Ankles are one of the most commonly injured joints in the body. At Capital Orthopaedics, we diagnose and treat all types of injuries and conditions that affect your ankle joint.
Some of the most common problems we treat include: fractures, ankle sprains, ligament and tendon damage, ankle arthritis, footballer’s ankle and osteophytes (bone spurs).
Our team of expert surgeons, physiotherapists, radiologists and sports medicine professionals ensure that you get the most accurate diagnosis and the treatment plan that gets you back on your feet and back to your activities as quickly and painlessly as possible.
Some of the most common ankle conditions we treat include:
When cartilage is torn or damaged, the exposed bone surfaces beneath can get worn and rough. This means more friction in your ankle joint – causing pain, inflammation and potential damage to other tissues around it. In osteoarthritis, the exposed bones wear away over time, sometimes leading to bony growths (osteophytes). With an early diagnosis, arthritis can be treated conservatively using physiotherapy and injections to reduce inflammation and enhance healing. More advanced arthritis can be resolved with surgery – either smoothing and trimming the joint surfaces, or replacing damaged bones with prosthetic parts or a fusion.
Damage to the cartilage and the bone underneath (also called chondromalacia). The cartilage and bone beneath can be torn (chondral fracture) or worn away as a result of an impact, through wear-and-tear or sudden twisting movement. The resulting defects can cause pain, stiffness, limited range of motion and damage to other tissues in your ankle. Osteochondral defects are usually resolved using arthroscopic / keyhole surgery – to smooth the cartilage and bone surfaces, and stimulate repair.
Also known as anterior impingement, this pain at the front of your ankle is caused by repetitive movements where your foot is pointed downwards. Over time, the tissues can thicken and bony growths (osteophytes) can appear – which cause pinching at the front of the joint. At Capital Orthopaedics, footballer’s ankle is usually treated using arthroscopic or keyhole surgery. It usually involves removing the bone spurs to smooth the surfaces and repairing any other structures.
Soft tissue gets trapped at the back of the ankle – a common injury for dancers, cricket fast bowlers, footballers or even wearing high heels. It results in inflammation and pain in the back of the ankle, often spreading up the Achilles tendon and into the heel. The Capital Orthopaedics team offers physiotherapy and injections to reduce inflammation and promote healing. If symptoms persist, you may need keyhole surgery to release trapped tissues, to smooth damaged surfaces or to remove loose bodies and torn cartilage.
Your Achilles tendon runs from the calf muscle to the ankle joint. It is most often injured by an explosive motion such sprinting from standing start, or if you land heavily from a jump. It can also be torn as a result of repetitive actions, such as running or basketball. Achilles tendons can be completely torn or suffer micro-tears and become inflamed (tendonitis). We initially provide a physiotherapy programme to help your tendon to heal. In more severe cases, our surgeons will repair the torn tendon using minimally invasive techniques.
Your ankle can be broken in a number of ways. Most often, the slim fibula bone can be fractured where it connects to the ankle joint – particularly if your ankle has been suddenly twisted or you have an impact on the outside of the joint. It usually heals well with a weight-bearing cast or walking boot. More complex fractures can affect two or more of the bones in your ankle, and are often the result of high energy injuries in impact sports. These may require surgical repair, as they often involve displaced bones, damage to the soft tissues and instability
The peroneal tendons run under the bony lump on the outside of your ankle – connecting your Achilles tendon to your midfoot. Peroneal tendonitis is inflammation in the tendon due to repetitive use, with symptoms of pain and swelling. A peroneal tear – which can also be caused by overuse or trauma – also has symptoms of weakness or instability. They can be treated conservatively with physiotherapy and anti-inflammatory injections, or may need keyhole surgery to repair the tendon and any other damaged tissue.
This is when the tendons that run under the outside of your ankle bone slip out of place, as a result of acute or chronic twisting injuries (such as a sprain). This can lead to weakness and instability, and other problems in the structure of your ankle. Initial treatment usually includes physiotherapy and anti-inflammatory injections. Ongoing subluxation may need surgery to repair the tendon and any other damaged tissues – returning them to their correct position.
The Anterior Talofibula Ligament attaches the fibula to the outside of your ankle bone (talus). It stabilises the joint and is usually damaged when you twist or roll your ankle (sprain). If the ATFL is badly stretched, it can become partially or completely torn, leading to weakness, instability and swelling. Rest and physiotherapy can aid recovery, but severe ligament damage usually requires repair and reconstruction.
The posterior tibial tendon provides support to the arch of your foot. It attaches your calf muscle to the bones of the inside of your foot and runs under the bony lump of your inner ankle. It helps you to invert or turn your foot in and can be damaged due to overuse or direct trauma. Tibial tendonitis causes pain and instability and can lead to other disorders of your foot. We can treat it with physiotherapy and provide orthotics – shoe inserts – to take the strain off your tendon. If symptoms persist, you may require surgery to prevent other problems developing such as arthritis.
Other conditions that we treat with physiotherapy, anti-inflammatory injections and arthroscopic surgery include:
– Ossicles and loose bodies: parts of your bones may be naturally separated, or may have broken off due to degenerative conditions or injury. These can easily be removed with keyhole surgery.
– Arthrofibrosis: excessive scar tissue forms in your ankle joint as a result of injury. This can be removed using minimally invasive surgery.
– Cysts: non-cancerous lumps that develop along tendons or joints. These fluid-filled lumps can be drained using a syringe (aspirated) or removed using surgery.
– Synovitis and bursitis: swelling and inflammation of the tissues that line your ankle joint leading to swelling, pain, redness and difficulty moving the joint. It can be treated with anti inflammatory injections, or the sac can be repaired using surgery.
Simon Moyes is an internationally renowned orthopaedic surgeon and leader in the field of arthroscopic (keyhole) surgery. His Capital Orthopaedics team works from The Cromwell Hospital in London, with its state-of-the-art diagnostic and surgical equipment, and top sports medicine professionals. Contact Simon Moyes for an expert diagnosis and treatment of all your ankle problems.
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Your ankle is made up of three bones the tibia (shin bone), the fibula and talus. These are held together by strong, fibrous ligaments, and connected to your muscles with stretchy tendons. The bones are coated with a layer of slippery cartilage to help with smooth movement, and the whole joint is cushioned by a fluid-filled sac called a bursa.
Frequently asked questions about treatment for ankle conditions and injuries.
– Achilles tendon problems – tendinitis or tendon rupture
– Avulsion fractures – a tendon or ligament that is attached to the bone pulls a piece of fractured bone off
– Broken foot – a fracture of one or more of the bones of your foot
– Bursitis – the fluid-filled sac that cushions your heel becomes inflamed
– Gout – uric acid buildup in your ankle joint
– Osteoarthritis – degenerative bone disease
– Osteochondritis dissecans – the bone underneath the cartilage dies due to injury
– Pain around the joint, which can radiate into the heel, calf and foot
– Inhibited movement
– If pain and swelling doesn’t subside after a week of rest and anti inflammatory
– You have ongoing, intermittent or worsening symptoms
– Instability is affecting your sport or day-to-day activities
– You have experienced major trauma to your ankle such as a car accident
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