All About Ankle Ligament Surgery

Pain in your ankles can arise from a variety of different things. Perhaps you’re dealing with an injury from playing your favorite sport or maybe due to a fall that you took. Maybe you’re dealing with arthritis in the joints or you’ve had a more significant injury due to a car accident. Whatever the case may be, when it comes to the ligaments in your ankles, sometimes you can get away with lots of rest and a few other topical methods. Other times you may need ankle ligament surgery to correct the issue at hand. Here are a few things to know about this type of procedure and the different options that you have.

Ankle Ligament Surgery

This procedure is what your physician will do to help repair a torn ligament due to an injury to the ankle area. This is used to help treat your ankle when you’ve had a serious sprain or if you’ve had instability in the ankle due to an injury. This is typically a procedure done within a day so you’ll be back home before you know it. You’ll leave in a cast that comes up to your knee and given some directions for follow up and how to handle the ankle itself.

Lateral Ankle Ligament Reconstruction

Also known as the Brostrom procedure, this is where the physician will repair one or more of your ligaments in the ankle. It is because you’ve had multiple sprains in your ankle, your ankle has become weak over time due to injury, or there may be a defect in the ankle area that this can help to correct.

If you’ve dealt with problems such as hindfoot Varus, midfoot cavus, or a disease such as Ehlers-Danlos where your ligaments are very loose, this is the surgery that can help you to get some stability back in your ankles. There are some risks involved but you should consult with your physician on your personal risks.

The procedure will involve you being put under general anesthesia or just some local anesthesia depending on the severity of the surgery. The surgeon makes a small incision and uses instruments to carry out the procedure if the surgery is a minimally invasive one. In some situations, the doctor will need to make a longer incision for severe cases.

The doctor will then go in and either shorten your ligaments, remove them, and attach your ankle differently to help give it stability, or do other constructive means to help give the ankle the strength it needs. Lateral ankle ligament reconstruction and ankle ligament surgery can assist you in getting back on your feet. Once you’ve gone through the period of about six weeks after surgery, you can start to bear weight on your ankle and getting back to life.

Achilles Tendinitis: Causes, Symptoms, & Treatments

Have you noticed when you’re walking or exercising that you have pain on the back of your lower leg down near the heel of your foot? If so you could be dealing with Achilles tendinitis. This condition is common for those who overuse the foot or after years of walking/running or exercising. This is a degenerative condition that can come on with age or if you’ve injured your leg. Take a look at what causes Achilles tendinitis and what the symptoms and treatment options you have available.

Causes

There are two types of this tendinitis, noninsertional and insertional. In the first type, it is common in those of the younger generation that are more active and it affects the middle of the tendon. This is where the fibers in the middle of the tendon have begun to breakdown after being torn.

Insertional Achilles Tendinitis affects the lower portion of the tendon itself and can happen to anyone at any age. Once the tendons have started to break or have been damaged, they can begin to calcify and become hard. This can also lead to bone spurs in the area as well.

The basic cause of this issue is repetitive stress to the area itself. This can happen because someone decides to push their body farther than they were ready to go. If you have very tight calf muscles and then begin an aggressive program of exercise, you can end up with this type of injury as well.

Symptoms

The symptoms of Achilles Tendinitis include things such as:

  • Severe pain in the area the day after you’ve done your exercise program
  • Presence of bone spurs
  • Experiencing pain along the tendon when you’re exercising or using the ankle area a lot
  • If you notice a thickening of the area
  • Swelling that does not go away

Treatment Options

Once you know that this type of tendinitis is what is causing your pain, there are several things you can try. Anti-inflammatory medications can help to reduce the swelling, as well as icing the area to relieve the pain and puffiness. Be sure to get plenty of rest and get off your ankle for an extended period of time to allow the tendon to heal and relax.

Reduce the amount of stress put on your tendon by doing calf stretches each day. Physical therapy and learning how to strengthen the area as well can help you to relieve the pain. Injections and shoe lifts can also help to reduce the pain in the area.

Finally, there are surgical options that should be sought as a last resort to your tendonitis. Discuss these options with your doctor to find out what is right for your situation.

What is Ankle Arthrodesis (Ankle Fusion)?

