I often hear people around me complain of ankle pain, yet they don't take this symptom seriously. They think they've „walked more than usual“ or „been on their feet too long“ and that the pain will pass. Of course, sometimes that's the case, but more often there is a deeper problem.
Working in an outpatient clinic, I see a great many patients who come to an orthopaedic trauma surgeon with ankle pain. Unfortunately, quite a few of them do so too late, when conservative treatment is no longer an option and surgery is required.
So you might ask: when should you be concerned? To better understand when it's time to seek help, let's first look at the most common causes of ankle pain.
Acute pain after an injury is probably understandable to everyone. You can read about what to do after an injury in my previous article on ankle injuries.
Pain that appears for no obvious reason and lasts a long time (at least 6 weeks) is more confusing. We can call this kind of pain chronic.
One of the most common causes of such pain is ankle osteoarthritis (wear of the cartilage). According to various sources, as many as 70% of people with ankle pain suffer from this condition. One of the most common forms is post-traumatic osteoarthritis. This is damage to the cartilage of the ankle joint that develops after various injuries. And not necessarily after fractures – even simple ligament sprains can contribute to osteoarthritis. So if you have had ankle injuries in the past, it's worth paying attention to this.
WHY IS ANKLE OSTEOARTHRITIS SO DANGEROUS?
Unfortunately, the articular cartilage in our body does not regenerate (it does not grow back). There are various surgical methods to improve the condition of the cartilage and slow the progression of osteoarthritis, but fully restoring it is, sadly, not yet possible. That's why it is so important to diagnose this condition as early as possible and start treatment before the cartilage has completely worn away.
Otherwise, once osteoarthritis has progressed significantly, the only options left are ankle joint replacement or joint fusion surgery – arthrodesis. Unfortunately, not all patients are suitable for joint replacement, and after fusion surgery movement through the ankle joint is lost, reducing mobility. That's why it is so important to seek help in time, while these operations can still be avoided!
Another common cause, responsible for up to 20% of ankle pain, is chronic joint instability. This problem most often results from repeated ankle injuries and ligaments that have healed poorly or become lax. For us women, this problem is especially relevant, as injuries very often happen when wearing unsuitable high heels or when the feet haven't been prepared for wearing them.
Ankle instability is also affected by muscle imbalance: if one muscle group is weaker than another, the ankle doesn't move correctly, which leads to uneven load distribution and chronic pain.
When talking about ankle pain, it's also important to mention tendon inflammation – tendinitis. Repeated injuries or overload can cause an inflammatory process in the tendons. The tendon then thickens and causes pain during movement. This condition is usually easily treated with anti-inflammatory medication and rehabilitation procedures.
It's important to understand that everything in the foot and ankle is closely interconnected. That's why foot deformities, especially flat feet, can also cause ankle pain. As this problem becomes long-standing and the arch of the foot drops, the ankle joint tilts inwards, so the load is distributed unevenly and the joint cartilage is damaged, which leads to the osteoarthritis mentioned earlier.
WHEN SHOULD YOU SEEK HELP?
If your ankle pain lasts longer than 6 weeks and nothing helps to relieve it, you must see an orthopaedic trauma surgeon! I recommend seeing a doctor who specialises in this particular area. When booking online, the doctor's areas of interest are usually listed, and when booking by phone you can always ask the receptionist.
If possible, before booking an appointment, also look online to find out which doctors specialise specifically in ankle conditions. Of course, you will still get help if you book with another doctor, but you may well be referred to a different specialist, and then the whole treatment will take longer.
HOW CAN YOU AVOID ANKLE JOINT PAIN?
Based on the most common causes, I recommend:
- When wearing high heels, choose shoes with a lower heel if you don't have much experience, and walk on even surfaces to avoid ankle injuries.
- Prepare your feet and shoes before wearing high heels. Do warm-up exercises and make sure your feet don't slip inside your shoes. You can learn how to prepare for wearing high heels and how to walk correctly at our high heel training!
- Strengthen the muscles that stabilise the ankle joint. A physiotherapist can help you identify which muscle groups are causing problems and which exercises will benefit you specifically.
- If you have flat feet, wear orthopaedic insoles.
- And most importantly, see an orthopaedic trauma surgeon in good time about ankle joint pain, so you can find out the cause and receive the right treatment.
Have questions? Write to me and together we'll try to find the best solution to your problem!
Karolina
