Footballer’s ankle

Findings

There is a history of rest pain, better with activity. Inspection and palpation show thickened, swollen, soft tissues around the ankle, with no synovial swelling, unless a loose body is in the joint or the capsule is inflamed. There is a stiff, limited joint range.

Cause

Chronic minor trauma to the ankle, from both sprains and direct trauma(kicked), which heals with thickening and calcification of the soft tissues, osteophytes and loose fragments.

Treatment

a)      Electrotherapeutic modalities, such as ultrasound and laser, to settle inflammation.

b)      Massage and mobilizations, such as frictional massage, to release scar tissue.

c)      Ankle mobilizations and electrotherapeutic modalities, such as interferential, pulsed shortwave diarthemy and ultrasound, to warm and mobilize scar tissue.

d)     Proprioceptive rehabilitation.

e)      Achilles ladders

Sports

Invariably soccer, but the athlete can play sport with this ankle, because the pain improves with activity. They may preffer strapping or an ankle support, plus shin pads with ankle flaps. Pre- match non-steroidal anti-inflammatory drugs may help.

This is a stiff ankle caused by soft damage and has a history typical of soft tissue lesions, mainly worse at rest, better on the move. As such, physiotherapy and mobilization help, and an injection of steroid or local anaesthetic is rarely required.

"Concise guide to sports injuries, 2^nd edition",Churchill Livingstone, Malcolm T.F. Read,  foreword by Bryan English