Ankle microfractures

Microfractures of the bones that make the ankle joint are considered to be a result of overloading the joint, therefore they are seen as overuse syndromes. Due to excessive loads on the ankle and/or wrong or decreased foot and lower leg muscle activity, active ankle stabilizers, as well as due to instability, weakness and decreased function of the ankle ligaments, passive ankle stabilizers, with time small, microfractures on the ankle joint bones can develop. Ankle microfractures can become a chronic state if they are not properly treated.

This overuse syndrome develops gradually, with time, with accumulation of small changes in the bone structure and loss of their strenght and density. Symptoms include a dull, longlasting pain, swelling, limitations in ankle joint mobility and functionality which impair normal performace of either daily or sports activities. The occurence of ankle joint microfractures can have many causing factors such as, being overweight, constatnt and longlasting static load of the foot and ankle, inproper treatment of a traumatic/acute ankle injury, with certain medical conditions (ostoeporosis, neuropathy – muscle weakness), choice of low quality or inadequate footwear, irregularities in the training regime (sudden training intensty and extensity changes, constatnt performance of a movement in an incorrect way), etc.

Tretment is through a conservative approach, the exact activity or factor that caused this pain syndrome to develop should be properly diagnosed and removed and the activity which causes pain and discomfort should be decreased in order to remove the load from the ankle. RICE method (resz, ice, compression, elevation) should be used in the initial therapy stages to relieve pain, swelling and remove the load from the affected ankle in order to let the microfractures heal properly. In the later stages of rehabilitation process, when the microfractures are fully healed, progressive and gradual funcional therapy should be implemented with use of ankle mobility, lower leg and foot muscles strenghtening and ankle joint stability and balance exercises.

Prevention: use of quality and adequate footwear depending on the sports activity or job description, maintaining a balanced body weight, correct movement patterns, especially of certain movements that are used constantly, proper approach to increasing the training load, correct, timely and proper sanation and tretment of earlier acute ankle joint injuries, etc.