Simply walking on an uneven surface can be enough to trigger a sprain and give you ankle pain, says Chartered Physiotherapist, Gopi Kitnasamy. “The ankle is where three bones meet,” he explains, listing the bones known as tibia, fibula and talus. Pain may result from a diverse number of conditions, including a simple sprain or, [...]

The Sunday Times Sri Lanka

That ache in your ankle

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Simply walking on an uneven surface can be enough to trigger a sprain and give you ankle pain, says Chartered Physiotherapist, Gopi Kitnasamy. “The ankle is where three bones meet,” he explains, listing the bones known as tibia, fibula and talus. Pain may result from a diverse number of conditions, including a simple sprain or, more seriously, arthritis. As part of our ongoing series, this month Mr. Kitnasamy tackles 7 things you need to know about that ache in your ankle.
A sprain is not the only source of pain:

Arthritis, gout, nerve damage or injury, blocked blood vessels or infections in the joint can also be a source of pain in your ankle. When your ankle rolls or twists inward, you can tear the ligaments that hold the bones together, resulting in a sprain. Gout is caused by a buildup of uric acid in the body – pain occurs when the uric acid concentrations are so high that crystals are deposited in the joints. It’s well-known that arthritis can also cause ankle pain. While several kinds of arthritis have been associated with pain in the ankles, osteoarthritis is the most common culprit. Septic arthritis, which is caused by a bacterial or fungal infection, can also be a source of pain.

Watch out for those peroneal tendons:
Your peroneal tendons stabilize and protect your ankle, as a result they are the two tendons most at risk of being strained. You are said to have tendinitis when your tendons become inflamed as a result of overuse or trauma. An acute tendon tear can occur when the joint experiences sudden trauma or force. Tendons can also rupture. Subluxation refers to a tendon that slips out of place.Other conditions include repeated microscopic tendon tears that accumulate over time, because of being repeatedly over -stretched.

Tendinosis may take years to develop:
When proper healing of those microscopic tendon tears doesn’t take place, you are likely to develop tendinosis. Symptoms of tendinosis include sporadic pain on the outside of the ankle as well as a sensation of weakness or instability. Many patients notice an increase in the height of the foot’s arch. As tendons heal more slowly than muscles, treatment of such injuries calls for patience and careful rehabilitation.

Being overweight  can put you at risk  of ankle problems:
Being overweight or obese increases stress on your knee and ankle joints, even during ordinary activities such as walking or going up and down stairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage. Other risk factors include a lack of strength and flexibility, and playing certain sports such as basketball or even simply running on uneven sources can leave you more vulnerable. Whether you’re walking, dancing or jumping, choose your footwear with care. High heels, flat shoes, pointed shoes or even shoes of the wrong size can all cause ankle strain. If you’ve been injured in the past, you’re also more likely to turn an ankle and have a fresh injury.

Fractures can sometimes be mistaken for sprains:
The symptoms of a sprain and of a fracture are very similar. In both, you are likely to experience pain, often sudden and severe, along with swelling, bruising and an inability to walk as the injured joint cannot bear the weight. However, an ankle may also be stiff as the result of a sprain, while with a fracture the area will be tender to the touch, and the ankle may also look deformed or out of place. While mild sprains are associated only with swelling and light pain, a severe sprain can cause intense pain.

Imaging scans can help with diagnosis:
A doctor will typically start out with a physical exam – moving the joint around, he or she will check to see what your range or motion is and whether any position is particularly painful. If the injury is severe, you may be asked to undergo an imaging test like an X-Ray, Magnetic Resonance Imaging (MRI) or CT Scan. The first uses a small amount of radiation to produce images of your bones. The second combines radio waves and a strong magnetic field to produce detailed images of internal structures, including soft tissue injuries. Finally the CT scan is deployed to examine more details of the bones by taking X-rays from many different angles and combining them.

A well-balanced diet can help prevent an ankle injury:
Eating nutritious food keeps your muscles strong, and also helps you control your weight, both key elements in preventing ankle injuries. Other tips include avoiding exercising or playing sports when you are tired or in pain, wearing shoes that fit well and that are suited to whatever exercise you’re currently undertaking and making sure the heels of your shoes aren’t disproportionately worn down on one side.

Try to exercise every day, and remember to warm up and stretch before you play a sport. Run on flat surfaces. If you’ve already experienced an injury, it is important to follow your doctor’s advice and stick to the plan of rehabilitation and strength building.

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