We’ve all tweaked our ankles at some point in our lives. Some of us have even done it so forcefully that we have sprained a ligament, broken a bone, or strained a muscle. Hopefully, you took appropriate care and are feeling better, but often in my practice, I hear the dreaded phrase, “oh yeah, that’s my bad ankle. It never got better after I did (insert something youthful and nostalgic here).”
There are two forms of untreated ankle issues I see in the clinic regularly. The painful ankle that is effectively avoided or the stiff ankle that the patient thinks is normal. Both can have long-term effects on ankle health and wear and tear on the knees, hips, and even low backs.
Think of how you walk now. Then think of how you walk with a rock in your shoe. Pretty big difference, right? Pain can change how we move in an instant. The nice thing about this example is we can take the rock out of the shoe. Unfortunately for people with unresolved ankle pain, the fix is not so easy. Most will have at least tried to address it with medication or home remedies, but long term, a common solution is to change how you walk.
If you couldn’t remove that rock in your shoe, your next choice would be to walk on different surfaces of your foot to avoid where the rock is. If you are not addressing your ankle pain, your body is doing the same, whether you know it or not. A key motion in the walking cycle is dorsiflexion or the motion of bending your ankle to bring the top of your foot closer to the front of your shin. This motion is also the most limited by pain from ankle arthritis and various soft tissue impingements. If you can’t dorsiflex, you have trouble getting your foot behind you when you walk. This usually leads to an outward rotation of the leg to shift weight to the instep versus pushing off through the toes. This can create everything from achilles tendonitis, hip joint wear and tear, and low back pain.
The stiff ankle is the less obvious but sometimes more sinister version of the painful ankle. A stiff ankle is almost always an ankle that doesn’t have great dorsiflexion, but because it’s not painful, it is less likely to be addressed. You need dorsiflexion to squat, lunge, run and work on your knees efficiently. When you can’t get that motion from your ankle, the same compensations happen in the knee, hip, and back.
The tricky thing is that a stiff ankle can cause pain in different areas, but the treatments rarely address the underlying cause. I can’t tell you how many times I have seen knee meniscus tears, hip labral tears, or lumbar strains that “just keep coming back when I run,” or “I’ve been seen by a chiropractor, acupuncturist, and two PTs and it doesn’t go away.” Often the issue is not addressing the whole movement pattern. Usually, the patient could have saved a lot of time and money just by seeing someone who addressed the entire leg and how the ankle causes other joints to work harder.
If you have nagging ankle pain or pain in other joints that won’t allow you to get back to the things you love fully, you should consider having your ankle assessed by a skilled therapist who will look at the whole leg. At Athletico, we see athletes and complex orthopedic issues daily, so stop by for a free assessment today. Free Assessments are available in-clinic and virtually through our telehealth platform.
*Per federal guidelines, beneficiaries of plans such as Medicare, Medicaid, Tricare, VHA and other federally funded plans are not eligible for free assessments.
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