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The ankle joint

With every single step, the feet, and particularly the ankle joints, have to complete many complex tasks and facilitate a multitude of movements. The ankle joint is perfectly designed to fulfil its various functions and is characterised by a perfect interplay between the bones, muscles, ligaments and tendons.

The ankle joint is always in motion and also subject to the constant impact of strong forces. That makes it all the more important to treat injuries and any subsequent ligament instabilities properly at an early stage in order to prevent serious consequential damage.


Long-term effects: an underestimated risk

The ankle joint is stabilised by a strong system of ligaments. The elasticity of ligaments is limited to just 3% of the original length. Three individual ligaments protect the ankle joint from the outside. The inside is strengthened by a fan-shaped medial collateral ligament complex. Twisting your ankle to the inside or outside overstretches or even tears the ligaments.

Both the inner, medial collateral ligaments as well as the outer, lateral collateral ligaments can be injured, but an injury to the lateral collateral ligaments is significantly more likely. The medical profession refers to this type of injury as a supination trauma (spraining one’s foot outward). Every sprain or tear of the ligaments can result in instability and vulnerability of the ankle joint that can become chronic, i.e. permanent, and create further problems.

View of foot from two sides

Injuries/disorders
The ligaments in the ankle joint take approximately 9 months to completely stabilise and strengthen again. Incomplete healing of the ligaments or misalignment of the foot due to, for example, adopting a relief posture in the recovery period makes it more likely for the patient to twist their ankle or be less sure-footed after an injury. This is particularly the case for sporting activities or walking on uneven ground.
 
Chronic ligament instabilities could be prevented in a lot of cases, but more often than not, injuries to the ankle and ligaments of the foot remain untreated or insufficiently treated during the acute phase, i.e. immediately after the accident. Patients do not take their symptoms seriously, for example, or go to the doctor too late. As a result, every second person will experience problems not just in the foot, but also in other joints during their lifetime.

Osteoarthritis

Not usually a side effect of aging!

In a healthy state, joint cartilage facilitates the movement of the joints and provides a cushioning effect during walking. Osteoarthritis is a sign of wear and tear of the joint surfaces. But cartilage does not get damaged by age-related wear and tear alone. Insufficiently treated injuries resulting in osteoarthritis of the ankle joint as an after-effect are often to blame.

An injury can result in permanent inappropriate biomechanical stress to the foot. Over many years, this stress leads to wear and tear of the cartilage until the joint surfaces rub against each other and cause severe pain.

The earlier a ligament instability or onset of osteoarthritis is detected, the more effectively action can be taken. The aim, however, is to take preventive measures to avoid damage to the cartilage.

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Good to know

  • Be sure to have injuries to the foot examined carefully and promptly. A visit to a medical specialist is particularly important in cases of persistent pain after supposedly healed injuries to prevent any long-term effects.

Helpers for your ankle

Orthoses and supports
An injury to the foot can often be accompanied by pain with swelling and bruising, causing many patients to adopt a relief posture that may contribute to causing further damage. Orthoses and supports ensure optimal support for the ankle joint during the healing process.

Different Phases ankle joint

For every phase
Orthoses that can be worn immediately after an accident help to stabilise, relieve and guide the ankle in the acute phase. The JuzoPro Malleo Light orthosis provides you with maximum functionality and wearing comfort and is tailored to the specific requirements of non-surgical treatment after a ligament injury.
 
In the mobilisation phase, supports such as the JuzoFlexMalleo Xtra Strong support the ankle joint. They surround the ankle joint and provide a compressive effect. This improves proprioception, stimulates the muscles and stabilises the joint.

Orthoses and supports for every phase

Chronic instability of the upper and lower ankle joint are risk factors for the development of osteoarthritis. The JuzoFlexMalleo Anatomic has been developed for continuous use with this type of chronic instability of the lateral and medial collateral ligaments to provide patients with the necessary support for the foot and as a preventative for osteoarthritis. As a result, inappropriate stresses can be avoided and any existing irritations to the ankle joint will more readily subside.

Sample exercises for a stable ankle


We have put together a few exercises for you that help to strengthen the ankle or support recovery after an injury. These are easy to do and you can incorporate them into your daily routine for best results. If you are suffering from an acute injury, please consult your doctor first. Your doctor will tell you which of the exercises are suitable for you.

This exercise can be performed either on both legs (easy) or on one leg (hard).


Strengthening

2 x 15 repetitions

Strengthening exercise

1a. Stand on a step (e.g. on the stairs) by placing the ball of the foot on the step with the heel in the air.

Strengthening exercise

1b. Drop the heels down as far as possible

Strengthening exercise

1c. Press upwards with the ball of your foot until the you cannot go any further

Strengthening exercise


2. Attach the therapy band at a suitable place and sit down in a relaxed position, facing the therapy band, for example on a chair. The therapy band should be tensioned when you are in a neutral position (right angle between foot and lower leg). Keeping the heel in a stable position, lift the foot outward and slowly return to the initial position.

Perception

Perception exercise

3. Stand in front of a mirror and close your eyes. Hold your heels straight (no “bend” in the Achilles tendon). Shift your weight from the right foot to the left foot and then back to the centre. Now open your eyes and check the position of your feet. Repeat until your perception and the actual position of the feet match up.

Mobilisation

2 x 15 repetitions

Strengthening exercise

4a. Rest the foot on your thigh and, using you hand, move it in the direction of the knee and then as far away from the knee as possible. Hold the end positions for a few seconds each.

Strengthening exercise

4b. Hold on to the heel with one hand and move the outside of the foot in an outward direction followed by an inward direction. Hold the end positions for a few seconds each.

Improving sensorimotor function

2 x approx. 10 to 15 seconds

Strengthening exercise

5. Roll the foot over a tennis ball or spiky massage ball. Also include the outside and inside of the foot. Also perform the exercise on the non-affected side for comparison.

Stabilisation

2 x 15 repetitions

Strengthening exercise

6. Stand on one leg and press the entire sole of the foot into the ground. Keeping you upper body in an upright position, slightly bend your knee and then return to the initial position. The knee must not project out beyond the toes or be twisted in any way when in the bent position. 
To increase the difficulty, perform this exercise with your eyes closed. Also perform the exercise on the non-affected side for comparison.