Ankle & foot pain

Causes for Ankle Injuries

The cause of an ankle injury most often occurs initially as an acute injury, a distortion, a sprain or trauma to the ankle.

Ankle problems can then often become a persistent problem and lead to multiple episodes of sprains or other trauma to the ankle.

There are several factors that have an impact on this persistent situation.

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Overuse injuries

Overuse of muscles in the calf or shin can also occur in connection with overtraining in running, football, handball, etc. This often results in shin inflammation, heel spurs or muscle fiber tears in the calf

The Ankle and foot joint

The foot consists of 26 different bones, 33 joints, over 100 ligaments and countless muscles. This high number of structures plays an important role in terms of mobility, stability and force transfer. The 33 joint connections provide flexibility so that the foot can adapt to different surfaces and at the same time absorb shock loads upwards in the skeleton. The many ligaments that hold the foot together have an essential function in terms of force transmission. Ligaments and tendons contain a high concentration of elastane, which when stretched can absorb energy which then is used to save effort, e.g. by running.

The stability of the foot and ankle depends on how well the muscles, tendons, joints and nervous system can work together and the more structures an area consists of, the less stability there is.

Proprioception

The ankle joint is one of the joints in the body that requires the greatest proprioception, i.e. the body’s ability to perceive the position of your joints. The foot and ankle joint are the first joints to have contact with the surface. During walking or running, the nervous system is informed about the spatial awareness and at the same time the brain is informed about the surface and how the muscles, connective tissue and other joints should respond to the specific stimuli.

Proprioception is controlled by the brain and central nervous system, but there are other important areas in the body that have an influence on this.

The Neck, jaw joint & and their relation to foot pain

The skull, the upper cervical vertebrae, together with the temporomandibular joint, affect approximately 30% of the proprioceptive function in the body. The head, neck and jaw are at the top of the body hierarchy as the brain and nervous system control the autonomic nervous system, i.e. the system that keeps us alive. Posture, i.e. the position of joints in the body, is controlled by the position of the head so that the head itself is tried to be kept straight, after which the body follows. Therefore, problems such as trauma to the head, neck pain and orthodontic treatment might have consequences on the entire body.

Achilles tendonitis

Can be described as inflammation in one or more of the tendons from the calf muscles that attach to the heel bone.

Symptoms of Achilles tendonitis include thickening of the tendon, stiffness in the tendon in the morning (which improves with activity), pain when starting to run (which improves when the tendon warms up), tenderness when touching the tendon, and warmth and sweating in the area. If the condition is advanced, any type of activity will worsen the pain in the tendon.

Causes of Achilles tendonitis are often poor blood circulation to and from the leg, altered physiology in the body such as acidity in the blood.

Sunken forefoot

Sunken forefoot or sunken metatarsals is a syndrome in which one or more bones in the forefoot have changed their original position. This often results in altered foot mechanics, making the muscles and tendons in the foot more easily overloaded. The condition should be considered as a possible cause if you have long-term or multiple injuries to the foot.

Causes of sunken forefoot may include dysfunction in the hormonal system (e.g. pregnancy or metabolism), repetitive heavy lifting, arthritis, decreased strength of the foot muscles and the nervous system to the foot.

Heel spurs and inflammation of the plantar fascia

Heel spurs and plantar fasciitis are inflammations of the plantar fascia, the connective tissue or tendon under the foot. Symptoms of both conditions include severe start-up pain, which is often relieved when the foot is warmed up, difficulty supporting on the foot, pain when pressing under the foot, and discomfort under the foot at rest.

Causes can be incorrect foot posture, sunken forefoot, flat feet, overactivation of the nervous system due to back problems, sciatica, poor blood supply to the area, dysfunction in the autonomic nervous system, etc.

Shin splints

Shin splints is an irritation of the muscles, tendons and/or tendon attachments of the lower leg.

Shin splints are a common sports injury that most often occurs in connection with running. Symptoms of shin splints include pain and swelling in the calf and/or shin during weight-bearing activities, and activities that involve impact through the foot (such as running) will often worsen the symptoms.

A feeling of pressure in the lower leg and pain will often persist after the activity.

Symptoms of foot and ankle problems

The most common complaints with the foot or ankle are ankle sprain, Achilles tendon inflammation and/or overload, sunken forefoot, heel spur, heel pain, plantar fasciitis, chronic ankle instability, sinus tarsi syndrome, cartilage damage in the ankle, stress fractures, arthritis (rheumatoid arthritis, gout, osteoarthritis, tarsal tunnel syndrome, ankle stiffness, posterior tibial syndrome, chronic ankle and foot problems, ankle impingement.

Osteopathic approach to ankle pain/foot pain

The cause of the ankle pain / foot pain must be determined, where examination of, among other things, the mechanical load that affects the ankle (muscles, tendons, joints), the blood circulation to and from the ankle and the nerve supply to all structures in the ankle is essential.

All conditions that affect the ankle joint must and should be treated so that a quick and lasting effect is achieved.

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