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Chronic
Ankle Pain may be more
than just a Sprain
Newswise —
Ankle sprains are a common injury after
a fall, sudden twist or blow to the ankle
joint.
• Approximately 40 percent of those who
suffer an ankle sprain will experience
chronic ankle pain, even after being treated
for their initial injury.
A review article published in the May 2009 issue of the
Journal of the American Academy of
Orthopaedic Surgeons (JAAOS)
explains that tendon injuries to the ankle
can be a possible cause for this chronic
pain. In some cases, the condition is
untreated or overlooked which prolongs the
pain and the problem.
“When patients injure their ankles, the
injury may not seem serious at first,”
explains Terrence Philbin, DO, lead author
of the article and Fellowship Director of
the Orthopedic Foot and Ankle Center in
Columbus, Ohio.
“People may not seek medical attention and
they can think it will just get better on
its own. I think that is why this condition
often goes undiagnosed."
The authors of the article describe how in some cases
chronic ankle pain may actually be the
result of injuries to the peroneal tendons.
• The peroneal tendons are located behind
the outside portion of the anklebone (called
the fibula). The tendons help to stabilize
the foot and ankle.
• Tendon injuries can include
tendonitis or swelling around the
tendons. In more severe cases, the peroneal
tendons can actually tear or there can be a
swelling of the tendons behind the fibula
bone. This can cause the ligament that holds
the tendons together to stretch out and
tear, or even rupture.
Symptoms associated with peroneal tendon
injuries can include:
• Ankle pain that is not responding to
treatment
• Swelling and tenderness around the outside
of the ankle
• Pain behind the anklebone
• Pain that transmits from the ankle down
into the foot
The use of magnetic resonance imaging (MRI)
or ultrasound can be helpful when
identifying and diagnosing peroneal tendon
injuries and disorders. “These imaging
techniques offer a more complete look at the
peroneal tendons,” noted Philbin. “One might
consider getting an MRI or ultrasound
especially if you have chronic ankle pain.”
If the condition is caught early,
non-operative treatment options can include:
• Rest, ice and elevation
• Anti-inflammatory medication
• Immobilization in a cast or brace
• Physical therapy
More serious injuries of the peroneal
tendons, including tears or ruptures, will
very likely require surgery.
Peroneal tendon injuries can happen suddenly
or can develop over time. The injury is most
common among athletes involved in sports
that require repetitive ankle motion and in
individuals who have high arches of the
foot.
A proper diagnosis is essential in order to
treat peroneal tendon injuries correctly and
to help alleviate chronic pain. Philbin
reminds patients, “If you have ankle pain
and it is not getting better, do not ignore
it. Get it evaluated by a physician who has
experience treating foot and ankle
injuries.”
Disclosure: Terrence Philbin, DO, and the
co-authors of this article received no
compensation for this review article.
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