The ankle is the joint that creates the intersection for the foot and leg bones. It also makes it possible for the foot to hinge upward and downward. Typically when people talk about the ankle, they are referencing the joint and the area around it, extending from the top of the foot to the base of the leg. A person may experience ankle pain if the muscles, tendons, ligaments, tendons, or bones in the area became damaged or inflamed. Pain in the ankle is often experienced alongside other symptoms such as weakness, stiffness, or instability; bruising, redness, or swelling; or sensations of pins-and-needles, burning, or numbness.
Often, ankle injuries occur during athletics, but it is easy to twist an ankle on an uneven sidewalk or any other context outside of sports. These injuries strike people at all ages. Interestingly, 15-24-year-old males are likelier than females of the same age to experience ankle sprains; however, among those aged 30 and above, women are more susceptible than men to the injury. Sports are responsible for half of ankle sprains. An incredible 25,000 people suffer from ankle sprains daily in the United States. Ankle injuries, as a general category, result in over 1 million emergency room visits annually. Fractures and sprains are the most frequently occurring ankle injuries. However, tendon tears and strains can also happen.
Let’s look at three broad conditions that might cause someone to experience pain and other symptoms in their ankles.
Fractures, sprains, and strains
When we talk about ankle injuries, the most logical way to do so is to categorize the types of damaged tissue: tendon, ligament, or bone. The talus of your foot connects with the fibula and tibia of the leg at the ankle. Ligaments, connective bands of tissue that allow the ankle to move while stabilizing bone position, are responsible for binding these bones to one another at the ankle. Finally, muscles are connected with bones via tendons, allowing for motion and stability.
If you experience an ankle fracture, that means you break a bone or multiple bones at your ankle. If you sprain your ankle, that means that you have pulled or stretched ligaments beyond their capacity, resulting in injury. Sprains can be complete ruptures or tears, or they can be composed of various tiny tears. Finally, muscles and tendons can become strained – which is stretching beyond the range of motion.
People will often experience strains of the muscles or tendons in the lower back and legs. The strains that occur within the ankles typically involve the peroneal tendons that shield the ankle and give it stability. When these tendons are subjected to a force or are overused, inflammation – called tendinitis – can result. An incident of trauma can result in acute tears of the tendon. A person might develop tendinosis if they experience excessive stretching over and over, resulting in many different microscopic tears. A rupture is also possible, as is a subluxation, in which the tendon shifts from its natural position.
Osteoarthritis, rheumatoid arthritis, and gout are all types of arthritis that can impact the ankles – bringing with them symptoms such as pain and inflammation:
- Osteoarthritis (OA) is a chronic condition and the most frequently occurring type of arthritis. In OA, there is degeneration of the cartilage that acts as the padding at the ends of your bones where they connect to the joints. Without the cartilage there is bone-on-bone friction – producing pain, giving rise to stiffness, and decreasing mobility. In the region, OA is most often experienced in the big toe; but it can also occur in the ankle.
- Rheumatoid arthritis is characterized by the body’s immune system errantly targeting the membrane around the joints, the synovium. Pain, inflammation, and disability can result. Approximately 9 out of every 10 people who have rheumatoid arthritis experience it in the joints of their ankles and feet.
- Gout occurs when uric acid, which is a waste product, is left within the joints and other tissues as deposits of monosodium urate crystals. The beginning of gout is often pain or inflammation in the big toe following an injury or illness. Additional joints, such as the ankles, are often impacted thereafter. If the disease progresses, tophi, uric acid lumps, can start accruing under the skin at the ankles.
One other common ankle problem is Achilles tendinitis. In this condition, the tendon becomes inflamed. Inflammation occurs naturally when disease or injury occurs. Achilles tendinitis can be subdivided by the region of the tendon in which inflammation occurs:
- Noninsertional Achilles tendinitis – In this version, fibers in the middle of the tendon develop tiny tears, become thicker, and swell.
- Insertional Achilles tendinitis – In this version, the lower heel is impacted at the point where the heel bone and tendon connect.
Are you experiencing pain or other symptoms in your ankles? As a board-certified orthopedic surgeon, Dr. Dominique Nickson provides diagnosis and treatment to patients with ankle problems. Learn more.
Call us at (972) 547-0047 or book an appointment online.