What is ankle arthritis?
The ankle joint is formed by the lower end of the tibia (shin bone) and the talus (ankle bone).
In a normal healthy joint, there is a layer of cartilage which acts as a shock absorber and allows a smooth gliding motion. In osteoarthritis the cartilage is worn which can cause pain. Sometimes extra bone can form osteophytes which together with scarring of the joint lining can be responsible for joint stiffness. Pain and stiffness are the two main symptoms of ankle arthritis.
Many patients respond well to non-surgical treatments. There are many options, and these should be tried first before considering surgery.
- Diet: Losing weight will reduce the strain on your ankles.
- Medication: Taking sufficient and regular pain relief is an important part of managing this problem. It is advised that you speak to your GP about this.
- Cold and Elevation: Use a cold pack wrapped in a damp towel and apply for 10-15 minutes. In addition, elevating the foot so that it is higher than your hip can help reduce the swelling.
- Heat: Can help reduce the pain. Use a heat pack or hot water bottle; wrap it in a towel to ensure it does not burn the skin, and apply for 10-15 minutes.
- Footwear: Wearing supportive and shock absorbing footwear (e.g. trainers or boots that come up above the ankle) can help provide your ankle with more support. In addition, wearing a small heel can help.
- Ankle supports and insoles: There are many different types available that can help to support your ankle/foot.
- Walking Aids: A walking stick or an elbow crutch held in the opposite hand to the arthritic ankle will help to offload your weight.
- Activity modification: Avoid running, squatting and carrying heavy loads. Non-weight bearing cardiovascular exercise (e.g. swimming or cycling) would be best to prevent irritation.
- Exercise: Your physiotherapist will show you some exercises to try and prevent your ankle becoming stiffer (please see below).
- Steroid Injection: Can help reduce the inflammation and your symptoms.
After conservative treatment options have been exhausted, surgical interventions can be considered if your symptoms are affecting your quality of life. The most common operation is an ankle fusion which involves fusing the tibia and talus to relieve pain by reducing movement.
Below are a few exercises that we would recommend you do regularly:
- Either sitting or lying.
Pull your foot up towards you and push down towards the floor. Repeat 10 times.
Then rotate your ankle. Repeat 10 times.
- To improve your balance; hold onto a supportive surface while standing, gain your balance on one leg before slowly letting go of the support, if able.
- Stretch your calf. Place one foot in front of the other, ensure your back foot is pointing forwards, bend the front knee and keep the back heel down.
Hold 20-30 seconds, relax and repeat three times.
- Stand next to a supportive surface and hold on if required.
Rise up on your toes, as far as feels comfortable and slowly lower. Gradually increase number of repetitions as able.
If you have any questions or concerns, please contact the Physiotherapy Department at North Devon District Hospital on 01271 322378.
(Illustrations – © PhysioTools LTD)