Making the Diagnosis for Ankle Injuries

The ankle is one of the most common areas for sports injuries. 25% of sports injuries occur in the foot and ankle. The foot and ankle are also two distinct joints. The ankle being above the foot where the tibia meets the talus.

An important structure is a tendon that lines the back of the leg bone or tibia, known as the posterior tibial tendon (PT tendon) which stabilizes the foot by preventing it to have flatten arches. Beginning as a muscle on the backside of the leg, this tendon will insert itself behind the ankle bone onto a bone within the foot and onto various other bones of the base of the foot.

The PT tendon essentially lifts up the arch as you stand. As you walk, the foot is assisted up toward the other leg thanks to this tendon. The primary reason the PT tendon is subject to vast amounts of stress is due to the excess firing of the tendon. Long walks and other strenuous activities can make the tendon painful and inflamed. Anything that exerts pressure within the ankle joint like unsupported pronated feet or loose ankles may lead the fibers to fray causing the condition, adult acquired flatfoot.

In addition to a clinical exam, Dr. Pearl uses either x-rays, ultrasounds, or a combination of the two to distinguish between soft tissue and bone injuries. The treatment for this injury is support. An acute condition is treated with an appropriate brace, rest, and possibly physical therapy. In long term/chronic cases, orthotics, ankle braces can be used as treatment.  Surgery repair and deprivement of the tendon is considered a last resort. Stay tuned for our next blogpost in which we’ll go over acute sprains.