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Paul Townley on Assessing Ankle Injuries (NAT Workshop)


There are many different types of ankle injuries - often with very similar symptoms

Most people immediately associate ankle pain with common strains but in reality there are many different type of ankle injuries - often with similar symptoms of pain, stiffness and weakness in the ankle.


Ankle Injuries


Tibialis Posterior Tendinitis

Pain along the medial (inner) side of the lower leg, ankle and foot may be the result of tibialis posterior tendinitis.

The tibialis posterior tendon stabilises the foot against eversion and supports the medial arch of the foot, which puts friction and tension on the tendon.

If the arch falls, stress on the tendon will increase. This can occur with poor running mechanics, improper footwear or untreated injuries.

Cause of injury

Improper running mechanics. Improper footwear. Prior injury to the medial side of the ankle.

Signs and Symptoms

Pain and tenderness over the inner side of the shin, ankle and foot. Pain when walking or running. Some swelling may be noted over the tendon.

Complications if Left Unattended

If left unattended, this condition can lead to a fallen arch or a complete rupture of the tendon. The pain may cause a change in footfall during running leading to injuries in other structures of the foot and ankle.

Immediate Treatment

RICER. Anti-inflammatory medication.

Rehabilitation and Prevention

After pain subsides it is important to stretch and strengthen the calf muscles to support the tendon and speed recovery.

Arch supports may be required until the tendon heals and the muscles are strengthened.

Gradual reintroduction into activity is important and proper warm-ups will help prevent a recurrence of the injury.

Proper footwear and corrections of any mechanical inefficiency will also help prevent this injury.

Long-Term Prognosis

Proper treatment should lead to a complete recovery.

The longer the condition exists before treatment the longer recovery will take.

In some cases orthotics may be required to prevent a recurrence.


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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell. 





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