Ankle Pain Treatment & Physiotherapy Coventry, Warwickshire

The ankle is a "hinged" joint capable of moving the foot in two primary directions: away from the body (plantar flexion) and toward the body (dorsiflexion). It is formed by three bones. The end of the shinbone of the leg (tibia) and a small bone in the leg (fibula) meet a large bone in the foot, called the talus, to form the ankle. The end of the shin bone (tibia) forms the inner portion of the ankle, while the end of the fibula forms the outer portion of the ankle. The hard knobs on each side of the ankle are called the malleoli. These provide stability to the ankle joints, which function as weight-bearing joints for the body while standing and walking. Ligaments on each side of the ankle provide stability by tightly strapping the outside of the ankle (lateral malleolus) with the lateral collateral ligaments and the inner portion of the ankle (medial malleolus) with the medial collateral ligaments. The ankle joint is surrounded by a fibrous joint capsule. Tendons that attach the large muscles of the leg to the foot fit around the ankle both from the front and rear. The large tendon (Achilles tendon) of the calf muscle passes behind the ankle and attaches at the back of the heel. A large tendon of the leg muscle (posterior tibial tendon) passes behind the medial malleolus. The peroneal tendon passes behind the lateral malleolus to attach into the foot.

The ankle has the ability to move the foot, from the neutral position to right-angle position to approximately 50 degrees of plantar flexion and to approximately 25 degrees of dorsiflexion. The powerful muscles that move the ankle are located in the front and rear of the leg. These muscles contract and relax while in motion.

Causes and Treatment.

Inflammatory types of arthritis (inflammation of the joint) that can involve the ankle area include rheumatoid arthritis, reactive arthritis, gout arthritis, ankylosing spondylitis, and proriatic arthritis, among others. They generally are not induced by trauma injury and develop gradually. These types of arthritis are associated with pain, swelling, stiffness, and warmth in the afflicted area. Other conditions of the ankle which can cause ankle pain include tarsal tunnel syndrome. This is a result of nerve compression at the ankle as the nerve passes under the normal supportive band surrounding the ankle called the flexor retinaculum. Tarsal tunnel syndrome. Infections of the ankle joint are rare. They most commonly occur as a result of bacteria being introduced into the ankle joint through a wound or trauma. They also occur with a breakdown of the skin over the ankle as a result of ulcerations or abrasions It is possible to develop viral infections of the ankle joint Treatment by cold laser therapy. (See our cold laser section under conditions treated).

A "hinged" joint.

Ankle sprains ranges from mild (which can resolve within 48 hours) to severe which can require Cold Laser Therapy or surgical intervention.

Tendinitis of the ankle can be caused by trauma or inflammatory arthritis and is treated with cold laser therapy.

Treatment of Tendinitis

Tendinitis is an inflammation of the tendon. Tendinitis of the ankle can involve the Achilles tendon, the posterior tibial tendon, or the peroneal tendon. This condition usually results from trauma but can result from underlying inflammatory diseases or illnesses such as reactivearthritis (formerly called Reiter's syndrome), rheumatoid arthritis, and ankylosing spondylitis. All forms of tendinitis cause pain, swelling, and tenderness in the tendon area involved. The onset may be rapid, such as with an athletic injury. Immediate treatment involves immobilizing the area, elevation, and limiting weight-bearing, applying ice, and using cold laser therapy. (See our Cold Laser Section under conditions treated). To decrease inflammation To the hip joint Participation in sport should be limited when the tendon is still inflamed, as there is a significant risk of rupturing or tearing the tendon, especially in the Achilles area,. A rupture of the Achilles tendon is more frequent in patients who have had previous Achilles inflammation. (See cold laser section under conditions treated).

Sprained Ankle, Fractures & Injuries

Deltoid sprain and a Lateral sprain are the most common musculoskeletal injuries to the ankle. An ankle sprain is an injury to the ligaments of the ankle resulting in partial or complete tear following sudden twisting or stretching. The ligament injuries can occur on either or both of the inner and outer portions of the ankle joint. A sprained ankle injury commonly happens in the joint with pre-existing muscle weakness or a history of previous ankle injuries.

The typical injury occurs when the ankle is suddenly "twisted" in a sports activity or by stepping off an uneven surface. The pain is initially severe and can be associated with a "popping" sensation. Immediate swelling in the area of injury often occurs as the injured blood vessels leak fluid into the local tissue.

Examination of the area may cause extreme pain when the ankle is moved. The level of pain may not necessarily indicate the level of damage to the ligaments. Ligament injuries are often assessed on the grade from I to III, ranging from partial to complete tears. Partial tears retain some or little ankle stability, whereas complete tears cause loss of stability because the strapping action of ligaments is no longer bracing the ankle joint. After an examination, significant ankle sprains are commonly evaluated with an x-ray. Digital X-rays can determine whether there is a break (fracture) of the bone.

A sprained ankle is initially treated with ice, rest, and limitation of the amount of walking and weight-bearing on the injured ankle. The leg can be elevated to reduce swelling, and crutches are often recommended to avoid further trauma to the injured ligaments. Anti-inflammatory medications can be given to reduce local inflammation. Ice packs help decrease further swelling of the area and can reduce pain.

Cold or Low level laser therapy accelerates the healing process to the afflicted area, bringing fast and effective pain relief. Patients with severe injuries are placed in immobilization casts. Surgical repair of grade III injuries is considered, especially for those patients contemplating future athletic participation. Physical therapy programs are part of the rehabilitation process, incorporating strengthening exercises of the lower leg muscles. Fractures are repaired with casting to immobilize the bone for healing. Depending on the severity, fractures can require orthopaedic casting, surgical procedures including pinning, and open repair of the fractured bone.

Cold or Low level laser therapy has a 5 star rating for healing and pain relief of ankle sprains, fractures and injuries, further information can be found in our pain relief section.