Dealing with pain is never a good thing but sometimes that pain can make it hard to do everyday chores. Something as simple as walking to the mailbox or even your kitchen can become quite difficult to do. This could be because of your ankle and an injury or arthritis that has taken over the ankle joint. When that happens you can consider a procedure called ankle arthrodesis, or ankle fusion, to help get the movement back that you’re used to.

What is ankle arthrodesis?

This procedure, commonly known as ankle fusion, is only completed when your ankle joint has been completely worn down. This could be due to a variety of things including a severe ankle fracture or degenerative arthritis in the joint itself. After you’ve injured the ankle, several years down the road, it can wear out the joint and it can become quite difficult to move it as you have. This procedure basically removes the joint and allows your tibia to grow together with your footbone. That will remove the joint completely and allow your pain to subside.

What should you expect with this procedure?

Before the surgery, you and your doctor will decide if this procedure is right for you. The ankle fusion is a great choice for those who are younger and are very active as it will not wear out like an ankle joint replacement could. Once you’ve been cleared for surgery your doctor will discuss with you whether an open procedure or arthroscopic procedure is best in your situation. They will also warn you of any risks and answer any questions you may have.

What about after surgery?

You will leave the hospital in a cast and in two weeks that one will be changed to a shorter cast. You cannot put weight on your ankle itself until you’re sure that the bones are fusing properly as they should be. When you have this ankle fusion procedure, it could take up to 12-weeks afterwards for that to be certain. For the best reduction of pain after ankle arthrodesis, it is advised that you keep your ankle elevated about your heart and propped up on pillows to reduce the swelling and throbbing.

Be prepared that you will have rehabilitation to go through and running “normally” will not be possible in the future. However, with the inserts available for your shoes and with rehab, you can begin to walk with a normal gait as you did before.

If you’re dealing with a large amount of pain due to arthritis or injury, an ankle fusion may be your ticket to relief. Consult with your physician to be sure you know the ins and outs of this procedure and to help decide if it’s the route to go for you.

What is Total Ankle Arthroplasty (Total Ankle Replacement)?

Suffering from pain when you’re trying to move can lead to less movement on your part. When you’re trying to stay in shape, get in shape, or just keep mobile, pain can put a stop to all of those. Ankle pain can cause you to not want to leave your home or being reduce to having to have assistance when walking. Pain from arthritis can most times be tolerated but when it progresses it can leave you dealing with more pain than you can handle.

How can you deal with this type of pain? How can you keep living life as you want to live it pain free and on your terms? There is a procedure called a total ankle arthroplasty that can offer some light at the end of your tunnel. Discover what this total ankle replacement is and who it might help.

What is a Total Ankle Replacement?

Total Ankle Arthroplasty, or commonly known as TAA, is a total replacement of the ankle joint area. This is used when there is significant arthritis in the joint due to age or sometimes a previous injury such as breaking the ankle. When you’re suffering from arthritis in the ankle, it can lead to deformation of the joint area, pain, and loss of cartilage.

The procedure is performed by an orthopedic surgeon and the entire goal of this process is to allow you to walk and move your ankle with no pain and better movement. The surgeon will inform you on when it is best to have the procedure for your specific case. Not all cases are alike and some may benefit from this total ankle replacement while others may need to put the surgery off.

There are some cases where TAA is not recommended such as those who have had infections in the joint area, neuropathy in the lower limbs, or in cases where dead bone is attached to the ankle area. These would not be good viable cases for the TAA as an option.

What Happens After Surgery?

After you have the total ankle replacement surgery, you’ll have a time where you do not need to put weight on the ankle. This will allow the ankle to completely heal and the joint to set in place as it should. You should use crutches to assist you in walking and keeping off the foot as much as you can. You’ll probably be placed in a type of cast or boot to help keep it stable and in place.

Talk with your orthopedic surgeon to find out if you’re the perfect candidate for total ankle arthroplasty today and get back to living life on your terms.

4 Ways to Protect Ankle from Sprain

If you’ve ever had a sprained ankle you know just how painful they can be. Sometimes they can feel as if you’ve broken bones or torn ligaments but all you’ve done is twisted, or sprained, the ankle severely. Once your ankle sprain has finally healed, you may be susceptible to reinjuring the ankle if you do not take a few precautions. Here are four ways you can protect your ankle from reinjuring it after you’ve healed from the ankle sprain itself.

