Ligamentitis of the ankle ligaments

The hard base of the foot consists of several small bones connected to each other by many small ligaments. Each of them contains a huge amount of collagen fibers, tightly intertwined. Inflammation of one or more of these ligaments is called ligamentitis. The process can be either unilateral (affecting one leg) or bilateral. Ligamentitis should never be confused with tendinitis. These are completely different diseases that affect completely different structures of the foot. With tendonitis, the tendons, the collagen formations that attach muscles to bones, become inflamed. Plantar fascia ligamentitis is also called plantar fasciitis. With this pathology, the plantar aponeurosis is affected - a long ligament connecting the heel bone to the base of the phalanges of the lower limb. This pathology is the most common type of foot ligamentitis. You can read more about this disease here.

Causes

This disease can be infectious or non-infectious in nature. In the first case, inflammation develops due to the penetration of pathogenic microorganisms into the tissues of the foot, in the second - due to the influence of other provoking factors. The most common causes of ligamentitis:

• recent foot injuries;
• regular foot injury from uncomfortable shoes;
• increased load on the lower limbs;
• inflammatory processes in nearby joints and/or soft tissues of the foot.

Most often, ligamentitis affects people who have to spend a lot of time on their feet or in an uncomfortable position. The risk group includes builders, masons, welders, and professional athletes. People whose relatives also suffered from diseases of the musculoskeletal system are especially susceptible to the disease. Congenital defects in the development of the ligamentous apparatus play a certain role in the etiology of the disease. Ligamentitis can be caused by:

• vascular diseases;
• gout;
• diabetes,
• rheumatoid arthritis;
• thyroid diseases;
• heavy load on the legs during pregnancy.

The main causes of ankle ligamentitis

In young and old people, post-traumatic ligamentitis of the ankle joint is equally often diagnosed, which can be caused by:

• fractures of the tibia and fibula;
• cracks of the talus and calcaneus;
• sprains and tears of the ligamentous and tendon apparatus;
• penetrating wounds of the soft tissue surrounding the joint;
• cicatricial post-traumatic deformities;
• ankylosis and contracture that developed against the background of prolonged immobilization of the limb.

In middle age, degenerative dystrophic changes in joint tissues come to the fore. They can be triggered by the negative effects of the following reasons:

• pathologies of the vascular bed, such as varicose veins of the lower extremities, atherosclerosis, diabetic angiopathy, obliterating endarteritis, etc.;
• disturbances in the process of tissue innervation due to tunnel syndromes, lumbosacral osteochondrosis, aggravated by radiculitis and radicular syndrome, damage to the dural membranes of the spinal cord, etc.;
• disturbance of microcirculation of blood and lymphatic fluid in the lesion;
• slowing down the process of diffuse nutrition of cartilage, ligament and tendon tissue;
• rheumatoid pathologies, such as the articular form of ankylosing spondylitis, systemic lupus erythematosus, rheumatic arthritis, etc.;
• gout and gouty arthritis of the ankle.

In addition, in women, the period of gestation is often the trigger for the development of chronic ankle ligamentitis. During this time, numerous changes occur in the body. This includes changing the hormonal background, which can prepare the birth canal by softening the cartilage tissue. Accordingly, all synovial cartilaginous membranes in the joints also have a negative softening effect. It is for this reason that doctors advise pregnant women to wear only comfortable shoes with low heels. This allows at least a little protection of cartilage, ligament and tendon tissues from destruction. If a woman does not listen to the recommendations of doctors, then she risks developing serious pathologies in all large joints of the lower extremities.

Predisposing risk factors for developing ankle ligamentitis include:

• excess body weight, which increases shock absorption and mechanical load on all joints;
• maintaining a sedentary lifestyle without regular and sufficient physical activity on the lower limbs;
• smoking and drinking alcoholic beverages - negatively affects the condition of small blood vessels and worsens the trophism of tissues in the distal parts of the body;
• poor nutrition, which may lack important nutrients, trace elements and vitamins;
• heavy physical labor associated with prolonged standing, lifting and carrying heavy objects;
• endocrine pathologies such as diabetes mellitus, hypothyroidism, hyperthyroidism, etc.;
• wrong choice of shoes for sports and everyday wear.

It is possible that there is a violation of the intrauterine development of ligamentous, cartilage and tendon tissue. The first signs of dysplasia appear during the first 3 years of life. A full-fledged disease can develop by the age of 18–25 years.

Symptoms

Painful sensations are usually localized over the inflamed ligament.
The most characteristic sign of ligamentitis is pain that increases with walking and various movements. Most often, painful sensations are localized directly at the site of inflammation of the ligaments, but occasionally the pain can radiate to neighboring areas of the foot. As a rule, a sore leg prevents a person from walking normally and causes him a lot of discomfort. Possible symptoms of ligamentitis:

• the appearance of mild swelling at the site of inflammation;
• feeling of numbness in the foot area;
• increased sensitivity;
• limited mobility of the joint next to which the inflamed ligament is located;
• increased pain after prolonged immobility.

Diagnostics

What does ligament inflammation look like on an MRI?
Diagnosis and treatment of the disease is carried out by orthopedists and traumatologists. At the very beginning, the doctor talks and examines the patient. During the conversation, he finds out whether the person has suffered any trauma, whether he has serious systemic diseases or possible risk factors. After this, the specialist prescribes the necessary studies:

• Radiography. Allows you to see changes in bones or salt deposits in tissues. This method is of great importance in the differential diagnosis of heel spurs.
• Ultrasound or magnetic resonance imaging. With their help, you can see the localization of the pathological process. It should be noted that inflamed ligaments are best seen on MRI, but this research method is much more expensive than ultrasound.
• Laboratory research methods. Necessary to determine the cause of ligamentitis. They make it possible to identify infectious processes in the body, rheumatoid arthritis, gout, diabetes and other diseases that lead to damage to the ligamentous apparatus of the foot.

