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What is commonly referred to as the ankle is actually two joints, with one providing the up and down movement of the foot and the other providing the sideways movements.
The bones of the lower leg (tibia and fibula) meet the talus bone in the foot to form the ankle joint which provides the up and down movement of the foot. The bones you can feel on the inside and outside of your ankle are the ends of the tibia and fibula. The heel-bone (calcaneus) forms the subtalar joint with the talus bone, which provides the sideways movement of the foot. The foot is made up of the talus and calcaneal bones, seven tarsal bones, five metatarsals and fourteen phalanges which form the toes.
The calf muscles connect to the heel through the Achilles (Calcaneal) tendon. If there is any damage to the tendon then the heel cannot be lifted and the foot will drag. The muscles running down the front of the lower leg connect to the bones in the top of the foot through several tendons, with these muscles helping to control both the up, down and sideways foot movements. There are four ligaments at the ankle joint which provide stability; the most common ankle injuries are due to damaging these ligaments.
Some of the more common ankle injuries include:
Sprained Ankle–A sprained ankle is where the ligaments are stretched, twisted or torn and can result in pain, swelling and loss of movement and is one of the most common forms of ankle complaint, with the NHS reporting 1-1.5 million visits to A&E every year. Rolling the ankle inwards and over-stretching the ligaments on the outside of the foot is the most common cause of a sprain.
Ligament Damage – A sprain can be categorised from 1 to 3 in terms of severity with a serious ankle injury compromising the stability of the joint. A grade 3 tear or rupture may require surgery to repair the affected ligament before a lengthy period of physiotherapy.
Achilles Tendonitis – This can occur at any point whether you are active or not, however it is more common in men between the ages of 30 and 50. As with all forms of tendonitis the pain and swelling is caused by deterioration of the tendon. This can be due to overuse but other causes include having tight calf muscles or an unusual walking style. The tendon will be tender and may be swollen; another symptom is pain when you rise up on to your toes. After periods of inactivity the pain can become worse and sufferers often experience this when they first get up in the morning.
Achilles Tendon Rupture – A rupture of the tendon is most likely to occur when playing sports that involve quick bursts of movement such as football, basketball and tennis. As the tendon ages it becomes less flexible and more susceptible to damage, as with Achilles tendonitis it is more prevalent in people aged 30-50, but it can happen to anyone at any time. There is also a small risk that those with Achilles tendonitis can progress to rupture the tendon.
Following an ankle injury it is important to stop what you are doing and rest in order to minimise the risk of the problem becoming worse. Diagnosis is also essential in understanding the type and severity of the condition so that you know how to best treat it, whether that is rest, ice, physiotherapy, the use of a brace or support, surgery or a combination of all of these.