Wear a Brace

If it’s only been a few weeks since you hurt your ankle, wearing a brace for a month or two while you’re exercising is a good idea. It will help to support the ankle during vigorous activity that might otherwise reinjure you. The semi-rigid type brace is best for right after you’ve injured yourself and you’re healed. It will offer the necessary support and protection during running, walking and other exercise. There are also other wraps and braces you can use to support your ankle during the time of gaining your strength back such as air filled or lace braces.

Balance Work

Work on balancing on your foot that you injured. By practicing balancing exercises on that leg it helps to strengthen the leg and ankle to protect it from injury. Start out by only balancing on the leg for around 30 seconds or so. You can slowly increase this time as you gain more strength in the muscles. This should be done no less than three times a day and can be done more if you’re ankle is holding up to it.

Heel Raises

You should also perform heel raises to help strengthen the ankle. You can do these from a seated position or you can do them standing. Just as with the balance work, start by doing the heel raises and stretches for at least 30 seconds at a time and increase to three minutes or more as you gradually hold it longer.

Other Exercises

Other types of exercises you can use to help prevent an ankle sprain are toe raises, ankle circles and using steps to gain strength back in the ankle that was injured. You can also practice in and out motions where you turn your ankle as far in as you can and hold then turn it back out and hold. Adding in resistance to the in and out motion can also help you build strength back in the joint and ligaments.

These are just a few ways to help you gain strength and protect yourself from having another sprained ankle.

How To Recover From A Sprained Ankle Fast

Although a sprained ankle may not be a major injury, it could be quite a hindrance to daily activities and of course, sports would not be possible without further injuring the ankle. Depending on the severity of the sprain, recovery could take from 6 weeks to up to 4 months. However, with adequate rest, proper treatment and rehabilitation, the healing process could be sped up significantly.


Symptoms

Typically, an ankle sprain can be identified by the pain, swelling, stiffness and instability. A minor sprain involves a stretched ligament with slight tearing. The pain would not be too intense and it would still be possible to walk with a limp. If the ligament is completely torn, the ankle joint would lose its function and stability. Intense pain would be felt initially but it would wear off after a while till no pain is felt. Swelling would be extensive.


Treatment

R.I.C.E:

As with many other kinds of leg and joint injuries, the R.I.C.E (Rest, Ice, Compression, Elevation) method is the first form of treatment to contain the injury and reduce pain and swelling.

  • Rest: Avoid weight bearing as much as possible to allow the ankle to heal and prevent further aggravation of the injury.
  • Ice: Using an ice pack or ice wrap, apply it on the injured area for 10-15 minutes several times a day. This would reduce the pain and swelling.
  • Compression: After icing, use bandage to wrap around the injured area snugly. Make sure that it is not too tight that it cuts off blood circulation.
  • Elevation: Raise your leg above the heart level to further reduce the swelling.

These four steps should be repeated at least three times a day or until the pain and swelling subside.


Medication:

Nonsteroidal anti-inflammatory drugs (NSAID) can help to reduce the inflammation and reduce pain and swelling.

 

Rehabilitation

Keeping your ankle immobilized for too long can result in stiffness. Always wriggle your toes or move your ankle lightly whenever possible to keep it flexible. Once the injury has stabilized and is recovering, you can start rehabilitation exercises to restore its motion, strength and balance.

Light Exercises:

You can start off with sitting on a chair and moving your ankle up and down, followed by rolling your foot inward and outward. If these movements are bearable, proceed to stand with legs at hip width apart and lift up one foot at ankle level. Change to the other foot and repeat the reps.

Toe Raises:

Slowly lift your feet off the ground on a tiptoe and hold the position before lowering it back down. Use a support if necessary.

Calf Stretch:

With a wall for support, lean forward with one leg bent and reach out for the wall with both hands at head level. The other leg should be kept straight and feeling the stretch along the calf. Do the same with the other leg.

Common Ice Skating Injuries: Prevention & Treatment

Ice skating injuries can be either acute or overuse injuries. Single skating tends to lead to overuse injuries while pairs suffer more acute injuries due to the nature of the different styles of skating – single skaters have no external support and have to use their full strength to maneuver the moves while pair skaters perform more dangerous stunts that can cause traumatic injuries. That said, repetitive stress from excessive training could cause any skater to suffer overuse injuries and a slip of technique in any kind of sports could result in traumatic injuries.

