Injuries to the ankle are commonly dismissed as being of little significance, although there are multiple things that can be injured in an ankle injury, including ligaments, tendons and fractures (Large fractures, small fractures of the joint surface or avulsion fractures).
Lateral Ankle Injuries
The Ligaments of the lateral ankle (outside) are most commonly injured when you "roll" your ankle (Inversion). The 2 major ligaments that are injured are the Anterior Talofibular Ligament (ATFL) and the Calcaneofibular Ligament (CFL).
Swelling will generally be located around the lateral malleolus and into the foot. The severity of the injury will determine if it is painful to walk or not. A thorough examination by a physiotherapist is important in diagnosing the injury and they can refer for an x-ray if it is indicated.
Medial Ankle Injuries
Injuries to the medial (inside) side of the ankle are less common than the lateral side. They commonly occur from a forced movement in that direction, like someone landing on it in a contact sport. The ligament on the inside of the ankle is called the Deltoid Ligament. It is a large and strong ligament. When it is injured it can be common for an associated fracture or injury to the talar dome to occur.
Injuries to the deloid ligament take longer to heal and hence return to sport/activity can be upto twice as long as a lateral ligament injury
High Ankle Sprain
Is an injury to the Syndesmosis. What is a syndesmosis you ask? Well the syndesmosis located between the bottom end of the Tibia and Fibula (shin bones). The Ligament that holds these two bones together is called the Anterior Tibiofibular Ligament. When is is torn you can also split the interosseous membrane between the Tibia and fibula as well. These injuries are diagnosed with clinical tests and can be confirmed with a weight bearing x-ray.
Swelling will generally start a lot higher up the shin than the previously mention ankle injuries. It is managed in a moonboot or if severe surgery to hold the 2 bones together.
Tendonopathy is a term used to describe injury to a tendon. It is broad in nature and can encompass many injuries to the tendon, although the mechanism of injury is that of over use from a repetitive task. eg. Running.
Common Tendonopathies around the ankle include:
- Tibialis Posterior Tendonopathy
- Peroneal Tendonopathy
- Flexor Hallicus Longus Tendonopathy
- Achillies Tendonopathy
Treatment of a Tendonopathy requires the physio to find the cause of the overload on that tendon. This may be from a biomechanical issue, strength/weakness, technique, etc. Once the cause has been found they can then treat the local area of the injury and while also working on correcting the underlying cause. There is no quick fix for tendonopathies, but undertaking the correct rehabilitation is crucial to getting you back to the activities you enjoy.