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Ankle pain as it relates to back problems

Posted by Amy on 1/26/01 at 12:46 (037437)

I have written here before about my ankle pain after EPF surgery. It's been 3 months now. I spoke with my podiatrist this morning and he informed me that it could be tarsal tunnel syndrome and not related to the surgery. He suggested rest and an ankle support, and if it still does not clear up, cortisone shots. I'm going to try resting first. I have all kinds of spinal problems such as degenerative disc disease at L1 and scoliosis and I know one leg is longer than the other. The ankle has never bothered me before the surgery, however, so do you think the pain could be caused by my spinal problems? I never thought to ask my doctor about this but I just read Linda's question/answer on this site. She has a similar ankle problem.

Re: Ankle pain as it relates to back problems

Dr. Zuckerman on 1/26/01 at 17:21 (037454)

Hi,

It could be compensation from the surgery. It could be from your lower back

Rest, elastic support to prevent the ankle from inverting which will cause straining of the lateral collateral ligament and thus ankle pain.

May need to be placed into a boot cast or an air splint.

Re: Ankle pain as it relates to back problems

Amy on 1/26/01 at 17:43 (037457)

Thanks Dr. Z, I hope the pain is from compensating. By elastic support do you mean an ankle support or elastic stockings? Is the lateral collateral ligament the same as the deltoid tendon which you spoke of last time I wrote? I will try the air cast as well. Will use of the air cast while riding a stationery bike help eliminate further inurty to the ankle? I really need to exercise and walking on the treadmill these past 2 weeks seems to have aggravated my ankle. Not only do I need to lose weight but I'm depressed from not exercising in three months. Thanks so much for your support and time.

Re: Ankle pain as it relates to back problems

Julie on 1/27/01 at 03:25 (037493)

Amy, if one of your legs is longer than the other, this could be due to the scoliosis and the fact that the spinal curvature has brought your pelvis out of alignment so that one hip is higher than the other. You know your body - does that sound right? This would throw your whole body out of alignment, which would affect your ankle. If the difference is pronounced, an elevated shoe on the shorter side could help. I expect you've had osteopathic or chiropractic treatment for your back (forgive me if you've reported on this before and I've forgotten) - has it had any effect on the scoliosis?

The ankle support sounds a good idea. The Futuro ankle brace is excellent and gives good support to the arch too.

Re: Ankle pain as it relates to back problems

Julie on 1/27/01 at 03:29 (037494)

I've just read your reply to Dr Z. Yes, it's awful not being able to exercise,but treadmill walking (or any weight-bearing exercise) is probably not a very good idea. Have you thought about/tried swimming? It's aerobic, works the whole body, and is probably the best non weight-bearing exercise.

Re: Ankle pain as it relates to back problems

Dr. Biehler on 1/27/01 at 09:00 (037512)

You have to be carefull when you start to use heel lifts to rebalance the body when a limb lenght difference is caused by scoliosis. It has to be determined how much of the differance is rigid and how much is flexable. This should be done under the suppervision of a doctor. I was taught and have found an effective way to judge how much correction should be done ( a little at a time ) is to stand and put different size magazines under the shorter limb. When you can stand or step up and down without feeling like you are tilting or out of balance, that is a good level to start at. You must be carefull as the adjustment can and will start causing stain and stresses on you joints, ligaments, muscles and probably put some pressure on some nerves. Dr. B.

Re: Ankle pain as it relates to back problems

Amy on 1/27/01 at 11:11 (037522)

I have always had one hip higher than the other. You can see it when I wear pants. I have never been adjusted by a chiropractor because the scoliosis has never really bothered me. But with the degenerative disc disease at L1 - I've had some lower back pain and sciatica on the opposite leg of the PF foot. I have orthotics which were made by my podiatrist. He checked the leg length while I sat up on the chair in his office. All I did was sit up straight with my back all the way to the back of the chair and extended my legs out so that he could look down at my feet. Didn't seem very scientific to me - but he's the doctor. He told me the sciatic leg was only about 1/4' shorter and he didn't see the need to make any adjustments on that foot's orthotic because it was so slight and my hips and back didn't bother me. The scoliosis has never bothered me - not even during my 2 pregnancies. This ankle pain started right after EPF surgery. It's on the inside ankle of the PF foot. The pain radiates around the ankle and sometimes shoots down to the inside of my heel. Could this be nerve entrapment? It really does seem to have gotten worse from walking 30 minutes every other day on pavement and the treadmill. I am going to just wear my ankle support for a few days and if it does not get better, get an air cast support and only walk when absolutely necessary.I don't want to damage the nerve/deltoid tendon. How do I know which one it is that's bothering me?

Re: Ankle pain as it relates to back problems

Dr. Zuckerman on 1/27/01 at 13:55 (037530)

The elastic support is something like a futuro elastic support.

The deltoid ligaments are in the inside of the ankle.
The lateral collaterals are on the outside of the ankle. The lateral collatral are usually the one that you injury with a typical ankle sprain but sometimes the deltoid get involved . The trend mill must be stopped it is a real killer for this plantar fasciitis pain either especially after foot surgery.

