Popping Ankles: Complete Guide, Symptoms, Causes, Treatment
Overview
Sometimes you hear the click, snap, or pop from your ankle joint or other joints while walking, standing up, or stretching. It is common and harmless until it is associated with swelling and pain. People are more likely to link popping or noisy joints with age; also, young people experience it like athletes. Another reason for having noisy joints typically has a physical activity after a long period of physical relaxation.
Symptoms
This popping or click is generally caused when you roll your ankle or apply pressure on your ankle muscles. In medical terms, it is known as crepitus, caused due to gas bubbles formed in joint fluid or tendons moving. Like it occurs when you walk or stand up and sometimes happens with any movement.
If you hear the pop or click sound, discomfort at the ankle joint is caused by the tendon or muscle injury. A single episode of pain may happen by a ligament or ligament tear, tendon or tendon tear, bone fracture, and joint dislocation. In contrast, repeated and recurrent pain is associated with critical medical common issues like Osteoarthritis caused by cartilage degeneration or tear.
Causes
Popping ankles is a natural phenomenon unless or until it is accompanied by pain or swelling caused by certain factors like:
- Gas release
- Tendons friction
- Tendons subluxation/dislocation
- Tendons injury
- Osteochondral lesions
- Osteoarthritis
1- Gas Release
Most of the pop or click sounds produce commonly due to the release of gas bubbles from the fluid present in joints. The fluid known as synovial fluids helps lubricate the joints and reduces friction. This fluid contains several gases like nitrogen, oxygen, and carbon dioxide. On the stretch, the joint capsule is filled with synovial fluid and produces a pop or click by releasing a gas bubble. It is the most common reason for noisy joints when you roll your ankle while walking or standing up.
Treatment
Popping ankles caused by the gas release is expected, so, no need to be concerned about it. However, with some exercise, you can strengthen and stabilize the peroneal muscles of the ankle. So be active and improve the mobility of your foot and ankle.
2- Tendons Subluxation/Dislocation
One of the causes of popping the ankle is friction or rubbing between the peroneal muscles and bones. These peroneal muscles will stabilize the movement of the foot and ankle and supports them in the move. The two peroneal forces hold the ankle bone on the outside of the bone to help the ankle move upward and downward. One peroneal muscle is short, and another is long to stabilize and balance the movement. These peroneal muscles run down through a groove lined by a sheath. These peroneal muscles are kept in place by a fibrous ligament called the Retinaculum.
The noise from the ankle joint is caused when peroneal muscles rub beside an ankle bone due to a slip of the elastic band that holds them in place. When you stretch your ankle by rolling it outward, the peroneal tendons slip out from the groove and create a popping sound. It also produces strain in the retinaculum, and frequent spraining would result in elongation, separation, or injury. This condition is called peroneal tendons subluxation, or tendons subluxation is very uncommon. It mainly occurs in athletes moving their ankles in the in-ward forceful stretch.
Tendons subluxation or dislocation also occurs due to certain factors like;
- Weak fibrous band Retinaculum
- Unstable ankles
- Injury
- Unstable feet surface
- Shallow groove
These are the very uncommon factors of tendons subluxation other than general. The patient will experience continued popping or clicking from the ankle if he is walking, running, or climbing the stairs. The pain is annoying, limits the patient's activity, and is pretty depressing. The condition will worsen if left untreated, which may lead to tendons injury that causes complications in treatment.
Diagnosis
Diagnosis of tendons subluxation is easy as the patient has acute pain and swelling in the ankles. An experienced sports Physiotherapist or Orthopedic surgeon can diagnose through a simple test that moves the ankle in all possible directions to check that tendon is slipping out.
Ultrasound and MRI are also considered if the swelling and pain persist after physiotherapy and medication.
Treatment
The first management of peroneal subluxation or dislocation is physiotherapy for 4-6 weeks. But in the case of acute and chronic peroneal subluxation, the use of anti-inflammatories and painkillers followed by surgical procedures is done. The surgical procedures include the following:
- Retinaculum repair
- Groove reconstruction
- Construction of bony block
Post-surgery may include physiotherapy, braces, and arches, depending on the patient's condition. Braces and arches will help strengthen the ankle muscles and stabilize them. It helps increase the patient's mobility without pain, and the patient can walk firmly.
3- Tendon Injury
The sound of pop or click accompanied by shooting pain in the ankle area is caused due to injury in the peroneal muscles. The tendons could be damaged with time or suddenly injured, depending on the conditions. The small or partial tears in tendons will lead to the complete rupture of the tendon.
The other tendon injuries may occur in strains, tendinosis, or tendonitis. The acute tear may occur due to regular or excessive foot and ankle movement. Tendinitis caused due ankle sprain induces inflammation in both tendons. While tendinosis or degenerative tear happens over time, it takes years.
It commonly occurs in a person related to sports that include repetitive or excessive ankle movement. The cause of tendon injury is due to forceful strain produced in peroneal tendons that tear the tendon and ultimately result in a rupture. In this case, tendons lose their elasticity and behave like taffy.
Symptoms
The various symptoms are reported due to the variation in injuries and their types:
- Acute tear pain accompanied by popping, swelling, and instability of the foot and ankle.
