I have an ankle injury that's
not improving

Most sprained ankles recover in time but sometimes symptoms persist. If you have little pain but your ankle twists easily, you may have ligament incompetence as your torn ligaments have not healed properly. Sometimes, the ligaments are fine but the ankle gives way due to a lack of muscle strength and control. This is known as functional instability. Bad sprains can damage the peroneal tendons running behind the outside edge of the ankle, or the straps holding them in position can be torn, causing similar weakness and pain. This is called peroneal tendinopathy.

Tendon damage can also occur on the inside aspect of the ankle (posterior tibial tendon). Often followed by flattening of the arch, this is called posterior tibial tendon dysfunction.

Sometimes, the problem relates more to pain than instability. If you have a catching pain at the front of the ankle with inflammation or scarring, you may have anterior ankle impingement or, conversely, posterior ankle impingement if the pain is at the back of your ankle.

If your ankle twisted badly and you have deep, constant pain, the cartilage surface may have fractured, crushed or sheared off. This is called osteochondritis dissecans (OCD). It can occur spontaneously without any injury. OCD tends to cause a constant pain with less 'catching', unless the piece comes away and floats inside the joint. These impingement and OCD lesions often produce pain alone. However, they may also cause the ankle to give way, simulating incompetent ligaments. An ankle which repeatedly gives way and swells is at risk of progressing to wear and tear arthritis so it should be treated. Some people have a deeply arched foot shape (called cavovarus) that twists in naturally, making them more prone to ankle sprains and poor recovery.

Failure of any bone to heal up is known as non-union and may require surgery. The bone at the inside corner of the ankle and outside border of the foot are the most prone to this. Rarely, some people suffer from tarsal coalitions. Here, two bones are joined together where they should be separate, causing a flat, stiff foot which becomes painful during teenage years or following a twisting injury.

 

The following list is a summary of some symptoms you may have. For full assessment and treatment of your particular problems, please contact us.

I have...

• suffered a sporting injury.

• a painful bump on the side of my big toe.

• pain and/or a lump in my heel.

• an ankle injury that's not improving.

• a weak ankle.

• ankle pain and/or stiffness.

• flat arches or a collapsed foot.

• painful toes.

• pain in the ball of my foot.

• an in-growing toenail.

• a stiff or painful big toe joint.

• pain and/or stiffness in the midfoot.

• clawed or curly toes.

• pain in my forefoot.

• pains in my shin.

• a lump on my foot.