Collapsed Ankle: Why It Happens and What to Do About It

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I both love and hate getting older. The one part of getting older I do like is that I get to experience on a first-hand basis all of the stuff my patients present with. There is no better way to hone your skills than seeing it all happen in yourself. Up this week is my left inside ankle collapse. Let’s dig in.

What Causes a Collapsed Ankle?

When the inside of the ankle collapses inward, it’s also called ankle pronation. This is the opposite of ankle supination, which goes the other way. See below:

Medical illustration of the normal human foot and the foot with pronation and supination

Sakurra/Shutterstock

I don’t usually work out in front of a mirror, but since I’m down in Grand Cayman, the condo where I stay has a good gym with a mirror. I was doing some simple CrossFit exercises, and I noticed that my left ankle was collapsing inward. Check out my video below and pay attention to the inside of that left ankle.

inside ankle collapse

However, my outside ankle was the area that hurt the most, why? See my video below for that explanation:

The inside of the ankle is supported by strong ligaments. The main ones are called the deltoid ligaments. There are also the spring ligaments:

Illustration of a cross section of the ankle with phalanges, tibia, tarsals, and ligaments

Ankle joint vector illustration. Labeled educational leg structure scheme. Physiological orthopedics explanation with isolated toe closeup. Cross section with phalanges, tibia, tarsals, ligament graph

When these ligaments are loose, the ankle collapses inward.

Learn about Regenexx procedures for foot & ankle conditions.

How Do You Treat a Collapsed Ankle?

I definitely won’t get any surgery. I will have one of my Colorado partners inject high dose platelet-rich plasma using very precise ultrasound guidance. The goal is to get these weak ligaments to heal and tighten. I’ll also get a higher arch insert in the meantime (1).

What if I Leave a Collapsed Ankle Untreated?

The outside of my main ankle joint is taking on too much pressure because of these weak inside ankle ligaments. Hence, if I leave this and continue to be active, I will eventually get arthritis in the outside of my ankle joint (2). So this needs to be treated ASAP.

To see why I’m taking care of this right now, read my book about getting older and staying ahead of the multiple injuries that plague all of us middle-aged and older people:

The upshot? I need to take care of this right away! While getting old is hard, I do love making me a better doctor!

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References

(1) Hunt MA, Takacs J, Krowchuk NM, Hatfield GL, Hinman RS, Chang R. Lateral wedges with and without custom arch support for people with medial knee osteoarthritis and pronated feet: an exploratory randomized crossover study. J Foot Ankle Res. 2017;10:20. Published 2017 May 2. doi:10.1186/s13047-017-0201-x

(2) Golightly YM, Hannan MT, Dufour AB, Hillstrom HJ, Jordan JM. Foot disorders associated with overpronated and oversupinated foot function: the Johnston County osteoarthritis project. Foot Ankle Int. 2014;35(11):1159-1165. doi:10.1177/1071100714543907

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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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