THE STRUCTURES OF THE ANKLE JOINT
The foot and the ankle are the most important limbs that carry our body; consisting of many bones, ligaments, muscles and tendons that work in harmony, they play the most important role in walking, springing, gait and social activities.
It is of great importance to know the structure of your foot when buying shoes if you have pes planus (flat foot ) and choose shoes that have flat sole without back support, you may suffer various problems starting from foot to knee and low back pain and you may not realise that you have changed your gait.
It must not be forgotten to choose shoes in accordance with the ground and the kind of sports you perform.Lack of warming before sports may ensue muscle-tendon injuries during activities.Sprains that force the physiological limits of the foot may cause soft tissue ( muscle, tendon, ligaments) injuries or bone fractures, bone marrow edema etc.
IN WHICH GROUP of PATIENTS IS FOOT and ANKLE PROBLEMS MOSTLY SEEN?
Foot problems may concern every individual starting from birth, no matter what his/her age is.
-Imaging procedures (X-Ray, Ultrasound, MRI) aid the diagnosis
WHAT ARE THE MOST COMMON FOOT AND ANKLE PROBLEMS?
- Tendon injury-rupture
- Achille Tendon rupture
- Fracture (5.metatars fracture, distal fibula, tibia fracture etc)
- Bone marrow edema
- Epin calcanei (Plantar Fasciitis)
- Pes planus
Lateral Ankle Ligament Sprain
It is the most common type of injury seen in the ankle sprain group. It so due to sprain of the lateral ligament following excessive inversion of the ankle.
According to the grade of injury;
Grade 1: Stretch in a ligament (usually anterior talofibuler ligament) is seen. Mild pain and sensitivity with mild or no swelling.
Grade 2: Pain, sensitivity and swelling following one or more ligament injuries. Limitation in range of motion and gait.
Grade 3: One or more ligaments are ruptured. The joint isn’t stabil. There is excessive pain, sensitivity, edema and loss of function. It is hard to give weight to the foot.
-Physical therapy agents (TENS, Magnetic field, Intermittent Air Compression, Ultrasound, Laser etc)
-Stretching, strengthening and gait, balance exercises
-Strenghtening program with Cybex device
Syndesmosis is a joint that bonds the bones with fibrous ligaments. It is found in three different parts of the body; one in the foot. The Ankle joint is composed of three bones; Tibia, Fibula and Talus. Syndosmosis is formed by three ligaments that bond the Tibia and Fibula.
Syndesmosis is injury or rupture of one or more of these ligaments that we have mentioned above. It is mostly seen in football players, skaters and athletes. The approach to therapy differs according to the degree of the injury.
Grade 1: (moderate injury) similar to lateral ligament injury; there is only laxity/damage in the ligament and pain and swelling on the lateral part of the foot.
Grade 2: (moderate rupture) there is a parciel rupture of the ligament. That’s why pain and swelling is more and intense compared to Grade 1. The ankle isn’t stabil.
Grade 3: (Complete rupture) The Tibia and Fibula are seperated, caused by complete rupture of the ligament. There is sharp and widespread (sometimes up to the knee) pain in the ankle.The foot is not stabil. The patient cannot give weight.
-Physical Therapy Agents (TENS, Magnetic field, Intermittent Air Compression , Ultrasound etc),
-Streching, Strenghtening, balance-gait exercises,
-Strenghtening program with Cybex,
BONE MARROW EDEMA
Bone Marrow Edema is the incrementation of fluid in the bone.It may be due to many reasons; from injury of the bone to tumors.That’s why differential diagnosis is of great importance.
Avascular Necrosis can be manifested as Bone Marrow Edema Syndrome.Local surgical interventions,radiotherapy,medical interventions etc. may also be causes.