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Dr. Mark Hosko, MD, May 19 2022

Types of Ankle Injuries

Common Ankle Injuries, Causes of Injury & Proper Treatment

Introduction

Ankles are necessary for walking and almost every other form of movement. Problems with the ankles are quite common, with multiple grades ranging from mild to severe. Some issues may require weeks of recovery or even surgery. Explore the different issues with ankles to determine if you need to see a doctor for a full recovery. 

What are common types of ankle injuries?

Ankle injuries show up in three types - bone, ligament, and tendon. All three are kinds of tissues, and each connects to the lower leg. Three bones meet at the ankle, including the tibia, fibula, and the lower leg talus. The bones are held together by bones, ligaments, and tendons, all with separate purposes. 

The type of damage depends on which part has been injured. Most commonly, people experience Achilles tendonitis or tears, ankle sprains, stress fractures, fractures, and plantar fasciitis. Each of these injuries can make walking impossible so understanding the difference is necessary. 

Achilles tendonitis or tears refer to the largest tendon in the body and connects the two primary calf muscles. As this tendon runs vertically down the back of the ankle, which makes it more susceptible to overuse or inflammation. People who injure this tendon are prone to tears or full-blown ruptures from repetition. You can recognize this condition from a popping noise or sensation when landing. 

Ankle sprains happen because of ligament issues. Ligaments are connective tissues that keep the joint from moving too far to either side. A sprain occurs when the ligament does stretch too far or if it tears. Over time-stretched ligaments can lead to ankle weakness, repeated sprains, and arthritis. 

Stress fractures are caused by repetitive or excessive force and leave damage on the bones of the foot. Often, these are caused by traumatic injury or repetitive actions. Without time to heal, these tiny fractures can lead to tiny cracks in the bone, which weakens the bones. 

Fractures involve one of the bones in the ankle and happen from trauma or impact. Instead of microfractures, regular fractures are larger. Here the ankle can swell, bruise, become deformed, blister, stiffness, and more. Some people mistake fractures as sprains, which is an important reason you should visit your doctor for an accurate diagnosis. 

Plantar fasciitis is one of the most common problems for feet and ankles, affecting nearly two million people. The fascia band of tissue in the arch of the foot can become inflamed and cause sharp shooting pain in the heel. Even taking a few steps can cause problems when the band stretches. Often, these issues will resolve on their own with rest, ice, medications, and stretching. 

Tendinitis refers to acute tears of the tendon called the peroneal. Along with pain, you can expect swelling and warmth to the touch. Acute tears will also cause instability of both the foot and ankle. You may see the foot’s arch change or experience a snapping feeling. 

What are the types of ankle sprains?

Ankle sprains come in degrees of severity, including mild, moderate, and severe. Often these are referred to as grades 1, 2, and 3. The grades are determined by the amount of force to the ankle. 

A mild sprain involves slight stretching or tearing of the ligaments. It can include mild swelling, tenderness, and stiffness. The ankle is still stable, and walking is still possible but with a little pain. 

Moderate sprains are a mixture of overstretching and tearing a ligament. However, the tears are incomplete and include moderate pain, bruising, and swelling. The ankle may feel stable enough to walk on; the areas are damaged and tender while also making walking painful.

Severe sprains are a complete tear of the ligament. Grade three sprains include severe swelling and bruising. Walking on this sprain is not possible, and even attempting can cause the ankle to give out and instigate intense pain. 

Additionally, ankle sprains are separated by location. High ankle sprains are usually caused by a traumatic injury. Expect to feel pain above the ankle that increases with outward rotation of the foot. Also, a high sprain may cause pain when walking, bruising, swelling, and an inability to do a single-leg calf raise. 

Low ankle sprains involve the ligaments that support the joint just below the ankle. The subtalar joint allows the foot to rotate to each side. These types of sprains include bruising, pain, swelling, and joint instability. 

What are the most common ankle problems?

Sadly, fractures, sprains, strains, Achilles tendonitis, plantar fasciitis, and arthritis are all quite common. With stress fractures, the ones most often seen are in the second and third metatarsal, at the base of the fifth metatarsal, the navicular, and the sesamoid of the big toe. 