Re: Ankle pain as it relates to back problems

Dr. Biehler on 1/31/01 at 11:02 (037847)

The nerve is in the tarsal tunnel which is under the deltoid ligament. If you are getting radiating pain the nerve is affected. Try the ankle brace and see if it helps. Dr. B.

Re: Ankle pain as it relates to back problems

Dr. Zuckerman on 1/26/01 at 17:21 (037454)

Hi,

It could be compensation from the surgery. It could be from your lower back

Rest, elastic support to prevent the ankle from inverting which will cause straining of the lateral collateral ligament and thus ankle pain.

May need to be placed into a boot cast or an air splint.

Re: Ankle pain as it relates to back problems

Amy on 1/26/01 at 17:43 (037457)

Thanks Dr. Z, I hope the pain is from compensating. By elastic support do you mean an ankle support or elastic stockings? Is the lateral collateral ligament the same as the deltoid tendon which you spoke of last time I wrote? I will try the air cast as well. Will use of the air cast while riding a stationery bike help eliminate further inurty to the ankle? I really need to exercise and walking on the treadmill these past 2 weeks seems to have aggravated my ankle. Not only do I need to lose weight but I'm depressed from not exercising in three months. Thanks so much for your support and time.

Re: Ankle pain as it relates to back problems

Julie on 1/27/01 at 03:25 (037493)

Amy, if one of your legs is longer than the other, this could be due to the scoliosis and the fact that the spinal curvature has brought your pelvis out of alignment so that one hip is higher than the other. You know your body - does that sound right? This would throw your whole body out of alignment, which would affect your ankle. If the difference is pronounced, an elevated shoe on the shorter side could help. I expect you've had osteopathic or chiropractic treatment for your back (forgive me if you've reported on this before and I've forgotten) - has it had any effect on the scoliosis?

The ankle support sounds a good idea. The Futuro ankle brace is excellent and gives good support to the arch too.

Re: Ankle pain as it relates to back problems

Julie on 1/27/01 at 03:29 (037494)

I've just read your reply to Dr Z. Yes, it's awful not being able to exercise,but treadmill walking (or any weight-bearing exercise) is probably not a very good idea. Have you thought about/tried swimming? It's aerobic, works the whole body, and is probably the best non weight-bearing exercise.

Re: Ankle pain as it relates to back problems

Dr. Biehler on 1/27/01 at 09:00 (037512)

You have to be carefull when you start to use heel lifts to rebalance the body when a limb lenght difference is caused by scoliosis. It has to be determined how much of the differance is rigid and how much is flexable. This should be done under the suppervision of a doctor. I was taught and have found an effective way to judge how much correction should be done ( a little at a time ) is to stand and put different size magazines under the shorter limb. When you can stand or step up and down without feeling like you are tilting or out of balance, that is a good level to start at. You must be carefull as the adjustment can and will start causing stain and stresses on you joints, ligaments, muscles and probably put some pressure on some nerves. Dr. B.

Re: Ankle pain as it relates to back problems

Amy on 1/27/01 at 11:11 (037522)

I have always had one hip higher than the other. You can see it when I wear pants. I have never been adjusted by a chiropractor because the scoliosis has never really bothered me. But with the degenerative disc disease at L1 - I've had some lower back pain and sciatica on the opposite leg of the PF foot. I have orthotics which were made by my podiatrist. He checked the leg length while I sat up on the chair in his office. All I did was sit up straight with my back all the way to the back of the chair and extended my legs out so that he could look down at my feet. Didn't seem very scientific to me - but he's the doctor. He told me the sciatic leg was only about 1/4' shorter and he didn't see the need to make any adjustments on that foot's orthotic because it was so slight and my hips and back didn't bother me. The scoliosis has never bothered me - not even during my 2 pregnancies. This ankle pain started right after EPF surgery. It's on the inside ankle of the PF foot. The pain radiates around the ankle and sometimes shoots down to the inside of my heel. Could this be nerve entrapment? It really does seem to have gotten worse from walking 30 minutes every other day on pavement and the treadmill. I am going to just wear my ankle support for a few days and if it does not get better, get an air cast support and only walk when absolutely necessary.I don't want to damage the nerve/deltoid tendon. How do I know which one it is that's bothering me?

Re: Ankle pain as it relates to back problems

Dr. Zuckerman on 1/27/01 at 13:55 (037530)

The elastic support is something like a futuro elastic support.

The deltoid ligaments are in the inside of the ankle.
The lateral collaterals are on the outside of the ankle. The lateral collatral are usually the one that you injury with a typical ankle sprain but sometimes the deltoid get involved . The trend mill must be stopped it is a real killer for this plantar fasciitis pain either especially after foot surgery.

Re: Ankle pain as it relates to back problems

Dr. Biehler on 1/31/01 at 11:02 (037847)

The nerve is in the tarsal tunnel which is under the deltoid ligament. If you are getting radiating pain the nerve is affected. Try the ankle brace and see if it helps. Dr. B.