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Overview
Ankle injuries are very common. They can occur during exercise, activities and
sports. Ankle injuries also may occur during normal daily activities, such as stepping off
a curb or walking down the steps.
Ankle pain may also develop gradually due to "strain" or "overuse."
Appropriate treatment of ankle strain and sprain most often leads to painless, functional
ankle.
What causes ankle injuries?
Ankle injuries commonly occur as a sudden specific sprain of the ligaments. The
sprain may result from a "twisting" or "turning in" of the ankle,
causing pain and swelling on the outer part of the ankle.
Less common is a gradual increase in pain due to overuse or strain of a specific
tendon, or stress fractures of the bones in or near the ankle. It is possible, but
uncommon, to rupture a tendon or injure the inner part of the ankle when it is sprained.
What should I do if I injure my ankle?
The best thing to do is rest, elevate and ice the ankle. If your pain is not
relieved by these measures or if you have pain at rest, you should see your physician
promptly. Also seek immediate attention if you:
- Have repetitive injuries because your ankle is "giving way"
- Have torn skin on the ankle
- Have severe pain
- Are unable to walk
It is important to see your health care provider in these cases to make sure you did
not break a bone in your ankle. Broken bones usually require a cast or surgery.
The vast majority of ankle sprains are, however, treated without surgery and heal
without significant problems. Treatment depends on the severity of the sprain and may
include resting, bracing, and occasionally casting the ankle. Following treatment, a
home-based physical therapy program is recommended to rehabilitate (treat) the injured
ankle.
What are overuse injuries?
Overuse injuries of the ankle are typically caused by tendinitis, but can
represent stress fractures. Tendinitis is inflammation of the rope-like structure that
attaches muscles to bones (tendon). The inflammation causes pain and swelling in the
affected area. Peroneal tendinitis (on the outer part of the leg) causes pain on the
outside part of the ankle, while posterior tibial tendinitis (on the back and middle of
the leg) causes pain on the inner part of the ankle.
Treatments include rest, modification of activity, anti-inflammatory medication,
bracing and occasionally casting. Surgery is often required.
A stress fracture is a "crack" in the bone due to a combination of
increased activity and/or decreasing bone strength. The activity may be a new walking,
running or exercise program. Bone strength can be decreased by diabetes, rheumatoid
arthritis, osteoporosis, and other medical conditions.
Stress fractures are usually treated by resting the ankle and possibly using a cast. If
there is no obvious increase in activity level, the possibility of decreasing bone
strength may need to be evaluated.
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