Defining the Ankle and Best Treatment Options
Updated: Apr 10
Ankle injuries and foot pain are very common. Whether you are super active or mostly sedentary, the foot seems to be a problem wherever you look. The foot and ankle carry the majority of our weight and if we don’t take care of them then you may be looking at problems later on. Sprains, fractures, and strains are the most common injuries suffered by athletes and we’re going to go in more depth on each one and how you can treat them to get back to playing as soon as possible.
Ankle Sprains of All Levels
Spraining your ankle is painful and can put you on the sideline really quickly. Sprains are measured in 3 grades:
Slight tearing or stretching of a ligament
Incomplete tear of a ligament
Complete tear of a ligament
Grades 1 and sometimes 2 can be walked on and progressed back to sport and activity with relative success. Grade 3 often leads to ongoing instability in the ankle and surgery can be completed in young, active kids and active adults.
With grades 1 and 2 it is important to restore your range of motion and decrease swelling quickly. The old way of treatment was to rest and ice all day; however, it is now seen that gentle stretching and mobility is important to prevent scar tissue and instability and progress quicker.
Stage 3 brings bigger challenges as the ligament is torn and depending on which ligament is involved can lead to instability in the ankle if not surgically repaired. For every day activity and movement, you may not notice the instability once you have rehabbed back to normal. However, for an athlete this could limit your ability to cut, jump, and maneuver quickly around an opponent. Surgical repair is typically completed after failed rehab.
Ankle Fractures: What do I do now?!
The diagnosis of a fracture is terrifying! However, it’s been said before that “You may have been better off to fracture your ankle vs a sprain” due to the length of time that it can take for a ligament to heal vs a bone.
The most common bone fractured in the ankle is the fibula, the lateral bone that makes up the outside of the ankle. It often fractures when the ankle is severely rolled, spraining the outside ligaments and/or breaking the bone. Alone, it is not commonly surgically repaired and rehab is highly successful.
When the tibia, the inside bone that makes up the ankle, is broken it is more severe and surgery is more common. Limitations in range of motion seem to be the biggest hurdle to face following surgery and/or return to weight bearing. Rehab following a tibial fracture is important to return the ankle to normal including range of motion, strength, and stability in single leg activities.
Trimalleolar fractures include the tibia, fibula, and talus and they almost always result in surgery and extensive physical therapy to return the ankle to normal mobility and function. Surgery to repair these fractures include open reduction with internal fixation or ORIF which means rods and screws are used to put the bones back together. The hardware remains in the ankle ongoing unless it begins to cause problems with pain and motion later at which point it can sometimes be removed.
Following ankle fractures, it is important to rehab the ankle to increase stability surrounding the ankle to prevent further injuries and fully return to activity.
Strains & Tendonitis Stay Causing Pain
Strains to muscles and tendonitis are the most frustrating injuries to the foot and ankle. A strain occurs when there is a quick stretch or strain to a muscle causing partial to all fibers to tear or be pulled. Tendonitis is when there is inflammation of a tendon, which connects a muscle to bone.
Inflammation is common in both types of injuries and the return to sport can be frustrating. The most important aspect of rehab is determining where the strain or tendonitis is coming from or what is causing it and work to prevent it in the future.
The strain or tendonitis can come from many different things including:
Over-pronating in weight bearing
Hypomobility in the heel joint
Decreased arch control.
It is important to have a physical therapist assess your range of motion, strength, and balance to determine what exactly could be causing the problem.
The Key to Returning to Sport Following Ankle/Foot Injuries
Physical Therapy!!! Did you expect anything less? Don't believe me? Listen to these guys!
Rehabbing your injured foot or ankle is very important to returning to normal walking and balance in order to progress back to your previous level of play and function.
If you’re suffering from ankle or foot pain, you need to schedule an assessment by yours truly! You can visit my website by clicking here to schedule a No-charge phone consultation so we can determine the best plan of action to get you back to where you need to be.