Anatomy of the Ankle
The ankle works like a hinge, allowing you to walk, run, and jump. It’s made up of three main bones: the tibia, or shinbone, which makes up the inner (medial) part of your ankle; the fibula, which is the skinnier bone on the outside (lateral); and the talus, which is 60% covered in cartilage and connects the ankle to the rest of the foot.. These bones are held together by strong ligaments which are strong cords and sheets that are nature’s way of keeping bones and joints secure and stable. Along with ligaments, tendons also play a big part in allowing muscles to connect to bones and move joints. For instance, the Achilles tendon at the back of your ankle helps you push off the ground when you are on the move.
Common Issues with Ankles
When it comes to ankle injuries, sprains are the most common. They usually occur when your foot or ankle rolls in a weird direction. Examples include, when you step off a curb at the wrong angle or when you land awkwardly after jumping. That kind of motion can stretch or even completely tear the ligaments around your ankle. You may notice sharp pain right away and swelling shortly after. Sometimes, you will even see bruising develop after a day. If you have ever had an ankle injury, you know it can feel like your ankle might give out when you put weight on it. These injuries can range from a mild stretch to a full tear of a ligament.
A broken ankle is more severe and means that the bones are damaged. This often happens because of a more serious incident, like accidentally tumbling down some stairs, a biking crash, or a rough collision during a game. When you fracture your ankle, you will typically feel a ton of pain, see a lot of swelling and bruising, and in some cases, the ankle might even look out of joint. For most ankle fractures, won’t be able to put any weight on it, and it might even feel like something’s grinding if you try to move it.
There are two Achilles tendon issues that are the most common. One is Achilles tendonitis, which builds up over time, and is the tendon version of “wear and tear”. It can make your ankle feel stiff in the morning and tender to the touch, especially along the back where there might be swelling and/or a bump. The other issue is an Achilles rupture, which usually occurs suddenly with a specific injury. An Achilles rupture feels like a sharp pop or “kick” in your calf followed by severe pain and difficulty walking.
Non-Surgical Ankle Treatments
Most ankle injuries can be treated without surgery. However, if you are concerned, you should get checked out by a Foot and Ankle Surgeon. This specialist will check out your injury and direct treatment. When you first hurt your ankle, using the RICE method is key. RICE stands for Rest, Ice, Compression, and Elevation. First, you will want to stop putting weight on it; that’s the rest part. For the ice, grab a cloth-wrapped cold pack and apply it to the swollen area for about 15 minutes every two hours. For compression, you should wrap the ankle with a bandage that’s snug but not too tight; this helps keep the swelling down. Finally, elevation means keeping your ankle raised above your heart level while you rest to limit fluid buildup. Instead of using a traditional cast, many doctors will suggest using a walking boot or brace. This protects the ankle but still allows for some limited movement.
Then comes physical therapy, which is super important for getting back to normal. Ideally, you should start PT within a week or two after injury. Physical Therapy is not just about doing exercises; it is a process to retrain your ankle step by step. At first, you might just be moving your toes in the air to get things going. As time goes on, you might use resistance bands for strength and work on balance exercises like standing on one leg (maybe with a chair nearby for support). Generally, this whole process takes six to twelve weeks, so it’s important to be patient. Rushing it could lead to ongoing weakness or another injury. If your ankle still feels wobbly after healing, a custom brace or orthotic insert for your shoes can help provide extra support.
Surgical Ankle Treatments
In certain cases, surgery may be required. If you have a displaced fracture, where the bones are not lined up like they should be—Foot and Ankle Surgeons often have to realign the bones and secure them with plates or screws. This prevents development of pain and arthritis. If your Achilles tendon is completely torn, especially if you are an active person, a Foot and Ankle Surgeon will usually stitch it back together. If you are an athlete and have repeated ankle sprains over time, then surgery to repair or reconstruct the ligaments or fix cartilage injuries may be necessary.
Recovery after surgery is essential to allowing your ankle to heal properly. Typically, after an ankle procedure, a foot and ankle doctor will put the ankle in a cast or special boot for four to eight weeks. Then, the Physical Therapy process begins. Depending on the severity of the injury, getting back to full movement could take six to twelve months.
Ankle Injury Prevention
Building good habits and routines, like doing strength exercises a few times a week, can help avoid ankle injuries. Exercises like calf raises, where you slowly rise onto your tiptoes and then lower yourself back down, and using resistance bands to push against tension in different ways all help to strengthen your ankles.
If you play sports on a court, consider getting high-top shoes for extra support. Always throw out shoes that are worn out or feel unstable, offering little support. Do not forget to warm up and stretch before starting activities. Even just five minutes of brisk walking, with some ankle circles, goes a long way. Be careful on uneven surfaces, and listen to your body. If something feels off, take a couple of rest days to avoid bigger injuries down the line.
Our goal at the Orthopedic and Sports Medicine Institute (OSMI) is to provide our patients with quality, cutting-edge orthopedic treatments, both surgical and non-surgical. If you have questions about ankle injuries or physical therapy, please submit an online appointment request. We have clinic locations in Fort Worth, Mansfield, and Decatur.