Arthritis is often the cause of chronic ankle pain, but other conditions such as osteochondral lesions of the talus can certainly be the reason a patient suffers from the condition. People who are involved in sports are at risk of ankle instability and peroneal tendon injuries, although the conditions can also be the result of repeated injuries over time.
While a sprained ankle is not usually viewed by patients with great alarm, if the cartilage does not heal properly, the damage can be long lasting. The top of the dome-shaped ankle bone (talus), which is completely covered with cartilage, forms the ankle joint where it meets the shin bone (tibia). When this tough, rubbery tissue is injured by a sprain, for example, it must be allowed to heal completely otherwise it can soften and separate from the rest of the cartilage, causing chronic pain.
Although conservative treatment, such as immobilizing the ankle in a cast on a strictly non-weight-bearing basis, tends to resolve the situation with young patients, adults usually require surgery. The surgical options for this condition vary from arthroscopic minimally invasive techniques to open cartilage transplant procedures.
Chronic ankle instability is a condition that often develops after repeated ankle sprains. In addition to causing persistent pain, it may cause a cycle of re-injury, leading to a general weakening of the ligaments, which in itself results in greater instability. Treating the initial sprain correctly and then rehabilitating the muscles and tissues in the ankle for strength and balance is crucial.
Similarly, a peroneal tendon injury, such as a tear, subluxation or a case of tendonitis, can become chronic and should be evaluated by a foot and ankle surgeon as soon as the patient feels pain and experiences swelling and/or the back of the ankle is warm to the touch. If non-surgical treatments are not an option, the post-operative recovery period will generally include six weeks of non-weight-bearing immobilization followed by physical therapy.
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