How do I know what type of ankle injury I have?

The best way to know what type of sprain you have is to visit your doctor. They have the equipment necessary to determine what type of ankle injury you are dealing with. It’s best to get x-rays and a physical examination when it comes to the ankle as issues can prevent walking and all daily activities. Only a doctor can accurately determine the problem and, therefore, the method to heal and prevent a recurring issue. 

What are the symptoms of ankle injuries?

Each ankle problem comes with its own set of symptoms; however, many of the symptoms overlap where the ankle is concerned. First, pain in the ankle indicates an issue, and it’s often sudden and severe. Second, ankle injuries often include bruising, swelling, and an inability to put weight on the injured joint or walk. Third, the ankle may be stiff or tender to the touch or even deformed. 

For lower-level issues, you may notice sporadic pain around the ankle or weakness. Additionally, if the height of the arch on the foot increases in size, it could be an indication of an issue as it’s a sign of instability. A snapping feeling can be indicative of an ankle issue. 

What are common treatments for ankle injuries?

Depending on the issue, the treatment for ankle injuries can change. Doctors will assess the area and prescribe a plan of action. For minor injuries, treat with rest, ice, compression, and elevation or RICE. In most cases, you will not need a splint or cast but will need to keep weight off the ankle for a few days before stretching and strengthening. 

Grade two injuries will also follow the RICE approach, but you may also need a boot or splint to immobilize the ankle for a full recovery. After a few weeks, you can start physical therapy to improve strength. With grade three, you can expect a longer recovery and complete immobilization of the joint with even longer physical therapy. 

What types of ankle injuries can heal on their own?

Grade one ankle injuries can heal on their own but will take time. The goal is to be pain-free, regain full strength and range of motion. This does not happen overnight, even for minor injuries. Even with minor problems, you will need to rest and take it easy to prevent further injuring the ankle. While you may not require medical help, your ankle will still need proper care for a full recovery.

What types of ankle injuries require surgery?

Many issues can create the need for surgery. Achilles tendon tears or ruptures, broken ankles, heel bone fractures, and fractures may all require surgery depending on the issue and severity. In addition, recurrent ankle injuries may require surgical intervention to improve strength, stability, and mobility. Other reasons surgery may be the solution are for arthritis, chronic instability, and tendonitis. Check with your doctor to find out if your ankle issues require surgery. 

Most ankle injuries do not require surgery, but over time, if you continue to injure the ankle, you may require surgery. Fractures may require treatment if the ankle is extremely unstable; surgery may protect the ankle from future injury in the future. After the surgery, you will still need to wear a splint before moving to a cast. 

Ankle sprains rarely require surgery unless the damage is quite extensive involving multiple ligaments or when other treatments fail. Some grade three sprains that do not respond to standard treatment in a reasonable period of time may require surgery to reconstruct ligament tears. Tendon issues may also require surgery if the structure of the foot has been compromised. 

Why choose Portland Urgent Care for ankle injury treatment?

Portland Urgent Care offers a variety of services to help support ankle injuries. We work with many insurance companies to serve more customers quickly. Also, by combining the use of integrated medical resources, including both western and eastern medical healthcare, we can better serve you the way your body needs. 

With options for same-day and walk-in appointments for ankle injuries and sprains for immediate relief with the best doctors, Portland Urgent Care is here for you. Get a dedicated treatment plan for pain management and to reduce chronic injuries. Find out about our other in-house options, including a chiropractor who can help to diagnose and find the best approach to recovery along with imaging and x-rays. Call and schedule an appointment today. 

Conclusion

Ankle injuries can interrupt your daily life and comfort. With the right care, you can regain the stability, mobility, flexibility, and function of your ankle. However, it’s always important to seek medical attention as untreated ankle injuries can lead to future injuries and complicate life. Call Portland Urgent Care today if you are experiencing issues with your ankles so you can get back to living. 

Written by

Dr. Mark Hosko, MD

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