The Trouble Ankle: Persistent Pain After Inversion Ankle Injury

Sports Medicine Rehabilitation (B Liem and BJ Krabak, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Sports Medicine Rehabilitation

Abstract

Purpose of review

Persistent pain after an inversion ankle injury is a relatively common occurrence in a sports medicine clinic and can be challenging for both the patient and team of healthcare providers.

Recent findings

Research to date has outlined diagnostic and treatment paradigms for persistent ankle pain after an inversion injury. Surgical techniques and non-surgical approaches are evolving, and balance and proprioceptive training as a part of a functional rehabilitation program is beneficial.

Summary

Persistent pain after and inversion ankle injury can be difficult; however, careful consideration of anatomy, pathomechanics, and patient function can guide evaluation and management.

Keywords

Ankle injury Chronic ankle instability Sinus tarsi syndrome Ankle sprain Problem ankle Inversion injury 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

  1. 1.
    Stormont DM, Morrey BF, An K-N, Cass JR. Stability of the loaded ankle. Am J Sports Med. 1985;13(5):295–300.CrossRefPubMedGoogle Scholar
  2. 2.
    Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train. 2002;37(4):364–75.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Lin C-F, Gross MT, Weinhold P. Ankle syndesmosis injuries: anatomy, biomechanics, mechanism of injury, and clinical guidelines for diagnosis and intervention. J Orthop Sport Phys Ther. 2006;36(6):372–84.CrossRefGoogle Scholar
  4. 4.
    Miklovic TM, Donovan L, Protzuk OA, Kang MS, Feger MA. Acute lateral ankle sprain to chronic ankle instability: a pathway of dysfunction. Phys Sportsmed. 2017:1–7.Google Scholar
  5. 5.
    Martin RL, Davenport TE, Paulseth S, Wukich DK, Godges JJ. Ankle stability and movement coordination impairments: ankle ligament sprains. J Orthop Sport Phys Ther. 2013;43(9):A1–A40.CrossRefGoogle Scholar
  6. 6.
    Valderrabano V, Hintermann B, Horisberger M, Tak SF. Ligamentous posttraumatic ankle osteoarthritis. Am J Sports Med. 2006;34(4):612–20.CrossRefPubMedGoogle Scholar
  7. 7.
    Sugimoto K, Takakura Y, Okahashi K, Samoto N, Kawate K, Iwai M. Chondral injuries of the ankle with recurrent lateral instability: an arthroscopic study. J Bone Joint Surg - Ser A. 2009;91(1):99–106.CrossRefGoogle Scholar
  8. 8.
    Willems T, Witvrouw E, Verstuyft J, Vaes P, De Clercq D. Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train. 2002;37(4):487–93.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Docherty CL, Valovich McLeod TC, Shultz SJ. Postural control deficits in participants with functional ankle instability as measured by the balance error scoring system. Clin J Sport Med. 2006;16(3):203–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Beckman SM, Buchanan TS. Ankle inversion injury and hypermobility: effect on hip and ankle muscle electromyography onset latency. Arch Phys Med Rehabil. 1995;76(12):1138–43.CrossRefPubMedGoogle Scholar
  11. 11.
    Kim E, Choi H, Cha JH, Park JC, Kim T. Effects of neuromuscular training on the rear-foot angle kinematics in elite women field hockey players with chronic ankle instability. J Sports Sci Med. 2017;16(1):137–46.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Webster KA, Gribble PA. Functional rehabilitation interventions for chronic ankle instability: a systematic review. J Sport Rehabil. 2010;19(1):98–114.CrossRefPubMedGoogle Scholar
  13. 13.
