The Ankle and foot structure
The foot is made up of 26 bone, 33 joints and more than 100 muscles, tendons and ligament.
This makes it a complex area structure with a lot of tendons, ligaments, muscles and joints that can get into trouble.
Common diagnosis errors.
Medically one can get a large range of so called "diagnosis" ranging for sprained ankle, peroneal tenonitis, planter fasciitis or Achilles tendonitis. However, this "specific" description creates difficulties as the actual underlying cause of the problem that may be coming from elsewhere can be overlooked. For example Achilles tendon pain, could be resulting from a talocrural joint restriction or peroneal tendonitis from a subtalar joint restriction.
Joints of the foot and ankle restrictions
Because there are so many joints in the foot if there if a restriction in one / or more joints they often are unnoticed by a patient. Additionally it requires a high level of palpation skill on the part of the practitioner to identify these often quite subtle restrictions. Therefore it is not uncommon for this to be missed altogether.
Importance of the Subtalar joint in sprained ankles
This is the joint between the Talus and the Calcaneus. It allows your foot to Evert (move out) or invert (move inwards). It is very important in balance or walking on uneven surfaces. Often balancing on one leg is improved when normal movement is restored to this joint.
The subtalar joint often becomes restricted after a sprained ankle (the person may not notice this). Practitioner will often get too focused and the ligaments after a sprain and not notice restriction in this joint.
When a joint is injured it frequently become stiff and restricted as a result. In ankle sprains that fail to improve this is commonly the case.
Tibio talar joint (Ankle joint)
The main movement in this joint is dorsiflexion (pulling foot up) and plantarflexion (pushing foot down). It is often injured in football when the toes get stuck in the ground and leg continues forwards (forcing into plantar flexion). Here again like with the sprained ankle, the injury to the joint often results in a restriction in this joint that goes unnoticed - and thus ongoing problems.
Another common injury to this joints is a sudden stop while running or tripping while going down steps. Here, the tibia shunts forwards on the talus.
Treatment
All the above respond well to treatment. I have focused on the above, as they (in my experience) are the most common reasons for pain continuing longer than expected and becoming chronic (more than 6 months).
