Your ankle is made up of bones that are supported with muscles and ligaments that balance and stabilize your body. Ankle disorders can result from damage to the bone, muscle, or soft tissue. Common ankle disorders include:
- sprains (injury to ligaments)
- tendonitis (inflammation of the tendons)
- arthritis (chronic inflammation of joints)
The ankle is the most frequently injured joint in the body. According to research published by the Walter Reed Medical Center, more than 20,000 ankle sprains occur each day in the United States. (Cooper, et al., 2011)
The causes of ankle disorders vary and can range from everyday activities, such as running and jumping, to sports-related injuries that are caused by overuse. Ankle sprains and fractures are commonly caused by:
- twisting or rotating the ankle beyond the normal range of motion
- tripping or falling
- landing on the foot with increased force
Tendonitis in the ankle or Achilles tendonitis can be caused by:
- lack of conditioning for the muscles in the leg and foot
- placing excess strain on the Achilles tendon (tendon that connects your calf muscles to your heel)
- bone spurs in the heel that rub on the Achilles tendon
Different types of arthritis (inflammation of joints and tissues) can also affect the foot and ankle.
Osteoarthritis is a degenerative type of arthritis that typically begins in middle age and slowly progresses. Over time, cartilage between the bones becomes worn down, resulting in pain and stiffness in the joint.
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease. This occurs when the body mistakenly attacks its own healthy tissues. RA affects the joints and also destroys cartilage.
Post-traumatic arthritis occurs after an injury to the foot or ankle. Stress from the injury can cause joints to become stiff or inflamed, even years after the injury occurred.
The symptoms of ankle disorders will vary based on the specific type of injury you have. Common symptoms include:
- problems moving the ankle
- the inability to put any weight on the ankle
- difficulty walking
Tendonitis and Achilles tendonitis may produce similar symptoms, but can be accompanied by:
- pain along the back of the heel that gets worse throughout the day
- thickening of the tendon
- swelling that gets worse with physical activity
- a loud popping sound at the back of the heel, signaling a ruptured tendon. If this occurs, seek emergency medical attention.
To diagnose an ankle disorder, your doctor will evaluate your symptoms, examine your ankle and foot, and ask about any recent injuries. To look for bone fractures or tendon tears, additional imaging tests will be needed. These tests include:
- magnetic resonance imaging (MRI)
- computed tomography (CT) scan
Treatment will depend on your specific condition and your symptoms. Treatments will include nonsurgical and surgical options. Nonsurgical options involve:
- taking pain medications
- taking medications to reduce swelling and inflammation (such as aspirin or ibuprofen)
- resting and elevating the ankle
- ice packs to reduce swelling
- compression bandages or casts to immobilize the ankle
- cortisone (steroid) injections to reduce pain and swelling
Severe fractures or ruptured tendons may require surgical treatment. Surgical procedures used to treat ankle disorders include:
- reconstruction to rebuild bones and joints in the ankle
- removal of damaged tissue (debridement)
- lengthening the calf muscles to reduce pressure on the Achilles tendon
- fusion of the bones in the ankle to make the ankle more stable (arthrodesis)
- replacement of the ankle joint (arthroplasty)
If you have an ankle disorder, your long-term outlook will depend on the severity of your disorder and the amount of damage that has occurred to the ankle. It will also depend on whether or not you need surgery. Ankle sprains are quite common and generally heal within six weeks. Similar outcomes can be expected if you have an ankle fracture and do not require surgery.
If your ankle disorder requires surgery, full recovery may take several weeks or months. You may also need physical therapy after surgery to help strengthen your ankle. Physical therapy may last as long as 12 months.
Although surgery for most ankle disorders can be helpful for improving mobility, all surgical procedures carry potential risks, including the potential for infection and nerve damage. According to the American Academy of Orthopaedic Surgeons (AAOS), the most common complication is moderate to severe pain following surgery. (AAOS, 2010)
You can prevent ankle disorders by maintaining good physical fitness, strength, and flexibility. Regular exercise is crucial for building strong bones and maintaining good balance. Other behaviors that can prevent ankle disorders include:
- stretching and warming up before and after physical activity
- wearing comfortable shoes that provide ankle support
- paying attention to your body’s warning signs—don’t push yourself too hard