    Springer S, Gottlieb U. Effects of dual-task and walking speed on gait variability in people with chronic ankle instability: a cross-sectional study. BMC Musculoskelet Disord. 2017;18:316.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Ju S, Park G. Effects of the application of ankle functional rehabilitation exercise on the ankle joint functional movement screen and isokinetic muscular function in patients with chronic ankle sprain. J Phys Ther Sci. 2017;29(2):278–81.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    McKeon P, Ingersoll CD, Kerrigan DC, Saliba E, Bennett BC, Hertel J. Balance training improves function and postural control in those with chronic ankle instability. Med Sci Sports Exerc. 2008;40(10):1810–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Helgeson K. Examination and intervention for sinus tarsi syndrome. N Am J Sports Phys Ther. 2009;4(1):29–37.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Lektrakul N, Chung CB, Ym L, Theodorou DJ, Yu J, Haghighi P, et al. Tarsal sinus: arthrographic, MR imaging, MR arthrographic, and pathologic findings in cadavers and retrospective study data in patients with sinus tarsi syndrome. Radiology. 2001;219(3):802–10.CrossRefPubMedGoogle Scholar
  18. 18.
    van Bergen CJ, Kox LS, Maas M, Sierevelt IN, Kerkhoffs GM, van Dijk CN. Arthroscopic treatment of osteochondral defects of the talus: outcomes at eight to twenty years of follow-up. Bone Joint Surg Am. 2013;95(6):519–25.CrossRefGoogle Scholar
  19. 19.
    Saxena A, Perez H. Pigmented villonodular synovitis about the ankle: a review of the literature and presentation in 10 athletic patients. Foot Ankle Int. 2004;25(11):819–26.CrossRefPubMedGoogle Scholar
  20. 20.
    Lynskey SJ, Pianta MJ. MRI and thallium features of pigmented villonodular synovitis and giant cell tumours of tendon sheaths: a retrospective single centre study of imaging and literature review. Br J Radiol. 2015;88(1056):20150528.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Kanatli U, Ataoğlu MB, Özer M, Yildirim A, Cetinkaya M. Arthroscopic treatment of intra-artricularly localised pigmented villonodular synovitis of the ankle: 4 cases with long-term follow-up. Foot Ankle Surg. 2017;23(4):e14–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Schnirring-Judge M, Lin B. Pigmented villonodular synovitis of the ankle-radiation therapy as a primary treatment to reduce recurrence: a case report with 8-year follow-up. J Foot Ankle Surg. 2011;50(1):108–16.CrossRefPubMedGoogle Scholar
  23. 23.
    van Dijk N. Anterior and posterior ankle impingement. Foot Ankle Clin. 2006;11(3):663–83.CrossRefGoogle Scholar
  24. 24.
    Nazarian LN, Gulvartian NV, Freeland EC, Chao W. Ultrasound-guided percutaneous needle fenestration and corticosteroid injection for anterior and anterolateral ankle impingement. Foot Ankle Spec. 2018;11(1):61–6.CrossRefPubMedGoogle Scholar
  25. 25.
    Walsh SJ, Twaddle BC, Rosenfeldt MP, Boyle MJ. Arthroscopic treatment of anterior ankle impingement: a prospective study of 46 patients with 5-year follow-up. Am J Sports Med. 2014;42(11):2722–6.CrossRefPubMedGoogle Scholar
  26. 26.
    Waterman BR, Owens BD, Davey S, Zacchilli MA, Belmont PJ. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am. 2010;92(13):2279–84.CrossRefPubMedGoogle Scholar
  27. 27.
    Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med. 2014;44(1):123–40.CrossRefPubMedGoogle Scholar
  28. 28.
    Konradsen L, Bech L, Ehrenbjerg M, Nickelsen T. Seven years follow-up after ankle inversion trauma. Scand J Med Sci Sports. 2002;12(3):129–35.CrossRefPubMedGoogle Scholar
  29. 29.
    Kemler E, Thijs KM, Badenbroek I, van de Port IG, Hoes AW, Backx FJ. Long-term prognosis of acute lateral ankle ligamentous sprains: high incidence of recurrences and residual symptoms. Fam Pract. 2016;33(6):596–600.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Rehabilitation MedicineSidney Kimmel Medical College at Thomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Physical Medicine and Rehabilitation Residency ProgramThomas Jefferson University HospitalPhiladelphiaUSA

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