Ankle fractures are common injuries that can have a big impact on a person’s ability to move and enjoy life.
The ankle is made up of different bones, and fractures can happen from various types of accidents. It’s not just about the physical damage; these fractures can make it tough to walk, keep your balance, and do everyday activities.
Managing ankle fractures is a complex process that involves careful diagnosis, personalized treatments, and a thoughtful plan for recovery.
In this article, we’ll explore the basics of ankle fractures—where they commonly occur, how they happen, and the modern approaches to treating them. Our goal is to make this information accessible to those on the journey to healing.
- Risk Factors for Ankle Fractures
Several factors can increase the likelihood of an ankle fracture, including:
- Age: Older adults, especially those with osteoporosis, are more prone to fractures due to reduced bone density.
- Sports and Physical Activities: High-impact sports like basketball, soccer, or running put stress on the ankle joint, increasing the risk of injury.
- Accidents or Falls: Slips, trips, or motor vehicle accidents are common causes of ankle fractures.
- Weak or Unstable Ankles: Individuals with a history of sprains or ligamentous laxity may have weaker support structures around the ankle, making fractures more likely.
- Obesity: Excess weight increases the stress on joints, including the ankles, making them more susceptible to injury.
6. Inappropriate Footwear: Wearing high heels, poorly fitting shoes, or shoes without proper support can increase the risk of ankle fractures.
In an addition:
*The higher level of activity in younger males, particularly in risk taking and sports activities, might explain the high rates of ankle and foot fractures in this age group.
Pathophysiology
Ankle fractures can be classified depending on the anatomical location into:
- Isolated medial malleolus fracture
- Isolated lateral malleolus fracture
- Bimalleolar ankle fracture; two malleoli are fractured, either the medial and lateral malleoli or less commonly the posterior and lateral malleoli.
- Trimalleolar ankle fracture; the three ankle malleoli (medial, lateral, and posterior) are broken.
Signs and symptoms
- Unable to bear weight on the injured ankle
- Pain while touching at both sides of ankle
- Bruising
- Swelling
- Increase pain during activity
- Starting Position:
- Sit on the floor with your legs extended in front of you.
- Place a towel around the ball of one foot, holding both ends of the towel with your hands.
- Foot Placement:
- Flex the ankle of the leg you want to stretch, bringing your toes toward your shin.
- Towel Assistance:
- Hold the towel firmly with both hands, keeping it wrapped around the ball of your foot.
- Use the towel to pull your toes gently toward you, creating a stretch in the calf muscle.
- Back Straight:
- Keep your back straight and shoulders relaxed during the stretch.
- Avoid rounding your back or hunching your shoulders.
- Stretching Movement:
- Slowly lean forward from your hips while maintaining the stretch on your calf.
- Continue until you feel a comfortable pull in your calf muscle.
- Hold and Breathe:
- Hold the stretch for 15 to 30 seconds, focusing on deep and controlled breathing.
- Repetition:
- Repeat the stretch on the other leg.
- Seated Position:
- Sit comfortably in a chair or on the floor with your legs extended.
- Ankle Movement:
- Lift one foot off the ground, and imagine your big toe is a pencil.
- Begin to “write” the alphabet in the air using your big toe.
- Full Range of Motion:
- Try to make each letter as large as possible while maintaining control.
- Move through the entire alphabet with one foot before switching to the other.
- Repetition:
- Repeat the exercise 1-2 times with each foot.
- Flexibility and Control:
- Focus on achieving a full range of motion at the ankle joint.
- Perform the exercise slowly and with control.
Ankle Dorsiflexion:
Setup:
- Sit on the floor with your legs extended.
- Loop the resistance band around a fixed point or secure it to a sturdy structure.
- Place the band around the top of your foot.
Instructions:
- Flex your ankle, pulling your toes toward your shin against the resistance of the band.
- Hold the position for a moment, feeling the contraction in the front of your ankle.
- Slowly return to the starting position.
Repetitions:
- Perform 2-3 sets of 12-15 repetitions on each foot.
2. Ankle Plantarflexion:
Setup:
- Sit on the floor with your legs extended.
- Loop the resistance band around a fixed point or secure it to a sturdy structure.
- Place the band around the ball of your foot.
Instructions:
- Point your toes away from your body, pressing against the resistance of the band.
- Hold the position briefly, emphasizing the contraction in the back of your ankle.
- Gently return to the starting position.
Repetitions:
- Perform 2-3 sets of 12-15 repetitions on each foot.
3. Ankle Inversion and Eversion:
Setup:
- Sit on a chair with your legs hanging off the edge.
- Loop the resistance band around a fixed point or secure it to a sturdy structure.
- Place the band around the outside (lateral side) of your foot for inversion and inside (medial side) for eversion.
Instructions:
- For Inversion: Turn your foot inward against the resistance.
- For Eversion: Turn your foot outward against the resistance.
- Hold each position briefly before returning to the starting position.
Repetitions:
- Perform 2-3 sets of 12-15 repetitions for each direction on each foot.
4. Ankle Circles:
Setup:
- Sit on the floor or a chair with your legs extended.
- Loop the resistance band around a fixed point or secure it to a sturdy structure.
- Place the band around the ball of your foot.
Instructions:
- Rotate your ankle in a circular motion, moving clockwise.
- After completing clockwise circles, reverse the direction and move counterclockwise.
Repetitions:
- Perform 2-3 sets of 10-12 circles in each direction on each foot.
Starting Position:
Stand upright with your feet hip-width apart.
Place a sturdy chair or a countertop in front of you for support.
Hand Placement:
Hold onto the chair or countertop with both hands for balance and stability.
Foot Placement:
Ensure your feet are parallel to each other, with toes pointing forward.
Rise onto Toes:
Lift your heels off the ground by pushing through the balls of your feet.
Rise as high as you can, lifting your heels towards the ceiling.
Squeeze Calves:
At the top of the movement, squeeze your calf muscles to maximize the contraction.
Controlled Descent:
Lower your heels back down to the ground in a slow and controlled manner.
Full Range of Motion:
Aim for a full range of motion, lowering your heels below the level of your toes if possible.
Repetition:
Perform 2-3 sets of 10-15 repetitions, depending on your fitness level.
Breathing:
Inhale as you lower your heels and exhale as you rise onto your toes.
Safety Tips:
Keep your core engaged to maintain balance.
Ensure the chair or countertop is stable and won’t tip over.
If you experience any pain or discomfort, modify the range of motion or discontinue the exercise.
Progression:
As you become more comfortable with the exercise, you can gradually increase the number of repetitions or try single-leg calf raises for added challenge.
Prepared by
Choo Yee Ning
Your Physio Bukit Mertajam