Foot and Ankle Injuries
The most common injury to the ankle is an inversion sprain or “rolled ankle”. An ankle sprain involves damage to the ligaments, typically the lateral (outer) ligaments (Anterior talofibular ligament) on the outside of the ankle. Occasionally damage can occur to the tendons running behind and underneath the ankle bone which is a more serious injury.
Treatment involves the RICE (rest, ice, compression, elevation) for 48hours (no anti-inflammatories as these can impair the healing process), along with manual therapy to restore normal ankle range and function. Proprioception (sense of limb awareness) and balance exercises are important to restore strength and stability to the ankle, and reduce the risk of recurrence.
An ankle fracture can typically occur in the same fashion as an ankle sprain, ie rolling over on the outside of your ankle. Your physiotherapist is trained in diagnosing the difference between a fracture and a sprain, and will always refer you for an x-ray in the event they suspect a fracture. Treatment for a simple fracture involves immobilising the ankle in a boot or cast for 4-6 weeks before you can start your rehabilitation. More serious fractures and dislocations may require surgical intervention.
Plantar fasciitis presents as pain on the under the heel. Symptoms typically include pain first thing in the morning or after sitting for prolonged periods and pain with prolonged walking or running. This is commonly caused by biomechanical issues relating to your foot alignment, and can be managed with physiotherapy treatment, orthotics and advice on footwear.
Common achilles injuries include achilles tendinopathy (formerly known as tendonitis) or achilles tendon rupture. Achilles tendinopathy is a overuse injury of the Achilles but is not an inflammatory condition as its former names suggests. It is caused by the tendons inability to handle of keep up with the load so its begins to fill with water (and other chemicals) which results in pain and weakness. Achilles tendinopathy can be managed effectively with physiotherapy and addressing any biomechanical or training issues. Achilles tendon rupture is an acute injury in which the fibres of the achilles tendon either partially or completely rupture. A rupture typically requires surgery to repair then tendon.
Stress reaction injuries tend to occur with sudden increases in your weight bearing and loading, usually with an increase in physical activity. A common and typical example is when an individual increases their training for a running event. Weight bearing activities (such as running) places load through the bones. When these loads are excessive or highly repetitive, bony damage can gradually occur over time. Other contributing factors to stress reaction injuries are a person's nutrition status, body weight, age and gender.
If the load exposure is not properly managed with appropriate rest, this can then result in a stress fracture. A stress fracture is an incomplete fracture or crack in the bone. In the foot stress fractures are commonly seen in the metatarsal bones. Scans may be necessary to diagnose a stress fracture. Treatment will initially involve a period of immobilisation in a boot, followed by physiotherapy to restore any lost range of motion and ankle and foot strength.
For more on foot and ankle injuries, or If you are seeking help and want relief from foot or ankle pain