Common foot and ankle injuries - sports and orthopedic medicine (2023)

What types of ankle injuries are there?

Sprains, strains etcfractures

Ankle injuries are defined by the type of tissue damaged (bone, ligament, or tendon). Three bones meet at the ankle: the tibia and fibula of the lower leg with the talus of the foot. These bones are held together at the ankle by ligaments, which are strong elastic bands of connective tissue that hold the bones in place while allowing normal movement of the ankle. Tendons attach muscles to bones to move the ankle and foot and keep joints stable.

A fracture describes a break in one or more bones. A sprain is the term used to describe damage to the ligaments when they are stretched beyond their normal range of motion. A sprained ligament can range from many microscopic tears in the fibers that make up the ligament to a complete tear or tear. A strain refers to damage to muscles and tendons from excessive pulling or stretching.

Muscle and tendon strains are most common in the legs and lower back. There are two tendons in the ankle that often become tense. These are the peroneal tendons that stabilize and protect the ankle. They can become inflamed from overuse or trauma. Acute tendon ruptures are the result of sudden force or trauma. Inflammation of a tendon is called tendonitis. Microscopic tears in the tendons that accumulate over time from being repeatedly stretched and not healing properly lead to a condition called tendinosis. Tendons can also tear. Subluxation refers to slippage of the tendon.

What Causes Ankle Injuries?

An ankle injury occurs when the ankle is twisted too far from its normal position. Most ankle injuries occur while playing sports or walking on an uneven surface that forces the foot and ankle into an unnatural position. The unnatural position of the ankle in high-heeled shoes or walking in loose, unstable clogs or sandals also contribute to ankle injuries. In addition to wearing faulty shoes, an ankle injury can occur from:

• stumble or fall
• Clumsy landing after a jump
• Walking or running on uneven ground
• A sudden impact such as B. a car accident.
• twisting or twisting of the ankle
• roll the ankle

Are there different signs for different ankle injuries?

The symptoms of a sprain and a fracture are very similar. In fact, fractures can sometimes be confused with sprains. That's why it's important to get an ankle injury checked out by a doctor as soon as possible. Signs include:

• Pain, often sudden and violent
• swelling
• hematoma
• Inability to walk or put weight on the injured joint

A sprain can also cause the ankle to become stiff. If there is a fracture, the area will feel tender and the ankle may also appear deformed or dislocated.

If the sprain is mild, the swelling and pain may be mild. But with a severe sprain, there is a lot of swelling and the pain is usually severe.

Tendonitis and acute ruptures of the peroneal tendon cause pain and inflammation. In addition, the ankle area feels hot with tendinitis. An acute tear results in weakness or instability of the foot and ankle.

It can take years for tendinosis to develop. Symptoms include:

• Intermittent pain on the outside of the ankle.
• Ankle weakness or instability
• An increase in the height of the arch of the foot.

With a subluxation, you notice instability or weakness in your ankle. You may also notice sporadic pain behind the outer ankle and a "popping" sound around the ankle.

What should someone do after an ankle injury?

You can provide first aid for an ankle injury by remembering R.I.C.E: Rest, Ice, Compression, Elevation.

• Relax. It's important to rest your ankle to prevent further damage and take the weight off your ankle.
• It is. Using ice will help slow or reduce swelling and provide a numbing sensation that reduces pain. Proper freezing includes freezing within 48 hours of an injury. Never leave the ice on for more than 15 to 20 minutes at a time to avoid frostbite. Wait 40 to 45 minutes before re-icing to allow the tissue to return to normal temperature and sensation, and repeat as needed. You can apply an ice pack with a plastic freezer bag filled with ice cubes and water to mold to the ankle, or use a frozen bag of vegetables such as corn or peas (do not eat and refreeze after use), using a layer of towel in between the skin and the plastic bag.
• Compression. Wrapping the injured ankle in an elastic bandage or ready-made compression bandage will help keep it immobilized and supported. Make sure you don't wrap your ankle too tightly. If the toes turn blue, cool down or lose the feeling that the bandage is too tight.
• Lift. Raising the injured ankle at least to heart level reduces swelling and pain.

