Ankle arthroscopy allows examination of the joint through small incisions. Many injuries to the joint can be treated with this technique including inflammation of the joint, injury to cartilage or bone, or removal of loose pieces. The subtalar joint, below the ankle joint, can also be treated with arthroscopy.
Ankle sprains are the most common sports injuries, with an estimated 25,000 occurring every day in the US. Sprains can happen with any sport, including just walking across the yard! Ankle sprains are most common in ball sports such as basketball, soccer, volleyball and others.
An ankle sprain is tearing of the ligaments which connect the bones on the outside of the ankle. These almost always heal, but for a small percentage of people the ligaments heal too long. This leads to repeated ankle sprains making athletics or even walking on uneven ground difficult.
Ankle and Foot Tendonitis
Tendons are the structures which link muscles to the bones, controlling the movement of the joint. A single injury or repeated injuries over time can lead to inflammation, swelling, microscopic tears which lead to pain or loss of function.
The Achilles tendon is commonly involved. There are 2 types of Achilles tendonitis:
- Insertional: occurring where the tendon attaches to the back of the heel bone. There is often a bump and an x-ray may show calcification in the tendon.
- Non-insertional: thickening and soreness in the middle of the tendon, about 2-4 inches above the heel bone.
The peroneal tendons run along the outside of the tendon. They help to stabilize the ankle but can be injured after an ankle sprain, chronic ankle instability, or other injuries.
Tendon Tears or Stress Fracture
Tearing of the Achilles tendon is the most dramatic, usually as sudden pain sometimes with a “pop” you can hear. Most common in men over 40 years old, this injury needs prompt attention to allow correct healing. Other tendon tears happen slowly, causing pain and swelling.
Stress fractures result from overuse, often in runners. Think of it like bending a paper clip. It doesn’t break the first time, but if you keep bending it will break. Stress fractures usually cause pain with activity and sometimes swelling.
Foot and Ankle Arthritis
Arthritis comes from the Latin for “inflammation of the joint.” A history of trauma such as a fracture (break) can make developing arthritis more common, but it also happens as wear-and-tear over the years of using your feet every day. The most common symptoms are pain with activity and often worst when taking the first steps. Swelling or deformity may also occur. Any joint from the toes back to the ankle can develop arthritis.
Posterior Tibial Tendonitis
This special kind of tendonitis affects a tendon on the inside of the ankle. Inflammation of the tendon progresses to microscopic tearing. Over years, like an old rope stretching out, the tendon lengthens. This leads to deformity in the foot with a collapse of the inside of the foot (pronation). The front of the foot and toes may turn out to the side and with more time it may look like you are walking on the inside of the ankle.