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Ankle Pain Causes Explained.

Join this channel to support the channel. https://www.youtube.com/channel/UCOHfqHMhHvfQCYJDXfpSAiw/join Ankle pain. Ankle pain is an extremely common complaint with several common causes. It is important to make the correct diagnosis of the cause of ankle pain so the appropriate treatment can be given to the patient. So what are the common causes of ankle pain? We're gonna group all causes of ankle pain into four groups. One group, in front of the ankle or anterior to the ankle. The second group, medial to the ankle, on the inside of the ankle. The third group, behind the ankle, or posterior to the ankle. The fourth group is lateral to the ankle, on the outer side of the ankle. The sites and location from different causes of ankle pain appear to be close to each other. It may be difficult to determine the source of the pain, and this makes diagnosis of ankle pain difficult or confusing. So let's take them one by one. Causes of anterior ankle pain: anterolateral impingement means there is painful limitation of full range of motion of the ankle due to soft tissue thickening or tibial bony spur impinging on the talus, limiting dorsiflexion of the ankle. Arthritis of the ankle. It can occur due to an injury or inflammation. You can diagnose it by examination or by an X-ray. Osteochondritis dissecans of the talus is a little chip fracture inside the ankle that causes pain, swelling and stiffness. Tibialis anterior tendonitis is an overuse condition. Causes of medial ankle pain. Tarsal tunnel syndrome. Compression on the posterior tibial nerve reduces symptoms of pain and numbness on the medial side of the ankle. When conservative treatment fails, surgical treatment of tarsal tunnel release may be needed. Posterior tibial tendonitis or rupture. Posterior tibial tendon problems can occur from overuse activities, from degeneration or from trauma. The posterior tibial tendon is one of the major supporting structures of the foot. The tendon helps to keep the arch of the foot in its normal position. When there is insufficiency or rupture of this tendon, the arch begins to sag and a flat foot deformity can occur associated with a tight Achilles tendon. The posterior tibial tendon rupture occurs in the hypovascular area which is distal to the medial malleolus. The patient will have painful swelling on the posteromedial aspect of the ankle. The patient will be unable to perform a single heel toe rise. Patient will have too many toes, flat foot or fixed deformity of the hind foot. A rupture of this tendon could be missed. Flexor hallucis tendonitis. Pain, swelling and weakness posterior to the medial malleolus. Dorsiflexion of the big toe may be reduced when the ankle is placed in dorsiflexion. Triggering and pain along the tendon sheath may also occur with toe flexion. This condition often occurs in activities in which plantar flexion of the ankle is necessary, such as belly dancing. What causes pain on the posterior aspect of the ankle? Posterior ankle impingement due to os trigonum. The os trigonum, it's a non-united piece of accessory bone seen posterior to the talus. Tenderness in the posterolateral aspect of the ankle, posterior to the peroneal tendons, especially with passive plantar flexion of the ankle may be seen in association with flexor hallucis longus tenosynovitis. Achilles tendonitis. Irritation and inflammation occurs due to overuse. Pain, swelling and tears within the tendon. Usually treated with therapy and eccentric exercises. Rarely treated with surgery. Achilles tendon rupture. Achilles tendon can become prone to rupture with age, lack of use or by aggressive exercises. Rupture is diagnosed by Thomson test or by an MRI. Treatment may be conservative without surgery by doing early functional rehab, or it can be treated with surgery. Surgery is done by approximation of the torn ends. The risk of surgery is infection and skin and wound complications. The risk of conservative treatment is high rate of re-rupture of the tendon. Causes of ankle pain on the outer side of the ankle, the lateral side. The cause of ankle pain on the outer side of the ankle may be a sprained ankle, but diagnosis of a sprained ankle may be the wrong diagnosis. There are other structures in this area that can mimic an ankle sprain, but it is not an ankle sprain. So, let's start by understanding an ankle sprain. When the pain is anterior and around the fibula, it can be attributed to a ligament sprain. Ankle sprain can be a high ankle sprain, which is rare, or a low ankle sprain, which is common. A high ankle sprain is a syndesmotic injury. It requires surgery. The high ankle sprain is a serious injury because it injures the ligament that connects the tibia to the fibula at the ankle joint. The diagnosis is usually done by the use of external rotation stress view or by CT scan. A low ankle sprain is not a serious injury, and it does not require surgery. A low ankle sprain is a collateral ligament injury called an ankle sprain.