The ankle is one of the body’s hinge joints — connecting the long bones of the leg with the many intricate bones of the foot. Our ankles give us the flexibility to walk, run, jump, and dance, pivot from side to side and spring forward and backwards. The ankle, and the heel below it, engages with every step we take, making them subject to a great deal of wear and tear.
The ankle joint is made up of the union of three bones, and they proved the push and pull active that moves the joint. An injury to any of these bones, ligaments, muscles and tendons can cause pain and swelling and should be treated. The most common injuries are covered below.
Ankle sprains
Ankle sprains involve a tear in the ligament, which connects bone to bone. They are common to both athlete and the less active. About half result from athletic activities; the rest from everyday activities such as turning an ankle on an uneven sidewalk or going over on high heels. Most sprains occur on the outer side of the ankle and range from mild (only involving microscopic tears) to moderate (larger tears) to severe (where the ligament is completely torn causing serious instability to the joint).
Ankle strains
Ankle strains involve the muscles or tendons, which connect the muscles to the bones. These can be damaged when they are pulled or stretched because of overuse trauma.
Ankle fractures
Ankle fractures involve the bones in your ankle. Ankle fractures, sprains and strains can often look alike, causing pain, swelling and making it difficult to put weight on the ankle. As a result, see a doctor if there is significant swelling, the ankle looks misshapen or if you find it very painful to walk even a few steps. If a fracture is suspected, an X-ray will be ordered.
Heel pain
Heel pain is common in runners, the middle aged, people who are overweight, those whose jobs require prolonged standing, and pregnant women, It might involve injury to the hell bone or to the ligaments, tendons, muscles or the heel pad. Heel pain can also be caused by gait problems, such as rolling you feet inwards; shoes that don’t fit or don’t provide support; or by standing, running or jumping on hard surfaces.
Achilles tendinitis
Achilles tendinitis stems from inflammation of the Achilles tendon, a common problem for runners and those who walk for exercise, It causes pain at the back of the heel, where the Achilles tendon attaches to the heel.
Plantar fasciitis
Plantar fasciitis affects the main arch ligament that stretches from the heel to the forefoot. Either a tear or inflammation can be painful, especially with first putting weight on the foot in the morning.
Treatment
Mild ankle sprains and strains can usually be treated at home, guided by the RICE acronym:
¦ Rest the ankle to allow it to heal and don’t return to sports until its complete healed
¦ Ice the ankle to reduce swelling and inflammation
¦ Compression. Wrap the ankle with an ACE bandage to help control the swelling
¦ Elevation. Keep your foot up, preferable above the level of your heart.
Moderate ankle sprains and strains should be evaluated by a doctor. These may need a removable cast to provide stability and support. The most severe sprains may require surgery, but in many cases even a complete tear can heal if it is properly immobilized.
A simple fracture, when the bones are still in alignment, can usually be treated by setting the ankle in a short leg cast, your doctor will want to follow up with further X-rays to check that the bones are healing and staying in alignment. When there is separation of the bone, or there are band fragments, surgery is usually required to reposition and stabilize the bones using metal plates and screws. The foot and ankle will be in a cast and normally take six weeks to heal.
Most heel problems are treated with a combination of rest, anti-inflammatory drugs to deal with both the pain and inflammation, exercises to strengthen and maintain flexibility in foot muscles, taping to provide support, orthotic shoe inserts for cushioning and support, and in some cases special shoes that provide correction for biomechanical problems.
We count on our feet and ankles to keep us mobile. Wearing comfortable, supportive shoes and treating any injuries to ankles or heels promptly will keep us on solid footing as we walk, run and dance our way through life.
Lynette Hilbelink is a physical therapist at Bay Area Medical Center, Marinette.