Ankle pain or pain in the hindfoot can have a significant effect on everyday activities resulting in pain when walking or exercising, difficulty carrying out duties at work and affecting the types of footwear that can be worn comfortably. There are a number of different causes of ankle pain, including acute injury, arthritis, biomechanics and foot structure. Here we will discuss common causes of ankle pain and how a suitably qualified ankle specialist can get you back to living pain-free.
Posterior Tibialis Tendon Dysfunction (PTTD)
The posterior tibial tendon runs on the inside of the ankle joint and has a pivotal role in supporting the arch of the foot. When there is a significant flattening of the arch of the foot, or rolling in, the posterior tibial tendon becomes overworked and strained, leading to pain and sometimes swelling and weakness on the inside of the ankle. Many conservative treatments are available for this condition and may include orthotic therapy, supportive footwear and strengthening. If conservative measures fail, a special implant known as the HyProCure implant can be inserted into the hind foot to permanently support the arch of the foot and prevent excessive strain on the tendon. For more detailed information about HyProCure surgery click here.
Fractures affecting the hind foot are common and can occur as a result of ankle sprains, jumping from heights or other traumatic events. Suspected fractures or events causing significant trauma to the foot require an X-ray to evaluate for different types of bony injury. Fractures where the bones remain in their usual position usually require a period of immobilisation for healing to occur. On the other hand, sometimes the two ends of bone come away from each other as a result of the force of injury, this is known as a displaced fracture. Displaced fractures usually need to be fixed via an open procedure where the two ends of the bone are brought back together and held with screws and a small plate. An ankle specialist will thoroughly review your injury and use appropriate imaging to determine whether ankle surgery may be necessary.
Ankle Impingement (Os Trigonum)
Painful impingement at the back of the ankle is often caused by a small accessory bone called an os trigonum. The presence of this accessory bone is congenital (present at birth), however, the onset of pain related to it is often triggered by an event such as an ankle sprain, or becomes painful in people involved in a sport such as dancing, netball, basketball etc. Treatment in the first instance usually involves rest, immobilisation, and anti-inflammatory medication, however ankle surgery to remove the accessory bone may be required if the pain doesn’t settle.
Haglund’s deformity is a condition where a bony enlargement occurs at the back of the heel and can result in secondary irritation to the Achilles tendon at its attachment. The bump can be irritating in footwear, particularly shoes with a rigid heel counter. Opinion from an ankle specialist is helpful to determine whether surgery may be necessary to reduce the bony bump. This can sometimes be performed through a keyhole approach depending on the severity.
Perth Podiatric Surgery offers the latest surgical techniques including keyhole ankle surgery for a range of conditions. Book an appointment with our foot and ankle specialist online or speak to one of our friendly staff members by calling 08 9383 3851.