The ankle joint is divided into upper and lower joints. The upper one is formed by the tibia, the arrow and the talus block. The lower one is formed by the talus, calcaneus and navicular bones. Numerous ligaments tighten and stretch, thanks to which they provide stabilisation for the bones during movements. It helps keep the body upright, transfers loads to the foot, and is cushioned by the foot.
The most common ankle joint problems are:
- Dislocations/twists/strains – involve swelling, hematomas, ligament damage. There are three grades of twists depending on the damage.
- Nerve neuropathies (e.g., peroneal, tibial)
- Tarsal canal syndrome – compression of the tibial nerve at the ankle joint level, leading to an impaired sensation of the sole of the foot.
- Shooting ankle syndrome.
- Fractures – the most common are Weber fractures, i.e., avulsion fractures of the tibial lateral malleolus.
Rehabilitation is about protecting against the instability of the joint. A well-chosen exercise program and training instruction can prevent re-injury, and the range includes proprioceptive exercises and exercises on unstable ground. Muscle strength and endurance should be improved. It is vital to increase the range of movements and precision in their performance. Physiotherapeutic procedures such as ultrasound, electrotherapy and magnetron are often used. Rehabilitation allows to return to sports and perform everyday activities without the symptoms of dislocation and pain.
The foot consists of seven tarsal bones, five metatarsal bones and fourteen toe bones. The arch of the foot consists of three support points for the calcaneal tuber and the 1st and the 5th metatarsal bones. It is passively stabilised by ligaments while standing. It is actively stabilised by muscle strength while running or jumping. It has transverse and longitudinal arches that allow adjusting the foot to the ground. They transmit pressure forces, absorb shocks and give the foot elasticity and flexibility. Damage usually occurs when playing sports as a result of placing the foot on an uneven surface.
The most common foot problems include:
- Bone fractures (e.g., calcaneus fracture due to overload)
- Damage to the sesamoid
- Hallux valgus – deviation of 1 metatarsal bone and lateral deviation of the big toe is the cause of the development of muscle instability
- Hammer-like and clawed fingers
- Morton’s neuroma – involves the entrapment of the interdigital plantar sensory nerve in the forefoot. Most often between the 2nd and 3rd metatarsal bones
- Heel spur – a bone growth on the base of the heel fascia as a result of chronic plantar fasciitis
- Hoglund-Sever disease – is an inflammation of the growth plate in the heel
- Splayfoot – no transverse arch. It can cause severe pain when walking
- Flat foot – no longitudinal arch. May cause pain in the calves and plantar fascia
- Nerve damage – leads to numbness, sensory impairment and imbalance
- Neuromuscular imbalances can lead to talipes equinovarus, hollow, hook-shaped, talipes equinovalgus. Symptoms of muscle shortening or weakness may include poor posture or gait problems
- Vascular diseases (blood, lymphatic) – causing venous stasis, ulceration, oedema/swelling
- Gout – mainly affects one metatarsophalangeal joint of the big toe. It causes a build-up of uric acid in the joint.
- Diabetic foot – is caused by untreated diabetes, which can even lead to foot amputation
Rehabilitation is tailored to the problem. The therapist may advise footwear insoles or other orthopaedic supplies, e.g., orthosis. They will apply the appropriate Kinesio-taping and adjust the exercise program, supported by manual therapy or massage. They will also apply physiotherapy treatments, ultrasounds, laser and magnetron to reduce pain and improve tissue nourishment, accelerating repair processes.