Ankle

Explanation:

Ankle sprains are extremely common and generally occur when someone ‘rolls’ on their ankle damaging ligaments of the region. Most commonly sprains occur on the lateral side of the ankle (the outside region). Ankle sprains range in severity from a simple strain to a complete tear of the ligament. Although the majority of ankle sprains resolve quickly, in some cases pain and disability can persist for months due to problems such as synovitis (joint inflammation) which can develop if return to full weight-bearing after a sprain is too early or has been forced.

Causes:

Possible causes of ankle pain include:

instability due to repeated ankle sprain or if the ankle does not heal adequately after a bad sprain. This can be due to a combination of the ligaments being stretched out and muscles around the joint failing to support the joint.
poor proprioception, our unconscious awareness of body movement and position (see below)
bony and soft tissue impingement syndromes
fractures of the tibia/fibula
tendon problems such as tibialis posterior tendinosis

Poor proprioception is a common underlying cause of injury to the ankle. Little sensors / receptors built into the tissues of our body (joints, muscles, and ligaments) detect movement and send information about its direction and speed to our brain which in turn uses this information to plan and coordinate movement. Injury to tissues with these built in receptors mean that the brain has less information to work on and fails to activate muscles when appropriate, for example to ‘right’ the ankle when it is about to ‘roll’.

Treatment:

Physiotherapy treatment for ankles may include:

proprioception exercises to ‘retrain’ this pathway from the receptors to the brain
manual therapy to mobilise restrictions in range of movement
electrotherapeutic modalities
specific exercises to restore strength in relevant muscles, proprioception improvement and elimination of any biomechanical dysfunctions identified