Ankle collapsing inwards when walking

///Ankle collapsing inwards when walking
Ankle collapsing inwards when walking
Viewing 6 posts - 1 through 6 (of 6 total)
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  • Jellyhall
    Participant
    Post count: 75

    Dr corenman,

    I have problems throughout my spine, but we are focussed on trying to relieve my lumbar spine pain at the moment.
    I had a lumber fusion and decompression of L4/5 for spondylolisthesis 9 years ago. Sadly, the two levels above (L3/4 and L2/3), and one level below (L5/S1) are in a bad way now with atrophied facet joints, herniated discs and spinal stenosis.

    A pain that I have had in the past, but only occassionally, is a feeling that I have very badly sprained my left ankle meaning that I find it very painful to try to walk on it. The pain is at the inneer ankle and upwards to about mid calf, again on the inner part. Previously while walking I would experience this pain, causing me to limp and sometimes have the feeling that my ankle is giving way. It would last for a while, but as I continued to walk by limping it would slowly resolve and be gone.

    This pain has deteriorated and I have experienced this pain in the inner ankles more often now, but it is lasting much longer and gets worse and worse as I try to walk. I have found that if I sit down for a while it improves, but it will return if I keep walking again.

    Today, because I have shorter trousers and no socks on I have noticed that my foot is taking up a strange position as I put weight on that foot. I am flat footed anyway, but now this foot/ankle is collapsing inwards and turning out slightly. Especially as my body moves forwards over the foot this is very noticeable. It doesn’t happen with the other foot, other than being flat footed.

    I am wondering if this is being caused by weaker muscles in my ankle and inner calf. Could this be coming from my lumbar spine problems?

    I am hoping that physiotherapy will be able to strengthen my ankle again so that I can walk normally.

    Donald Corenman, MD, DC
    Moderator
    Post count: 6657

    Your complaint of; “feeling that I have very badly sprained my left ankle, pain is at the inneer ankle and upwards to about mid calf, sometimes have the feeling that my ankle is giving way
    and now this foot/ankle is collapsing inwards and turning out slightly”. The L5 nerve could be affected. This nerve serves the Extensor Hallicus Longus muscle (brings up the great toe), the peroneal muscles (brings the foot out to prevent spraining the ankle) and about 50% of the time. tibialis anterior (foot drop). If your L5_s1 level has been affected by the degeneration, you might have foraminal stenosis which could compress the L5 nerve.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Jellyhall
    Participant
    Post count: 75

    Thank you Dr Corenman, for your reply.

    On reading my message to you I have noticed some errors.
    I meant to say that I have … hypertrophied facet joints …

    and that … this foot/ankle is collapsing inwards and my foot is turning out slightly.

    I will be having a left facet joint injection at L5/S1 in 8 days. Do you think that it may help this pain and weakness?

    Donald Corenman, MD, DC
    Moderator
    Post count: 6657

    I assumed hypertrophied facets as this is what occurs with degeneration. The foot collapsing inwards is typical for peroneal weakness which can originate from an L5 radiculopathy. If you have radiculopathy (leg pain with motor weakness), the facet block is the wrong injection. In the face of radiculopathy, I would consider a selective nerve root block.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Jellyhall
    Participant
    Post count: 75

    I think that the reason they want to begin with facet joint injections is because they did a SPECT CT scan, and although I have many levels with increased uptake of the radioactive substance, the left facet joint at L3/4 and L5/S1 are glowing particularly intensely.
    They have suggested that we try a caudal epidural injection next, which they say will be able to flood up to cover three levels of L5/S1, L4/5 and L3/4. Do you think this is a sensible idea that would help me?

    Donald Corenman, MD, DC
    Moderator
    Post count: 6657

    Caudal epidurals are an old technique that can work well but are not diagnostic. This injection takes a significant amount of fluid mass to get up high enough and sometimes doesn’t not reach its intended target. None-the-less, it is an acceptable technique. I still would recommend a more specific injection to can hone in on the area of suspicion.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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