- Tendinitis- pain with inflammation and swelling. Feel the warmth on the touch.
- Tendinosis or Degenerative tear- is an intermittent pain in the ankle with instability and an increase in the height of the arch.
Diagnosis
It can be easily diagnosed through an x-ray recommended by the orthopedic surgeon after e the evaluation of the ankle. After checking the pain, swelling, instability, and warmth, a surgeon could. Peroneal tendon injury is a much worse condition and could lead to severe damage if untreated or wrong diagnosed.
Treatment
There are some conventional ways to treat peroneal tendon injuries other than surgery.
- We can use anti-inflammatory drugs to relieve pain and swelling.
- The patient's mobilization can be limited by using a cast or splint.
- Physical therapy that includes ice, heat, or ultrasound therapy can be recommended to decrease the pain and improve the stability of the foot and ankle.
- Braces can be recommended for a short period by an orthopedic surgeon.
- We can do surgery to repair the tears or ruptures in the tendons.
4- Osteochondral Lesions
Osteochondral Lesion damages the cartilage, which connects the bones with joints. The break, tear, and separation maybe occur in the articular cartilage (chondral) and the bone (osteo) underneath. Most Osteochondral lesions are caused due to ankle sprains and fractures. Osteochondral lesions mostly happen in the athlete population.
There are three types of lesion formation:
- The injury in the cartilage surface under the bone part is the subchondral bone.
- The shear or tear of the superficial cartilage surfaces.
- The cyst formation in the deep cartilage surfaces.
Symptoms
The symptoms associated with Osteochondral lesions are included pain with joint swelling. The joint swelling may cause the clicking and locking of the joints. It also limits movement and produces instability.
Diagnosis
The Osteochondral lesions are hard to diagnose as they are not evaluated through physical examination. We can analyze the Osteochondral lesions through MRI or CT. Because the cartilages are connective tissue, any defects in them will not be seen in an X-ray.
Treatment
Conservative care of Osteochondral lesions is done using braces or casting with NSAIDs. But it is temporary and difficult to resolve the pain permanently with braces and casting. We may follow surgical procedures regarding the type of lesions and patient age. Surgical treatment includes surgical excision of a lesion, curettage, fracturing, transplantation of Osteochondral, and filling of defect with bone grafting.
5- Osteoarthritis
The degeneration of the cartilage over time describes as Osteoarthritis. In other words, Osteoarthritis is a degenerated joint disease that commonly occurs in athletes and older adults. Osteoarthritis causes the cartilage surface to be thin and rough, affecting the ankle joint's smooth movement. It causes pain and stiffness in the joint due to irregular surface friction produced between the cartilage surface and the collective. OA-related factors include age, gender, obesity, common injury, and joint abnormalities.
Symptoms
The main symptoms are pain and stiffness in the joint with noise. This pain is worn off as you ride on your foot after rest until the discomfort worsens. Sometimes the swelling of joints has also been observed.
Diagnosis
Osteoarthritis is a slow process and hard to diagnose until an incident or pain and stiffness worsen. The doctor can recommend X-ray and MRI with blood tests to ensure the risk of Gout.
Treatment
The treatment depends on the type of symptoms that appear in the patient. You can treat Osteoarthritis through exercise, weight loss, heat and cold therapy, and adequate sleep. In contrast, different type of analgesics is used for the management of Osteoarthritis. These analgesics are specified as oral, topical, NSAIDs, and corticosteroids.
Exercise Helps To Improve Ankles Mobility
We can prevent popping ankles and their causes by doing several exercises to improve mobility and strengthen the ankle and foot muscles.
1- Calf Raise
It strengthens the calf muscles and reduces the pressure from the ankles.
- Stand on the platform having little height like a stool or low table. Place your half feet on the platform by your calf only, and hang your heel off.
- Start to rise on your toes, using your calf to drive your heels upward.
- Gently allow your heels to back down and lower the edge.
2- Ankle Circles
It increases the mobility of ankle muscles and can be performed in sitting and lying positions.
- You balanced your one leg on a stable surface with an elevated heel.
- Now move your heel in a clockwise direction several times.
- Now move your heel in an anti-clockwise direction the same number of times.
- Swap the legs and repeat the exercise on the other foot.
3- Draw The Alphabet
This can be performed in both lying and standing positions. Start it by lying on your back in a posture where your one leg is held up in the air with a lifted foot in an upward direction. Or you can stand with raised feet on one leg by holding the support.
- Draw the alphabet A-Z with an elevated foot in the air while moving your ankle.
- Swap the legs and write the alphabet again from the feet using the ankle joint.
4- Single-legged Balance
This can be performed by standing on your feet with your stretching arms wide apart to shoulder length.
- Lift your one foot and bend your knee.
- Balance yourself on the other leg for 30 sec.
- Now change with the other leg, and repeat the same exercise.
Bottom line
Popping ankles are natural and harmless until they are followed by pain, swelling, and inflammation. We can prevent popping ankles and other medical conditions by doing proper exercise. Popping or clicking with pain will not be left untreated, and you must see a doctor for further diagnosis and treatment.