It is important not to put any strain on the ankle until it has been examined by a doctor, which should be done as soon as possible. Fractures and sprains that are ignored or not treated properly can lead to chronic, long-term ankle problems such as recurrent injuries, ankle weakness and arthritis.

How does a doctor diagnose an ankle injury?

The first thing a doctor will do is ask questions about how the injury occurred. The doctor will then examine the ankle and determine the extent of the swelling and bruising. Physical examination of the ankle can be painful because doctors need to move the ankle to assess pain and swelling to make a correct diagnosis.

For most ankle injuries, pain is controlled with over-the-counter medications, such as acetaminophen or another nonsteroidal anti-inflammatory drug, such as ibuprofen. The specific treatment for injuries depends on the type of injury.

fracture treatment

Fractures can be treated surgically or non-surgically. The doctor can treat the fracture without surgery by splinting the ankle if only one bone is broken and the bones are not misplaced and the ankle is stable. Usually, the doctor will do this by applying a splint, which works like a splint, or by applying a cast. If the ankle is unstable, the fracture is treated surgically. Often the ankle is stabilized with a metal plate and screws to hold the bones in place. After the operation, the ankle is fixed with a splint and then with a plaster cast until the swelling has subsided.

Bones usually take at least six weeks to heal. Your doctor will likely ask you to take weight off your ankle during this time to allow the bones to heal and align properly. Ligaments and tendons may take longer to heal after a fracture has been fully repaired. It can take up to two years to regain full range of motion and strength without pain after an ankle fracture, although most people are able to resume normal daily activities within three to four months.

Once your doctor has determined it's safe for you to move your ankle, you may need physical therapy to help with gait, balance, strengthening, and mobility exercises. The therapist will develop a home program that will allow you to return to your previous normal function. It may take several months before you return to a normal walk without a limp.

treatment of sprains

Sprain treatment depends on the severity of the injury. They are classified as easy, moderate or difficult. Surgery is generally not a treatment option unless the damage is extensive, affects more than ligaments, or when other treatment options have failed.

Mild sprains, called Grade 1, are treated using the RICE method for several days until the pain and swelling subside. If you have a minor sprain, you don't need a splint or cast. Your doctor will direct you to put on ankle weights soon, in one to three days, for as long as you can tolerate, and will prescribe range of motion, stretching, and strengthening exercises.

If your sprain is classified as moderate or grade 2, your doctor will use the RICE approach but allow more time for healing. The doctor may also use a device such as a boot or splint to immobilize the ankle. You will be given exercises to first improve your range of motion and then stretch and strengthen your ankle. Your doctor may also prescribe physical therapy to help you regain full use of your ankle.

Grade 3, or a severe sprain, involves a complete tear or rupture of a ligament and takes much longer to heal. It is treated with immobilization of the joint, followed by an extended period of physical therapy for range of motion, stretching, and strengthening. Occasionally, particularly if the sprain does not heal in a reasonable amount of time, surgery to repair the torn ligaments is considered.

On average, initial treatment for a sprain involves resting and protecting the ankle until the swelling goes down for about a week. This is followed by a one to two week exercise period to restore mobility, strength and flexibility. It may take several weeks to several months before you gradually return to your normal activities while continuing to exercise.

Treatment of tendon injuries

The options for treating tendon injuries are similar to treating sprains. They include:

• Plaster or splint immobilization
• Oral or injectable anti-inflammatory drugs for pain relief.
• Physiotherapy for mobility, strength and balance
• A bandage to support activities.
• Surgery to repair the tendon or tendons and sometimes to repair the supporting structures of the foot.

Can ankle injuries be prevented?

The National Institute forArthritisand Musculoskeletal and Skin Disorders recommends the following steps to reduce the risk of ankle injury:

• Avoid moving or playing sports when you are tired or in pain.
• Keep your muscles strong by eating a balanced diet.
• Maintain a healthy weight.
• Try to avoid falls.
• Wear shoes that fit well and are appropriate for the activity you are doing.
• Do not wear shoes with heels worn on one side.
• Practice every day.
• Maintain the right physical condition for every sport you play.
• Warm up and stretch before exercising or exercising.
• Wear the right gear for every sport you play.
• Walk on flat surfaces.