The Ankle
The ankle is made up the lower end of the tibia (shin bone) and the upper foot bones, known as the talus and the calcaneus (heel bone). They make the connection between the lower leg and the jigsaw of foot bones. The bones of the ankle and foot are connected by extremely tough ligaments which require very high forces to cause strain or damage.
If a sprain occurs, often by turning the foot inwards as you stumble, the ankle will quickly become swollen and painful. The swelling is your body's response to damaged tissues, but it can become a problem if it stays in the joint. We usually recommend that at the earliest opportunity a cold compress (such as a bag of frozen peas wrapped in a wet tea-towel) is applied to reduce the swelling for approximately ten minutes at a time. Be careful with ice treatments if you have any circulatory trouble or are diabetic. You should try to move the ankle forwards and backwards within comfortable limits from immediately after the injury to keep the healing process going well to prevent stiffness developing.
Our physiotherapist will then be able to advise you regarding further treatment, if needed. This might consist of hands-on treatment of the ligaments and techniques to promote healing, such as ultrasound, laser, or special strapping.
Ankle Fracture
Following an injury, such as a football tackle, or landing on the foot awkwardly in a fall, a break fracture of the bones in the lower leg or foot can occur.
Fractured ankles can be diagnosed with an X-ray, and will usually be put in a plaster cast until the bones are healed. When the cast is removed, we can help you to regain good quality movement and function of the foot and ankle as soon as possible.
We can quickly learn to use a limb differently when we have pain and walking with a plaster on your leg is hard work! When the plaster is removed it may not be easy to return to a good walking pattern. This can be due to stiffness in the joints from the prolonged immobility. Weakness in the muscles can also contribute leading to poor balance and position sense at the ankle (proprioception).
Proprioception is our feeling of movement. It is the brain's interpretation of the relative movement of joints. With a plaster on your leg, this information does not go back to the brain as readily, due to the lack of movement. The brain reduces the 'intensity' of these connections. When the plaster is removed, the connections do not automatically become sharp again. It is important to make the muscles work quickly and gain correct movement in the foot and ankle. A failure to do this can lead to the foot moving abnormally and can cause a recurrence of the pain. We can explain how proprioception can be improved following such an injury with exercises at home.
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