Ankle pain can include joint, ligament or tendon and other structures. The most common injuries that present are of the following:
- Achilles Tendinopathy
- Lateral (outside) tendinopathy or sprain
- Osteoarthritis or synovitis of the Ankle Joint
Is a debilitating injury sustained due to overuse or acute injury to the lower gastrocnemius and soleus muscles. It is the thickest and strongest tendon in the body beginning approximately half way down the leg and inserting at the back of the calcaneus (heel bone). It is primarily responsible for enabling propulsive takeoff during walking and running and hence absorbs massive strain and loading when carrying out this role. Injury to the tendon can be directly at the insertion, through the tendon itself or involve surrounding tissue including the sheath or fluid bursae opposing the tendon. Podiatrists at Stonnington Podiatry are experts at diagnosing and treating such conditions which often requires advanced diagnostic and treatment options including assessment of one’s biomechanics and gait, footwear and often the application of heel lifts and/or orthoses. Strengthening of the calf and stretching is also required, and modified rest from activity. Allied health involvement is also required and our podiatry team can guide you for this. Early intervention is essential for a quicker recovery.
Generally caused by an acute rolling of the ankle during activity, ankle or inversion spraining can be debilitating during acute stages and cause continuing pain and frustration if left to progress becoming a chronic inflammatory condition. Spraining usually causes varying degrees of pain and damage to three ligaments that support the lateral or outside of the ankle. Often other structures can be damaged also including bone, joint capsule and tendons. Diagnosing the specific tissues and severity of their involvement in the injury involves an in depth understanding of the foot and ankle. Podiatrists are able to assess such problems, diagnose the injury type and severity and create a treatment plan specific to the needs of the patient. Footwear, splinting, taping, and orthoses options are combined with other therapies to bring about resolution of the ankle pain.
OSTEOARTHRITIS / SYNOVITIS
A form of arthritis whereby the talo-crural or ankle joint is subject to various forms of degenerative changes including loss of articular cartilage, bony thickening or sclerosis, formation of bony or cartilaginous masses in the joint, and inflammation of the synovial membrane that encapsulates the joint otherwise known as synovitis. Sufferers report varying degrees of pain and range of motion limitation that may range anywhere from morning stiffness to complete loss of function due to debilitating pain. X-rays and ct scans are generally used to establish a diagnosis and severity of the problem so as to help devise treatment strategies to minimise the pain and limit the condition from progressing.
Treatment varies depending on the condition but may include orthotic therapy, massage, stretching, and allied health referral for mobilisation and strengthening / proprioceptive training. So when considering your treatment options for all forms of ankle ailments remember a podiatrist is the only foot and ankle specialist and should be your first point of call.
TIBIALIS POSTERIOR DYSFUNCTION
Tibialis posterior dysfunction is a inflammatory disorder affecting the tibialis posterior muscle on the inside of the leg and foot. This muscle is primarily responsible for the maintenance of arch height and for stiffening and stabilising the foot during the propulsive phase of gait.
This disorder is caused by:
- Tight tibialis posterior muscle/tendon
- Weak tibialis posterior muscle
- Abnormal foot position
- Poor footwear that does not provide enough support.
Tibialis posterior dysfunction can present as a ‘flat foot’ or one with a reduced arch height. There is often pain when walking on the inside of the foot that can travel up the inside of the leg. There is usually a ‘bulging’ on the inside of the foot, when observed from behind.
Treatment of this condition is usually therapy to reduce the inflammation such as ice and anti inflammatories; massage and stretching to reduce tightness in the muscle and strengthening exercises to build up weak muscles. Orthoses are also a key to support the muscle, increase arch height and allow normal muscle function of the foot during gait without damaging the tibialis posterior muscle and tendon.
For further information on this or any other foot, ankle or lower limb related problems, contact Stonnington Podiatry.