Ankle arthritis can develop in younger age athletes which literally hurts, and hurts their game.  Some sports are prone to ankle repetitive injuries such as ankle sprains, or severe trauma. This can lead to early onset of ankle arthritis. One such sport is Basketball. Those who know the history of the sport can recall two professional Basketball legends who were affected by ankle injuries. Bill Walton and Kevin McHale. Fans of ESPN’s 30 for 30 may recall the series on the Los Angeles Lakers and Boston Celtics of the 1980s. Kevin McHale of the Boston Celtics was featured in a segment of this series. McHale played heroically, despite obviously significant ankle and foot pain. These types of ankle pain injuries lead to early onset ankle arthritis, which can end a brilliant sports career.

Ankle Pain from Ankle Sprains

Ankle pain may arise from sources. The most common is a sprained ankle. This is actually a ligamentous injury. Ligaments connect two bones together. So when the ankle is inverted the ligament connecting the talus to the fibula is sprained. This the most common ankle sprain is really an anterior talofibular ligament sprain. The outer knob of the ankle is the lateral malleolus, which is the distal end of the fibula. The opposite action when the ankle is everted or rolled out strains the tibiotalar ligaments. Commonly the medial ligament is called the Deltoid ligament and is very strong. It’s an attachment to the tibia is the protuberant knob at the inside of the ankle known as the medial malleolus. Chronic ankle sprains may lead to future ankle arthritis.

Ankle Talar Dome Fractures

Violent ankle injuries may forcefully drive the top of the talus into the tibia. This is atypically injury is not easily seen on x-Rays, and a skilled clinician must be aware of it for a missed Talar dome fracture in an athlete, can be hazardous. It is readily seen on MRI scans. Talar dome injuries may lead to accelerated degenerative ankle arthritis progression.

Achilles Tendon Pain

Behind the ankle joint lies the Achilles tendon. It inserts at the base of the foot onto the calcaneus. It is not uncommon in certain athletes to have partial, or even complete Achilles’ tendon tears. Chronic posterior ankle athletes, especially in middle age or older age athletes, may have a brittle fraying Achilles’ tendon. Just like the rotator cuff tendons of the shoulder, the Achilles may wear down from chronic use over time.  Regenerative Medicine may be used as an alternative to Achilles tendon surgery in some

Ankle Avascular Necrosis or Osteonecrosis

Avascular Necrosis (AVN) may occur in several areas around the ankle. Avascular necrosis may also be called osteonecrosis. Suspicion for AVN must be given when an injury does not heal in a normal fashion or the pain seems out of proportion to the injury. Avascular Necrosis occurs when the blood supply to a region of bone becomes disrupted, this leads to bone cell death or necrosis. A simple ankle sprain not responding to conservative treatment, and pain out of the norm for an ankle sprain especially if non-weight bearing, is one type of clue that may indicate the presence of another disorder such as AVN. Regenerative Medicine options such as stem cells have been used for ankle AVN. It is important to consult an expert on AVN such as Dennis M. Lox M.D. to help with treatment decisions.

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