Updated: May 12, 2022
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Hey Dr. McNamara here with a Wellness Wednesday. What I wanted to talk to you about today is the most common ankle injuries that we get when we run. So the first, most common injury that we often see is a stress fracture.
Now stress fractures are primarily due to overuse type of injuries. So maybe you just did a little too much too early on in your training. Generally what we see occurring the most with a stress fracture is the metatarsal getting affected, which are those big bumps on the bottom of your feet before your toes.
The next pathology that we see a lot is plantar fasciitis. This is also a pathology that affects the foot and it affects that fascia underneath the bottom of the foot. So if you're feeling pain in that middle of the foot or in the heel, particularly in the morning after waking up, if it's really tight and gets better, as the day goes on, that's a indicative of a plantar fasciitis.
Moving along other common ones we see is Achilles tendonitis or Achilles tendinopathy. So any type of Achilles tendon injuries, that's that tendon that attaches the gastrocs and soleus, the calf muscles, into the foot and allows for that plantar flexion motion. So in running, we're constantly performing that motion and that can cause a little bit of an overuse injury and some inflammation in the form of Achilles tendonitis or tendinosis depending on long.
The next muscular tendon pathology that we're going to talk about is posterior tibialis, tendinitis, or tendinopathy. Now this one's less well-known than the Achilles tendon because it's often just overlooked because it's a very small muscle and it travels really close to your Achilles tendon, but attaches into your navicular bone on your foot. Now I get a lot of issues with this due to my flat feet and due to that, it causes extra tension onto that posterior tibialis tendon, as well as that navicular bone. And I actually have a little bit of a growth, an extra bone that's formed because of that so I have to be extra careful. If I feel any type of pain right behind the ankle that bump or the inside of your ankle, that's indicative of that posterior tibialis type of pathology.
Next one I want to talk about is a sesamoid injury. First, we have to talk about what a sesamoid is. And it's a floating bone, like your knee cap. It's stuck within the tendon of the quadriceps and then attaches into the tibia down here. So it's a floating bone. You have some of these in your feet. So everyone's got two under that first metatarsal that we talked about there, and often times those just get inflamed from overuse. There's some verses that are associated that can get inflamed and cause some bursitis and pretty much any of these sesamoid injuries are just inflammation due to overuse and improper biomechanics of the foot and ankle.
The next one I want to talk about is peroneal tendonitis. Now the peroneal muscles on the outside of our leg, also known as the fibularis and attaches into the lateral side of the foot. So oftentimes these muscles will get injured and this is more of an overuse injury type of thing too. Or if you maybe have a slight sprain of the ankle, you may have strain those muscles as well. So it may take a little bit of rehabilitation to fix that.
After that we got your common ankle sprain. Most common would be that inversion sprain, where the ankles going in and you're gonna damage those talofibular ligaments on the outside, but it does happen where we go inward too, just like that, an eversion sprain, but the most common we see is that inversion sprain. And generally what we would do with that is we would stabilize the area, make sure the tissue, the musculature ligaments around are healing properly with some manual therapy and some adjusting. Then we would want to rebuild the proprioceptive awareness of that ankle through some balance work, things like that so we don't re injure that ankle.
Then the last one, it's not as commonly seen, but does happen sometimes is posterior ankle impingement syndrome. This is another one that is an overuse injury. And generally we see it in people that are a little bit too plantar flexed, so they don't have enough dorsal flexion of their foot. And pretty much what's happening is the calcaneus is just getting compressed in that ankle joint from constantly being in that plantar flex position which causes pressure, a little bit of pain around the joint. And if you have a sesamoid bone, one of those floating bones around there that makes it a little bit more common.
So a lot of these things can be seen on x-ray or MRI but make sure you get in, if you're having any type of ankle pain, when you're running, jumping, or from any type of exercise so we can diagnose it properly to make sure we had the pain generator detected so we can get you the proper treatment.