Types of Common Ice Skating Injuries

Figure skaters are usually not foreign to injuries. Overuse injuries such as pump bump, lace bite and tendonitis are commonly experienced when skaters are breaking in their new skates. These injuries are usually caused by the stiff leather of the new boots. However, it could also be caused by incorrect skating technique and body alignment, which can lead to more serious injuries like stress fractures, knee pain and back pain.

Acute injuries are usually caused by falls and accidents. Skaters could incur wrist fractures from instinctively stretching their arms out to break a fall. An ankle sprain could also happen when landing a jump on a wrong foot. These injuries, however, could be avoided.

Prevention

To prevent overuse injuries, space out the training sessions to avoid overworking the body and stretch before getting on ice. When breaking in new skates, walk around in the skates on even ground or speed up the process with heat moulding. Ensure that proper techniques and postures are used every time.

Wrist injuries can be easily prevented by simply letting yourself fall without using your arms to absorb the impact. You should skate slowly so that should you fall, the impact would not be as damaging to your body. To protect yourself from ankle sprains and other leg injuries, make sure that your skates give enough support to your ankles, and allow just a slight lift in the air when jumping so that the landing would not be as hard.

Treatment

Usually, the R.I.C.E (Rest, Ice, Compression, Elevation) method is sufficient to treat mild to moderate skating injuries. There are also plasma and steroid injections available to treat chronic injuries. If any bones are broken (fractured), seek medical advice as soon as possible. Your doctor may order an X-ray to examine the severity of the fracture and decide if surgery is necessary. Regardless of severity, it is recommended to only resume skating after full recovery lest causing further injury.

Flexible Flatfoot: Symptoms & Treatments

Flexible flatfoot is a progressive condition that typically occurs in children and adolescents. The arch of the affected foot is visible when sitting but collapses when standing. One of the most common types of flatfoot, people with this condition usually bring it into their adulthood as the symptoms may not surface or bother them until much later, when the tendon has deteriorated over the years.

Causes

Patients with some preexisting conditions are at higher risk of getting flexible flatfoot. Diabetes, rheumatoid arthritis and obesity put stress on the tendon that supports the arch, causing it to stretch or tear over time and eventually collapse under pressure.

Other factors like old age, injury to the foot, bunion, hammertoe and short Achilles tendon can also lead to flexible flatfoot.

Symptoms

The first signs of flexible flatfoot are pain and swelling along the inside of the ankle. As the condition worsens, the front of the foot and toes would turn outward and the heel rolled inward. If treatment is further delayed, the pain would shift to the outside of the ankle with the risk of developing arthritis. Patients are also likely to complain about pain along the shinbone, lower back and knee.

Diagnosis

The doctor would first look out for the collapsing and returning of the arch when you stand and sit. Your feet are observed from the front and back to see how much the forefoot has turned outward. An X-ray, CT scan, ultrasound or MRI may be ordered depending on whether details on soft or hard tissue are required.

Treatments

Non-Surgical Treatment:

Treatment would only be necessary when the symptoms have surfaced. Usually, non-surgical treatments are sufficient to relieve the symptoms. Methods may include the following:

  • Rest

Reduce or stop activities that aggravate the pain. Rest your feet more often and avoid standing and walking for too long.

  • Immobilization

A boot or cast helps to prevent weight bearing to allow the tendon to heal.

  • Orthotics

Orthotics are shoe inserts that can be customized to give support to the arch.

  • Losing Weight

If obesity is the cause of the condition, weight loss would help to relieve the pressure and pain.

  • Physical Therapy

Doing exercises stretch the Achilles tendon and provide stability to the joint.

  • Medication

Medication may be prescribed to reduce pain and inflammation.


Surgical Treatment:

If non-surgical treatment does not relieve the symptoms or if there are other problems such as a tendon tear or rupture, surgery would be required. Depending on the injury and severity, these methods might be considered:

  • Tendon Transfer
  • Foot Lift
  • Joint Spacer
  • Bone Fusion or Realignment

Posterior Tibial Tendon Dysfunction (PTTD): Cause, Symptom & Treatment

Posterior Tibial Tendon Dysfunction (PTTD) is a common type of flatfoot that occurs in adults, also often called the Adult Acquired Flatfoot. One of the main supporting structures of the foot, the posterior tibial tendon holds up the foot arch and assists in the walking movement. When the tendon gets torn or inflamed, the foot loses stability and support and the arch collapses, resulting in a flatfoot.

