeking regular check-ups with one of our physiotherapists, individuals can minimize the risk of ankle injuries and enjoy an active, pain-free lifestyle. Here are some practical tips and advice for ankle injury prevention:
Wear Appropriate Footwear: It is crucial to wear footwear that provides adequate support and stability (Gefen et al., 2002). Properly fitting shoes with good arch support and cushioning help absorb impact and reduce the risk of ankle injuries (Willems et al., 2016). Avoiding high heels and unstable platform shoes for extended periods is recommended (Gefen et al., 2002).
Warm Up and Stretch: Prior to physical activities or sports, warming up and performing dynamic stretches is important (Witvrouw et al., 2004). Dynamic stretching of the lower leg, ankle, and foot muscles increases blood flow, improves flexibility, and prepares the muscles for activity (Witvrouw et al., 2004).
Avoid Risky Movements: Being mindful of movements that place excessive stress on the ankles helps prevent injuries (Kerkhoffs et al., 2012). Sudden changes in direction or jumping on uneven surfaces should be avoided to minimize the risk of ankle injuries (Kerkhoffs et al., 2012).
Maintain Foot and Ankle Strength: Regular exercise and conditioning of the foot and ankle muscles are essential for stability and injury prevention (Hoch et al., 2015). Strengthening exercises targeting the calf muscles, ankle stabilizers, and foot arches reduce the risk of ankle injuries (Hoch et al., 2015).
Balance and Proprioception Training: Improving balance and proprioception through specific exercises enhances the body's ability to react and adapt to movements, reducing the likelihood of ankle injuries (McKeon et al., 2015). Single-leg standing, wobble board exercises, and balance beam activities are effective in improving balance and proprioception (McKeon et al., 2015).
Gradual Progression and Rest: Gradually increasing exercise intensity and allowing for rest and recovery periods are important in injury prevention (Noyes et al., 2012). Avoiding overtraining and listening to the body's signals, such as pain or fatigue, helps prevent ankle injuries (Noyes et al., 2012).
Incorporating ankle injury prevention strategies into daily routines is crucial for maintaining foot and ankle health (McKeon et al., 2014). Simple habits like performing ankle range of motion exercises and balance exercises throughout the day help maintain strength and flexibility (McKeon et al., 2014). Regular check-ups with a physiotherapist can provide guidance and further support in minimizing the risk of ankle injuries (McKeon et al., 2014). At Keilor Road Physiotherapy, we are dedicated to educating individuals on injury prevention and promoting overall foot and ankle health to ensure an active, pain-free lifestyle.
Conclusion
Understanding ankle injuries is crucial for individuals who have experienced or suspect they have one, as well as for those supporting friends or family members dealing with ankle injuries. In this article, we have explored the causes, symptoms, and treatment options for ankle injuries, highlighting the importance of early detection, prevention, and seeking professional guidance.
By recognizing the signs and symptoms of ankle injuries, consulting an expert healthcare professional, and following appropriate treatment plans, individuals can effectively manage their injuries and facilitate recovery. With proper care, including rest, physiotherapy, bracing, and medications, combined with rehabilitation exercises, individuals can regain strength, stability, and mobility in their ankles.
At Keilor Road Physiotherapy, we are here to provide expert care and support for your ankle injury concerns. Don't hesitate to reach out and seek our professional guidance. With our specialist treatment planning, you can overcome ankle injuries, regain your mobility, and embrace an active and pain-free life.
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Article by
John Keller | Clinical Director
Sports & Musculoskeletal Physiotherapist
John graduated as a Physiotherapist from the Auckland University of Technology with the John Morris memorial prize for outstanding clinical practise in 2003. John has since completed Post Graduate Diplomas in both Sports Medicine and Musculoskeletal Physiotherapy with distinction, also collecting the Searle Shield for excellence in Musculoskeletal Physiotherapy.
Reviewed by
Dr. Jenny Hynes FACP | Clinical Director
Specialist Musculoskeletal Physiotherapist
Jenny sat extensive examinations to be inducted as a fellow into the Australian College of Physiotherapy in 2009 and gain the title of Specialist Musculoskeletal Physiotherapist, one of only a few physiotherapists in the state to have done so.