Unlike other joints, the ankle joint is more susceptible to injury. Ankle pain often occurs as a result of injuries and sprains. Due to the enormous strain placed on it in everyday life and during sporting activities, ankle pain is a very common complaint. Here you will find further information as well as selected specialists and centers for ankle pain.
The ankle joint is subjected to heavy strain every day. With every step we take, our ankle joints bear around five to seven times the weight of our body per square centimeter. This means that the load on the ankle joint is considerably greater than on any other joint in the body.
The ankle joint is subject to very high pressure, especially during certain sporting activities.
Although the ankle joint has been challenged and constantly stressed throughout its life, it is a very enduring joint. For example, osteoarthritis occurs less frequently in the ankle joint than in other joints such as the knee or hip.
In common parlance, we use the term "ankle pain" to describe any pain in the area between the lower leg and foot. However, ankle pain is actually only pain in the upper ankle joint. This joint is the actual ankle.
However, from a medical-anatomical point of view, pain in the ankle joint is not limited to pain in the ankle. The lower ankle joint can also cause pain. Pain that occurs as a result of damage to ligaments and muscles also counts as ankle pain.
Pain in the ankle does not always have to affect only the ankle (the upper ankle joint) © cirquedesprit | AdobeStock
The ankle joint is the connecting joint between the foot and lower leg and enables us to walk normally and upright. It is made up of the upper and lower ankle joints.
The upper ankle joint (OSG for short) consists of three different bones. These are
Tight ligaments around the joint are essential for cushioning, support and stability. They stabilize the joint. In the upper ankle joint, a distinction is made between the inner ligaments and the outer ligaments.
The ankle joint is surrounded by a capsule. The upper ankle joint and its ligaments enable movement between the foot and lower leg. This allows us to raise and lower the foot, roll it when walking and push off when jumping.
Due to its complexity, the lower ankle joint (USJ for short) is even more susceptible to injury than the upper ankle joint. It is therefore also more frequently responsible for ankle pain. The lower ankle joint also consists of several bones. It is held in place by multiple ligaments.
When standing on an inclined plane and running on very uneven ground, the lower ankle joint stabilizes the gait. As stability is automatically reduced when the foot is lowered, this often results in
This can cause considerable ankle pain. Cartilage damage can also cause further injuries to the ankle joint.
Anatomy of the ankle joint © bilderzwerg | AdobeStock
Due to the complex anatomical structure of the ankle joint, there are many different causes of ankle pain.
Ankle pain is usually the result of
Congenital ligament weaknesses or misalignments can also be a cause of ankle pain.
If the inner or outer ligaments are chronically overloaded or injured by a tear or strain, they cause pain.
People who suffer from a congenital weakening of the ligaments twist more easily and more frequently.
Fractures in the upper ankle joint can cause severe ankle pain. An ankle fracture is usually accompanied by a pulled or stretched ligament or a torn ligament.
Osteoarthritis is a collective term for all signs of wear and tear in joints. Osteoarthritis can also occur in the ankle joint and cause severe pain and associated movement restrictions.
Osteoarthritis of the ankle is less common than osteoarthritis of the hip or knee. Nevertheless, osteoarthritis of the upper ankle joint is one of the so-called widespread diseases.
In osteoarthritis, the protective layer of cartilage in the ankle joint gradually wears away. As a result, the load-bearing capacity decreases and the affected patients complain of very severe ankle pain.
Athletic people are affected more frequently. Sports involving rapid changes of direction and jumping in particular put a lot of strain on the ankle joint. In the long term, this can lead to considerable signs of wear and tear in the ankle joint. High-risk sports include, for example
Ankle arthrosis can have the following causes in addition to overloading through sporting activities:
However, previous injuries are a more common cause.
Pain in the ankle joint varies depending on the cause and location. Bones as well as ligaments and muscles can be responsible for ankle pain.
Injuries at the junction of bones and ligaments tend to be perceived as localized pain. If inner or outer ligaments are torn or ruptured, the pain is more likely to be widespread and spread across the foot.
Torn and stretched ligaments are accompanied by massive swelling or bruising. These press on the surrounding tissue and cause severe pain in the ankle.
Scarring of the tissue can sometimes occur during the healing process. This can also lead to pain in the ankle and blockages. Blockages considerably restrict the mobility of the ankle joint.
Particularly in certain postures of the foot or with special loads, pulling ankle pain occurs.
The pain usually increases with
increase.
Pain manifests itself due to an illness or injury. In order to treat the pain in the long term, the cause must first and foremost be identified and treated. Taking painkillers without treatment can worsen the symptoms and limitations over time.
Untreated instability also increases the strain on the cartilage and can lead to osteoarthritis. You should therefore consult a doctor at an early stage, who can then initiate cause-specific treatment.
After taking a medical history, the doctor will examine the ankle joint. During the palpation examination, the doctor will check the painful points by applying pressure as well as the stability.
As a rule, further diagnosis is made using x-rays of the foot. X-rays or magnetic resonance imaging (MRI) are well suited for diagnosing bony or ligamentous injuries. Injuries to
can be clearly identified and their structure imaged.
The bony structures of the foot in an X-ray image © Silvano Rebai | AdobeStock
As a rule, treatment is carried out by specialists in trauma surgery or orthopaedics.
The treatment of ankle pain depends on the diagnosis, i.e. the cause of the ankle pain.
In the case of a torn ligament, a splint is usually prescribed.
A plaster cast is often necessary for a fracture of the upper ankle joint. Depending on the type of injury, surgery may also be indicated.
In the case of sprains and strains, immobilization and relief using a splint is usually sufficient. The ankle joint should be protected and the swelling reduced by elevating the foot. In some cases, complete immobilization is not necessary or even recommended.
If torn ligaments do not grow back together despite splinting, ankle surgery may be necessary. The aim is either to join the existing ligaments or to replace them. Ankle arthrosis may also require surgery.
Arthroscopy is often used for ankle joint surgery. This is a minimally invasive procedure that does not require a large incision. Instead, a few small incisions are sufficient.
Arthroscopy can be used, for example, to discover and remove bone splinters that have become detached in a fracture.
Physiotherapy is also often an important part of medical treatment and the healing process. Physiotherapy serves to stabilize the impaired joints and permanently resolve the ankle pain.
Especially in sports such as
There is a risk of sustaining injuries that subsequently cause pain in the ankle joint. This is why it is particularly important for athletes to wear the right footwear.
Warm-up exercises and stretching exercises before sporting activities also help to minimize the risk of injury. Stretching exercises can also help with pre-existing pain in the ankle joint and have a preventative effect at the same time.
Depending on the type of sport, previous history and risk of injury, supportive supports may also be useful during sport.
Additional support for the ankle joint during sport can be provided by taping or wearing special orthoses. However, taping and support stockings are not aids for relieving the strain on healthy, resilient and fully functional ligaments.
Physiotherapy plays an important role in preventing ankle pain. Those affected can regain the necessary stability by strengthening the muscles. This helps to prevent accidents such as repeated twisting of an ankle.
Regular training of the shin muscles is recommended to prevent ligament injuries. If the affected person suffers from misalignments or incorrect loads when running, suitable physiotherapy can help to correct these problems.
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