Ankle Pain
This may be part of a generalised inflammation of joints or may be the ankle joint in
isolation. Frequently acute ankle pains result from injuries.
The ankle is the joint most frequently injured in sport, with ankle injuries accounting
for 20% of all sports injuries.
If the ankle is acutely painful following a twisting injury then first aid measures are
needed initially. These include: Rest Ice Compression and Elevation Although a
couple of days rest is useful, it is best to start taking some weight on the injured ankle
reasonably soon after injury, usually within 2-3 days. Also the patient should start to
exercise and stretch the injured ankle as soon as possible after the injury.
Normally a sprained ankle will recover within 6-8 weeks, although it may tend to
swell for a few weeks longer. If the following is present we suggest the patient goes to
Accident and Emergency:
Deformity
Worsening pain
Extensive bruising
Skin damage
If the ankle pain fails to resolve after several weeks then it is possible that a more
serious injury has occurred in the ankle joint. If the patient has rested and avoided
further injury but the ankle is still painful on minimal activity after 6 weeks then
physio may be required.
When do you need to see me?
You may need the help of an orthopaedic surgeon if there is a fracture, or locking, the
ankle pain becomes chronic, or fails to settle or if the ankle becomes unstable. OASIS
can help with any of these symptoms
Plantar Fascitis GP Guidelines.pdf
Ankle Instability
Ankle instability almost always results from an injury, unless it is part of generalised
ligamentous laxity. It is characterised by recurrent giving way of the ankle. It is most
noticeable in sport or when walking on uneven ground. Instability may be as a result
of one major injury to the ankle or as a result of several lesser injuries. It does not
necessarily mean the ankle is always painful, but does feel unreliable.
Diagnosis
Ankle Instability is diagnosed by a careful history and examination by a doctor or physiotherapist. They will try to see if there is anything, which makes the patient more liable to ankle instability than average. They will look for any sign that there is some other problem around the ankle, such as damage to the joint surface. Specific tests can be performed.
Tests such as X-rays, ultrasound or MRI scans are sometimes needed to aid the diagnosis.
Treatment
As most people with ankle instability have deficient proprioception and tendons, which are not working properly, the first treatment is a physiotherapy programme to re-train the peroneal muscles and tendons. Despite instability sometimes some parts of the ankle or Achilles tendon is stiff, and there is the need for exercises to stretch these, and increase the strength of the muscles around the ankle by exercises. If their foot shape is high arched it makes the patient prone to extra stress on the ankle ligaments, a moulded insole may be advised for the shoe to reduce these stresses.
When do you need me?
Most people with ankle instability will not need an operation. Even if the ankle still feels unstable after physiotherapy, you could try a brace rather than having an operation to tighten up or replace the ligaments. However, if no other treatment makes the ankle comfortable and tests show that the ligaments are weak, you may need my help.
Some of the procedures I carry out for ankle instability are:
M Shah Ankle Arthroscopy Patients Guide.pdf
If you are interested in making an appointment to discuss a treatment,
please click here to contact us, or telephone 01215807406
