The bones of the ankle are called tarsal bones and they consist of the;
Cuneiform - medial or internal.
6. Cuneiform – middle.
- lateral or external.
The ankle joint is formed where the leg and foot meet. The ankle aka talocrural joint is a synovial hinge
joint that connects the distal ends of the tibia and fibula in the lower limb with the proximal end of the talus bone in the
foot. The articulation between the tibia and the talus bears more weight than between the smaller fibula and the talus.
The lateral malleolus of
the fibula and the medial malleolus of the tibia along with the inferior surface of the distal tibia articulate with three
(3) facets of the talus. These surfaces are covered by cartilage.
The anterior (front) talus is wider than the posterior (back)
talus. When the foot is dorsiflexed (bringing the toes closer to the shin), the wider part of the superior talus moves into
the articulating surfaces of the tibia and fibula creating a more stable joint than when the foot is plantar flexed (moving
toes away from the shin).
1. The Deltoid Ligament supports the medial side
of the joint and is attached at the medial malleolus of the tibia and connect in four (4) places to the sustentaculum tali
of the calcaneus, calcaneonavicular ligament, the navicular tuberosity and to the medial surface of the talus.
2. The Anterior
& Posterior Talofibular Ligaments support the lateral side of the joint from the lateral malleolus of
the fibula to the dorsal and ventral ends of the talus.
3. The Calcaneofibular Ligament
is attached at the lateral malleolus and to the lateral surface of the calcaneus.
Ankle pain is often due
to an ankle sprain. In addition to ankle sprains, ankle pain can be caused by;
1. Gout occurs when
too much uric acid is produced. Uric Acid is a waste product in the body and when the body produces to much, the extra uric
acid is deposited in the joints and forms crystals.
2. Pseudogout occurs when calcium
deposits are deposited in the joint(s) and the result is pain, redness and swelling.
6. Septic Arthritis.
AKA SPRAINED ANKLE AKA TWISTED ANKLE AKA
ANKLE INJURY AKA ANKLE LIGAMENT INJURY
A sprain is an injury to the ligaments which
connect bones to one another. The ankle joint is more stable in dorsiflexion and a sprained ankle is more likely to occur
when the foot is plantar flexed. This type of injury occurs more frequently at the anterior talofibular ligament which is
also the most commonly injured ligament during inversion (sole faces inward) sprains.
The risk of an ankle sprain is greatest during
activities that involve explosive side to side motion such as tennis or basketball but you can also sprain the ankle during
daily activities such as stepping off a curb or slipping on ice. Chronic Ankle Instability (CAI) is when the ankle heals in
a stretched position resulting in less stability at the ankle joint.
FACTORS THAT CONTRIBUTE TO AN INCREASED RISK OF ANKLE
muscles/tendons that cross the ankle joint especially the peroneal muscles of the lower leg that cross the outside or lateral
aspect of the ankle.
Weak or lax ligaments that join together the bones of the ankle joint.
with inadequate heel support.
Wearing high heeled shoes.
5. Running on uneven surfaces.
Inversion (Lateral) Ankle Sprain is the most common type of ankle sprain occurs when the foot
is inverted too much in which the ankle is rolled over on the outside of the foot. Approximately 90% of ankle sprains are
inversion injuries. The anterior talofibular ligament is one of the most commonly involved ligaments in this type of sprain.
2. Eversion (Medial)
Ankle Sprain occurs when the ankle is rolled over on the inside of the foot. When this occurs, the medial aka deltoid ligament
is stretched too much.
Ankle Sprain is an injury to the large ligaments above the ankle that join together the two (2) long bones of the lower leg
which are the tibia and fibula. High ankle sprains commonly occur from a sudden and forceful outward twisting of the foot
which commonly occurs in contact and cutting sports such as basketball, football and soccer.
CLASSIFICATION OF ANKLE SPRAINS
GRADE ONE (1) SPRAIN there is slight stretching with minimal damage to the fibers in the ligament.
GRADE TWO (2) SPRAIN there
is some tearing of the ligament and the ankle joint moves in abnormal ways.
GRADE THREE (3) SPRAIN there is complete tears of a
ligament and the presence of instability is experienced. Bruising will also be present around the ankle.
OF ANKLE SPRAINS
An Ankle x-ray is required only if there is any pain in malleolar zone
and any of the following findings;
Inability to bear weight on the ankle.
2. Bone tenderness at the posterior edge
or tip of the medial malleolus.
Bone tenderness at the posterior edge or tip of lateral malleolus.
A Foot x-ray is required only if there
is any pain in the midfoot zone and any of the following findings;
1. Inability to bear weight on the ankle.
tenderness at the base of the 5th metatarsal bone.
3. Bone tenderness at the navicular bone.
I C E = REST
ICE COMPRESSION ELEVATION
2. ORTHOPEDIC WALKING BOOT
= Painful to walk with no swelling present.
3. FOOT TO ANKLE TO CALF =
Provides support and compression to reduce swelling.