Why Your Ankle Hurts (And What To Do About It!)

Summary

In this video, the speaker covers common ankle injuries, their symptoms, and treatment strategies. It begins with ankle sprains, detailing types of ligament damage like lateral and high ankle sprains, and emphasizing the importance of rehab to avoid chronic instability. The video also explores tendonopathies, such as Achilles and tibialis posterior injuries, explaining the impact of load management and rehabilitation. Other topics include bone stress injuries, nerve irritation, and the role of proper footwear. Viewers are encouraged to approach rehab carefully, with tailored exercises and progressions to restore strength, mobility, and function.

Takeaways

• 😀 Lateral ankle sprains are the most common ankle injury, often caused by twisting or rolling the ankle inward, and can vary in severity from grade 1 (mild) to grade 3 (severe).
• 😀 Chronic ankle instability can develop after an initial ankle sprain, leading to ongoing pain, weakness, reduced range of motion, and a feeling of the ankle giving way.
• 😀 A high ankle sprain, also known as a syndesmosis injury, involves damage to the tibiofibular joint and is usually caused by contact, like in football. It differs from lateral sprains in terms of symptoms and recovery.
• 😀 Tendon injuries, such as Achilles tendonopathy, are often gradual, overuse-related conditions where the tendon experiences persistent pain due to mechanical loading.
• 😀 The Achilles tendon, one of the strongest tendons in the body, can suffer from mid-portion or insertional tendonopathy, typically from activities like running and jumping.
• 😀 Posterior ankle impingement, also known as dancer's heel, causes pain when the foot moves into plantar flexion, often affecting dancers and athletes with repetitive motions.
• 😀 Tibialis posterior tendonopathy can lead to pain along the inner ankle or foot and may be associated with a flat foot posture, which can worsen over time.
• 😀 Stress fractures occur when bones cannot withstand repetitive loading, often resulting from training errors, and require special attention to recovery and load management.
• 😀 Rehabilitation after an ankle injury, including sprains and tendonopathies, should aim for gradual movement restoration, strength building, and load management, not complete rest.
• 😀 Shoes and orthotics can help manage symptoms by shifting forces to or away from specific tissues in the foot, but they should not be relied upon to correct structural foot issues.

Q & A

What is a lateral ankle sprain, and how does it occur?

A lateral ankle sprain occurs when the ankle is twisted or rolled inward at high speed, often involving the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). This injury is common in sports and can vary in severity, ranging from mild to severe.

What are the different grades of a lateral ankle sprain, and what do they mean?

Lateral ankle sprains are graded into three levels: Grade 1 is a mild injury with a quick recovery, Grade 2 is a moderate injury that takes a little longer to heal, and Grade 3 is a severe injury with significant swelling, bruising, and the longest recovery time.

What is chronic ankle instability, and how can it develop after an ankle sprain?

Chronic ankle instability refers to repeated episodes of the ankle 'giving way,' often accompanied by pain, weakness, or reduced range of motion. It can develop when an ankle sprain is not properly rehabilitated, leading to persistent issues even after the initial injury has healed.

How is a high ankle sprain different from a lateral ankle sprain?

A high ankle sprain, or syndesmosis injury, affects the tibiofibular joint, located between the tibia and fibula. Unlike lateral ankle sprains that involve rolling the ankle inward, high ankle sprains occur when the foot rotates outward relative to the tibia, often during contact sports.

What are the typical symptoms of Achilles tendonopathy?

Achilles tendonopathy usually presents with localized pain along the tendon, which may be aggravated by palpation, stretching, or load-bearing activities such as running. Symptoms often include stiffness, especially in the morning, and thickening of the tendon.

What is the primary cause of tendonopathy, and how should it be treated?

Tendonopathy is primarily caused by mechanical overload—when the tendon is subjected to more stress than it can handle, often due to overuse or a sudden increase in activity. Treatment focuses on gradual load management, strengthening exercises, and improving tendon capacity rather than anti-inflammatory approaches.

What is the significance of progressive loading in tendon injury rehabilitation?

Progressive loading is crucial for tendon injury recovery because it helps the tendon gradually adapt to increased demands without being overstressed. This approach minimizes the risk of re-injury and improves the tendon’s ability to handle regular activities like walking, running, or jumping.

How does posterior ankle impingement differ from anterior ankle impingement?

Posterior ankle impingement, also known as dancer's heel, occurs when pain is experienced during plantarflexion (pointing the foot downward), while anterior impingement causes discomfort during dorsiflexion (raising the foot upward). The causes and affected structures differ, but both result in a blocked sensation during movement.

What are the main causes of tibialis posterior tendonopathy?

Tibialis posterior tendonopathy is often caused by overuse or overload, especially in runners or individuals with flat feet. Other contributing factors include increased body weight or lack of physical conditioning, which can put extra strain on the tendon.

What role does diet play in rehabilitation for bone stress injuries?

Diet plays a significant role in the rehabilitation of bone stress injuries, as proper nutrition supports bone health and healing. Adequate intake of calcium, vitamin D, and protein is crucial for bone repair and recovery, and addressing any dietary deficiencies can speed up the recovery process.