Many people are taken aback by a sudden popping noise in the ankle. A popping sound can seemingly come out of nowhere and have no readily apparent cause. In some cases, a popping ankle is cause for concern, but in others it is really no big deal. If you are experiencing a popping sound, here are a few reasons this could be happening.
A Sprained Ankle
Sprains are the leading cause of popping noises coming from the ankle. To understand why, it’s helpful to know a little about your ankle’s anatomy.
Two leg bones known as the tibia and fibula partly form your ankle’s framework. Inside the place where these two leg bones connect sits the talus bone of the foot. The various bones are connected by a number of ligaments that hold everything together.
When any of these ligaments are torn or stretched beyond their normal capacity, you may experience an ankle sprain. While some people notice a popping sound at the time of their sprain, others will not experience it until after the ankle has healed.
A popping sound following a sprained ankle can indicate a loose tendon or ligament that is slapping against the ankle bone. This loosening is often temporary, in which case things shortly return to normal. Other times, surgery could be needed to repair tendons or ligaments that have become permanently stretched.
Types of Ankle Sprains
There are two basic types of ankle sprains:
• Inversion ankle sprain, a condition in which the ankle or foot turns inward, causing the outer ligaments to become stretched. • Eversion ankle sprain, whereby the foot turns outward, resulting in an inner ligament that is stretched beyond its normal capabilities.
Among the two, an inversion ankle sprain is by far the most common. You are also more likely to experience a popping sound following an inversion ankle sprain than you are an eversion one. That doesn’t mean an eversion sprain cannot produce a popping noise, but simply that it is less likely.
Not all Sprains are Minor
The majority of folks with a sprained ankle never seek professional treatment. Ankle sprains are typically thought of as a minor condition that can be cared for at home. Yet even one sprained ankle can result in joint instability that may lead to future ankle sprains as well as:
• An ankle that tends to give way while walking • Poor balance, which can make you more susceptible to falling • Difficulty walking, especially when going uphill or on uneven surfaces • Joint pain • Early onset of osteoarthritis
If you have experienced a sprained ankle, don’t dismiss it as nothing. We cannot stress how important it is to get off of your ankle and give it proper rest. Avoid standing on your feet or performing strenuous activities until your ankle has had adequate time to heal. Contact a physician right away if the swelling and pain does not subside within 24-48 hours.
Peroneal Tendon Subluxation
Your feet each have two peroneal tendons that run from your lower leg to the lateral malleolus (the bony lump located on the outside of your ankle.) When the peroneal tendon has a subluxation or partial dislocation, this too can cause a popping sound coming from your ankle. A condition known as peroneal tendonitis or inflammation of the tendon may also ensue.
The peroneal tendons are surrounded by a band of tissue known as a retinaculum. When the retinaculum tears, this can allow the peroneal tendons to relocate in front of the fibula. The retinaculum may tear due to inflammation, trauma, or overuse.
A peroneal tendon subluxation is one of the most common repetitive motion injuries involving the ankle. Accordingly, athletes who participate in sports such as basketball, football, soccer, and tennis often experience them.
Genetic Causes of Peroneal Tendon Subluxation
Some people are more genetically predisposed to peroneal tendon subluxations than others are. For example, those with an abnormally-shaped foot or ankle bone may naturally struggle with tendon stability.
Others may not have a groove on the back of their fibula for the peroneal tendons to sit in. This means that tendons essentially move over top of solid bone-something that can result in frequent popping noises when moving.
Osteochondritis Dissecans (OCD)
Articular cartilage covers the joints, which are areas where two bones meet. Osteochondritis dissecans or OCD is a condition in which blood flow to cartilage ceases, resulting in tissue dying.
Once tissue has died, bone and cartilage may form cracks and become loose. In later stages, the bone and cartilage may actually break away from the joint. Small fragments may also become lodged inside the joint itself, causing inflammation, pain, and a further eroding of the joint.
Dangers of OCD
If you suffer from osteochondritis dissecans, your ankle may pop and then lock into position. As a result, you’ll have a hard time bending or flexing your ankle. You might also feel as though your ankle is buckling underneath you when walking. Climbing stairs may be extremely difficult, and can greatly increase your risk of falling.
OCD Causes and Treatments
Scientists are not quite sure what causes a lack of blood flow to the cartilage. But they do believe repetitive motion is a factor, particularly since this condition largely affects athletes during their teen years.
A combination of rest and physical therapy is needed to regain full use of the ankle again. In more serious cases, surgery to remove small fragments of bone or cartilage might also be required. Although rare, advanced surgical procedures such as a joint replacement are sometimes performed in more severe cases.
Children who are still growing may require no treatment at all. Rather, the condition may eventually correct itself as new bone develops. That doesn’t mean kids should not worry about re-injury. Adolescents should allow adequate time to recover between training sessions, and report any serious pain or swelling right away.
Normally attributed to aging, crepitus involves the popping, creaking, or groaning sounds you hear coming from certain joints when you move them. Most often found in the knees, crepitus can also affect other joints such as the ankles, shoulders, or elbows. In fact, aside from the knees crepitus is most commonly found in the ankles.
Osteoarthritis and crepitus often go hand in hand. With osteoarthritis, cartilage on the end of your bones wears away, leaving two bones rubbing together. The friction between two bones rubbing together is typically what causes the popping noises. Osteoarthritis is the most common form of arthritis, affecting more than 15% of the worldwide population.
Inflammation can sometimes make crepitus worse. As such, one of the recommended therapies involves anti-inflammatory medication to alleviate swelling. You should also avoid high-impact activities such as running or jumping. In some cases, a brace may help stabilize your ankle so you do not cause any further damage.
Conservative Treatment for Ankle Popping
Most cases of ankle popping can be addressed at home using the RICE method. This involves:
Rest-Stay off your ankle as much as possible or use crutches
Ice-Apply an ice pack directly to your ankle to lessen pain and reduce swelling
Compression-Wear a compression brace to help stabilize your ankle and prevent further injury
Elevation-Propping your feet will help improve blood flow. Use a pillow to elevate your ankles above your heart.
The RICE method coupled with over-the-counter medications such as ibuprofen and sports cream is usually enough to alleviate minor ankle discomfort. Of course, if your condition does not improve you should seek medical attention right away.
When to See a Physician
Some people experience popping sounds only occasionally and are not bothered by them. Others may encounter them frequently and worry that something more serious is going on. How do you know when to ignore ankle pops and when to consult a physician? Schedule an appointment if you notice any of the following:
A popping noise that’s followed by a sharp, stabbing pain
Ankle instability, characterized by an ankle that buckles or gives way
Extreme redness or swelling that does not improve with the use of anti-inflammatory medications
Decreased range of motion
Frequent ankle sprains, which indicates a chronic instability
Pain that worsens when climbing stairs or standing on your feet for an extended period
A joint that feels warm to the touch, particularly if swelling is also present
Likewise, if you frequently experience ankle injuries or have been diagnosed with one or more ankle conditions, you’ll need professional medical treatment. While most ankle conditions are easily treated in their earliest stages, they tend to only get worse over time. So if you are suffering, do not delay getting help.
Easing the Anxiety over Ankle Popping Issues
At Mueller Sports Medicine, we regularly hear from people who are bothered by popping ankles. Whether you have had a sports injury or are just concerned about the condition of your ankles, we can offer a variety of solutions. Our braces can help you achieve the relief you are looking for, and can even be worn while playing sports or performing strengthening exercises.