Treatment of ankle ligamentitis

In the initial stages, treatment of ankle ligamentitis is carried out at home using conservative methods. Physiotherapy, non-steroidal anti-inflammatory drugs, vasodilators, massage, etc. are used. The patient in the acute stage is prescribed physical rest for the affected limb. But after 5-7 days, it is necessary to begin active rehabilitation with the help of an individually developed complex of therapeutic exercises or kinesiotherapy.

Optimal results are obtained by using manual therapy in combination with hardware. In our clinic, the following types of treatment are used to treat ankle ligamentitis:

• osteopathy – allows you to restore impaired microcirculation of blood and lymphatic fluid in the lesion, enhance cellular nutrition of tissues;
• massage – ensures the elasticity of soft tissues, triggers metabolic processes in them, promotes the removal of accumulated metabolites and toxins;
• kinesiotherapy and therapeutic exercises improve the condition of muscles, ligaments and tendons, regenerate them, improve diffuse nutrition;
• physiotherapy accelerates all metabolic processes at the cellular level;
• reflexology launches tissue regeneration processes by using the hidden reserves of the human body;
• Laser exposure accelerates the process of restoring the physiological state of all damaged tissues.

The course of treatment for ankle ligamentitis is always developed individually for each patient. The doctor takes into account the general condition of the patient and the presence of concomitant orthopedic pathologies. During the initial free consultation, comprehensive individual recommendations are given to eliminate the further effects of pathogenic influence factors. If you implement all the doctor’s recommendations, you can stop further destruction of the ligamentous and tendon apparatus of the ankle.

If you need safe and effective treatment for ankle ligamentitis, we recommend that you do not waste time. Book a free appointment with a podiatrist at our chiropractic clinic today. Fill out the registration form located further down the page.

Treatment

After conducting the necessary examination, the doctor makes a final diagnosis and prescribes the necessary treatment to the person. First of all, he tries to remove the cause of the disease. That is, if the ligaments are inflamed due to arthritis or gout, he prescribes medications that treat these diseases. Immobilization (immobilization) of the affected leg is of great importance in the fight against ligamentitis. If a person is unable to remain in bed for several days, he can use special orthopedic devices. Prolonged rest makes you feel better and speeds up recovery.

Conservative

The basis of conservative treatment is immobilization of the diseased limb for a period of at least two weeks. Some physiotherapy treatments are prescribed to combat pain and inflammation. Paraffin and ozokerite applications, phonophoresis, ultrasound and shock wave therapy are quite effective. The following drugs are used to treat ligamentitis:

• ointments based on NSAIDs and corticosteroids (Diclofenac, Hydrocortisone ointment);
• non-steroidal anti-inflammatory drugs in the form of tablets and injections;
• PRP method is the use of enriched autologous human platelet plasma.

Recently, the PRP technique has become increasingly popular. It allows you to quickly relieve pain and reduce the activity of inflammatory processes. Autologous plasma has a pronounced analgesic, wound healing and anti-inflammatory effect.

Clinical signs of ankle ligamentitis

Ankle ligamentitis clinically manifests itself only during periods of exacerbation. Most often, the disease occurs in a chronic, relapsing and slowly progressive form. The first signs of trouble appear suddenly. The ankle area is swollen. The skin turns red. Palpation is difficult and painful. Stepping on your foot becomes painful. All these signs indicate acute inflammation of the soft tissues in the ankle joint. In some cases, general well-being may suffer and body temperature may rise.

Gradually, these symptoms subside even without treatment. The disease passes into the subacute and then into the chronic phase of its course. Gradually, cicatricial post-inflammatory deformation of the ligament and tendon fiber occurs. Against this background, characteristic clinical symptoms of chronic ankle ligamentitis arise:

• pain of a dull or crushing nature, significantly intensifying after any physical activity;
• extraneous sounds while walking, this could be crunching, clicking, friction, crepitus, etc.;
• violation of foot placement (trying to unload the affected ligaments and tendons, the patient begins to place his foot when walking on the inner or outer edge of the foot, thereby provoking the development of flat feet or clubfoot);
• decreased range of motion in the joint, gradual development of ankylosis and contracture;
• change in gait, slight lameness;
• increased fatigue of the calf muscles;
• a feeling of stiffness in the affected joint after a long period of rest (night sleep, working in a static position, etc.).

To diagnose ankle ligamentitis, you need to see an orthopedist. The doctor will be able to make a preliminary diagnosis during the initial examination. By palpation, he will be able to determine which ligaments and tendons are subject to constant inflammation and subsequent scarring. To make an accurate diagnosis, you will need to do a number of laboratory tests:

• an x-ray of the ankle joint allows you to exclude the possibility of a violation of the integrity of the bone tissue (heel spur, deforming osteoarthritis of the ankle joint, the development of osteophytes, fractures and cracks);
• Ultrasound of soft tissues to exclude neoplasms in the lesion;
• Doppler ultrasound of blood and lymphatic vessels of the lower extremities to exclude relevant pathologies;
• MRI to visualize the condition of the ligamentous and tendon apparatus;
• arthroscopy is indicated if blood is obtained during puncture of the ankle joint and surgery is expected to be required to restore the integrity of the damaged joint tissues;
• biochemical blood test to exclude rheumatoid lesions, gout and a number of other systemic pathologies;
• general clinical blood test.

After all the examinations, the doctor makes an accurate diagnosis and develops an individual course of treatment. It will be aimed at completely restoring the integrity of damaged ligaments and tendons.