Ankle pain is a common complaint in outpatient physical therapy clinics. Whether it is secondary to an injury, such as a lateral ankle sprain (inversion) or medial ankle sprain (eversion), or it comes on insidiously, ankle pain frequently becomes a chronic complaint that becomes so functionally-limiting that patients seek medical help for treating it. At Life’s Work Physical Therapy (LWPT), we are highly skilled in evaluating patients with ankle pain, and consistently have outcomes that are superior to the national average for treating patients with these pain complaints.
Lateral ankle sprain
Lateral ankle sprains are frequent with athletes and the general population. The ankle typically points down and rotates outward, stressing the ligaments and musculature on the lateral ankle. Depending on the severity of sprain, the injury may be associated with significant pain, swelling and bruising, and ligament(s) laxity. Chronic lateral ankle sprains are commonly associated with anterior ankle pain, with decreased dorsiflexion range of motion, an antalgic (limp) gait, and pain during high-loading activities such as hill climbing, squatting, and running. Research has shown decreased talocrural (ankle joint) joint mobility is common after inversion sprains, which improves with manipulation and progressive functional retraining exercises. Chronic lateral ankle pain is frequently associated with poor ligament healing from the injury, peroneal tendinopathies (strains), or other midfoot joint hypomobilities, which respond well to proper physical therapy treatment.
Medial ankle sprain
Medial ankle sprains are less common, and occur when the ankle goes into extreme dorsiflexion and eversion (ankle rolls inward, vs. outward with a lateral ankle sprain). This injury is typically more debilitating, as it frequently involves the ligaments on the medial side of the ankle, and a splaying of the distal tibiofibular joint, which is the joint of the two lower leg bones as they come down to meet the top of the foot. This significantly affects the ability to weight-bear through the lower leg without pain, and can cause pain all around the ankle, along with swelling and decreased ankle range of motion. These injuries are commonly the cause of chronic symptoms of the ankle, but have been shown respond well from strict lower leg stabilization taping alongside a progressive functional retraining program, allowing patients to return back to normal function.
Achilles tendon pain (Achilles tendinopathy) is also a common complaint, which can either occur from an acute injury, or come on insidiously. Research has shown a poor blood supply to a portion of the Achilles tendon in the normal population, which leads towards normal degenerative changes that occur with aging and poor healing after injury. When injured, the Achilles tendon forms scar tissue, which is neither strong nor flexible, and is highly nociceptive (very tender to touch). Research has shown progressive stretching, and progressive eccentric strengthening can improve the status of the Achilles tendon and significantly decrease pain. At LWPT, we use a combination of manual therapy to the tendon to aid in the healing process, and a progressive home program which loads the Achilles tendon while bringing the patient back to their functional activities.
If you have injured your ankle, or have ankle pain that is not improving, contact Life’s Work Physical Therapy to get your ankle evaluated today. We will thoroughly screen the other parts of your hips and lower legs, pelvis, and lumbar spine to make sure nothing else is not going on that is affecting your ability to improve, or that the pain is not coming from somewhere else in the body. We will thoroughly educate you on the source of your pain, and make sure you understand every step of the process towards recovery, so you become empowered to self-manage your symptoms for the long-term. Our therapists look forward to working with you to get you back to where you want to be with your body!