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Ankle Pain

The majority of ankle problems I see at my clinic are usually related to a strain/sprain from “rolling” the ankle. Either the initial trauma or the lasting effects of that injury alters the mechanics of the joint. The resulting dysfunction leads to years of maladaptation and repetitive microtrauma with the most common outcome as osteoarthritis of varying degrees. As such an important foundation and weight-bearing structure, these injuries need to be resolved as soon as possible to avoid such damage accumulating over time.

The tibia and fibula are the two bones of the lower leg. These two bones sit on the talus which is the topmost foot bone. The junction between these three bones is the talocrural joint, commonly known as the ankle joint. The majority of the movement at this joint is a forwards and backwards motion (dorsiflexion and plantar flexion), but there are also components of side to side motion and minor amounts of rotation. Typical strains/sprains occur as the ankle encounters a motion that causes the foot to roll inwards or outwards and overwhelms both the muscular force and the ligamentous barrier along both sides of the joint. This damage can range from being minor to severe and requiring surgery.

It is very common for a patient to allow the ligament to heal by itself and simply protect the ankle for several weeks or months not realizing that the injury has resulted in altered joint mechanics. The truth is often that the ligaments have been damaged and stretched and can no longer hold the bones in the correct place during movement and weight-bearing. With the muscles strained, these too cannot manage to correctly stabilize the joint and the result is a chronically stressed structure. One of the tell-tale signs that this is occurring is clicking and popping or a sense of the joint feeling different. As you might imagine, re-injury is also quite common rolling the joint a second time or more. Over time, the condition results in repetitive damage of the cartilage in the joint and degenerative/arthritic changes set in.

Correction involves not just realigning and ree-balancing the joint with manipulation, but also strengthening the surrounding musculature to protect and restrict the motion in the joint. This gives the ligaments a chance to heal and shrink back up. This is in fact the nature of ligaments… they shrink and tighten over time. This is beneficial in most cases of healing, but can also result in dysfunction in other cases. It takes the right kind of physician to know whether ligaments need to be lengthened or shortened to correctly balance a joint. If you suffer from ankle pain, see a Chiropractor or other qualified physician that specializes in biomechanical injury. The longer you let the problem ride, the worse it is likely to become.

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