Causes

PTTD is an acute injury caused by a fall or traffic accident. It could also be an overuse injury usually caused by activities that involve intense usage of the tendon, such as running, hiking and soccer. The repetitive impact causes inflammation and tearing of the posterior tibial tendon over time.

Symptoms

Different symptoms develop as the severity of the condition increases. At the first stage, there would be pain, swelling and redness on the inside of the foot and ankle. When the arch begins to flatten, the forefoot and toes start to turn outward while the ankle leans inward with the same inner foot pain.

As the tendon further deteriorates, the arch gets even flatter. By then, the pain has shifted to the bottom outer side of the foot. There is a high risk of developing arthritis in the ankle in such severe cases.


Treatments

Non-Surgical Treatment:

As PTTD is a progressive condition, the earlier treatment starts, the better the chances to avoid surgery. In most cases, non-surgical treatment suffices to relieve the symptoms and keeps the condition from progressing further. Treatment may include the following methods.

  • Rest and Ice

Reducing or stopping activities that aggravate the pain. Then ice 3-4 times a day every 20 minutes to bring down the swell.

  • Immobilization

A cast or boot is worn for 6 to 8 weeks to avoid weight bearing and allow the tendon to heal.

  • Orthotics

Orthotics and braces help to position and support the foot.

  • Physical Therapy

Ultrasound therapy is used to reduce the inflammation while exercises help to reduce the stiffness of the muscles and regain stability.

  • Medication

Medication may be prescribed to reduce pain and inflammation. However, medication alone does not fully heal the injury.

 

Surgical Treatment:

If the symptoms do not improve after 6 months of conservative treatment, surgery would be required. Depending on the severity of damage, different types of surgery are used.

  • Lengthening of Achilles tendon
  • Cleaning the posterior tibial tendon of inflamed tissue
  • Tendon transfer
  • Cutting and shifting bones to support the arch
  • Fusion of bones to remove the joint

What Is Os Trigonum Syndrome?

Os Trigonum

The os trigonum is a bony ossicle, or a small bone, developed at the back of the ankle talus bone. Formed during the ages 7 to 13 years old, this happens when a part of the bone is not fully fused with the talus, causing an extra bone to jut out from behind.

Os Trigonum Syndrome

Patients with os trigonum syndrome may or may not realize the condition. Some people feel pain at the back of the ankle early on while others may only feel the pain when triggered by an injury. This syndrome is commonly experienced by ballet dancers, soccer players and people who are highly active in sports that require frequent downward pointing of the toes. Known as the “nutcracker phenomenon”, the injury occurs when the toes are pointed and the os trigonum is crushed between the talus and heel bones, causing the surrounding tissue to be torn and inflamed.

This condition has many names. It could also be called posterior tibial talar impingement syndrome, symptomatic os trigonum or the talar compression syndrome.

Symptoms

Os trigonum syndrome causes one to experience a deep aching pain at the posterior of the ankle, especially when toes are pointed downward or pushing the foot off the ground. The injured area also feels tender with visible swelling and reduced plantarflexion.

Diagnosis

To diagnose the condition, the doctor will ask questions about activities that the patient is involved in and the development of the symptoms. The MRI is the preferred scan as it can show the size of the os trigonum and the extent of the damage. However, an X-ray, MRI or CT scan may also be ordered.

Treatment

Non-Surgical Treatment:

Conservative treatment is usually recommended as the first approach to treating os trigonum syndrome as it yields a high success recovery rate.

Patient first has to completely stop all activities that can aggravate the injury for about 4 to 6 weeks to allow the inflammation to subside. Icing the area would help reduce the swelling. The foot is then immobilized in a boot or cast to reduce weight bearing. Oral medication and injections may be prescribed to relieve the pain, followed by regular sessions of physical therapy.

Surgical Treatment:

If the condition does not improve with non-surgical treatment, surgery would be considered provided that there is no infection in the skin and soft tissue around the area. Endoscopic os trigonum resection is a commonly used method as it helps the foot regain mobility and relieve other symptoms with less scarring and faster recovery.