My Ankle Keeps Catching

There could be a couple different factors at play, but for most individuals who describe a catching or locking up sensation, they are likely dealing with what’s known as an osteochondral lesion. An osteochondral lesion is a condition that involves an injury to the bottom bone of the ankle joint – the talus. The injury affects both the bone and the overlying protective cartilage. This can damage the smooth cartilage, making movement more difficult or leading to the development of cyst-like lesions in the area which can also impede normal range of motion. These developments can lead to this “catching” sensation you’re experiencing when moving your ankle in certain directions.

The vast majority of these lesions develop as a result of trauma to the ankle joint. Ankle sprains are a leading cause of osteochondral lesion onset, as are ankle fractures. Because of this, falls and sporting activities are two leading causes of injury that leads to osteochondral lesion development.

Symptoms of osteochondral lesions vary depending on the severity of the damage. As we mentioned above, for some, they may only experience mild discomfort when the ankle catches or locks up. Others may experience more noticeable symptoms which can include:

• Pain
• Swelling
• Catching
• Repeated Ankle Sprains
• Limited Range of Motion

Diagnosing and Treating Ankle Catching

Don’t just try to push through being uncomfortable, because the condition is unlikely to get any better on its own. In fact, symptoms may worsen and the condition can get harder to treat. Instead, set up an appointment with a foot specialist in your area.

During this appointment, your doctor will ask about your symptoms, review your medical history and conduct a physical exam of the ankle. They may physically manipulate the ankle joint or ask you to perform a few movement exercises to see the joint in motion. They may then order an imaging exam to confirm their suspicions. An x-ray is most common, but an MRI or CT scan may also be ordered to provide a clearer picture of the lesion.

Treatment depends on the severity of the condition. For some, conservative care may be all that is needed. Conservative care usually includes immobilization and restricted weight bearing, followed by weight bearing progression and targeted physical therapy to improve range of motion. This gives the cartilage time to heal and helps to improve joint function.

For more severe cases, surgery may be necessary. The goal of surgery is to restore a normal shape and cartilage surface to the talus so that the joint can function as intended. The surgeon may debride the cartilage, stabilize the joint or address the cyst, depending on what is needed. Surgery has a high rate of success, but your specific surgery will be determined by your needs and goals after a discussion with your surgeon.

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Causes and Symptoms of Osteochondral Lesions

An osteochondral lesion, also sometimes called osteochondritis dessicans or an osteochondral fracture, involves an injury to the talus and the nearby cartilage. The cartilage can roughen, develop cyst-like lesions or even fracture in conjunction with part of the talus bone. In most cases for an osteochondral problem to develop, traumatic injury needs to occur, as trauma to the ankle joint is the root cause of 85 percent of cases. The most common trauma resulting in an osteochondral lesion is a severe ankle sprain. Symptoms of an osteochondral lesion include:

• Pain
• Swelling
• Ankle instability
• Ankle catching or locking up

Injuries to the talus can be a little more difficult to manage than injuries to other parts of the ankle, simply because the talus does not get a great blood supply. This can inhibit healing and lead to prolonged symptoms, so proactive treatment is recommended.

Diagnosing and Treating Osteochondral Lesions

These types of injuries are pretty easy to diagnose, especially if you’re experiencing the locking up or freezing of the joint. This will give the foot specialist a good idea of what you might be dealing with, but they’ll confirm their suspicions by conducting a physical exam and imaging tests. X-rays do a pretty good job of pinpointing an osteochondral lesion, but in some cases, a CT scan or MRI may provide the best picture.

Treatment can involve conservative or operative options, but your doctor will most likely have you start with non-operative care. Conservative care tends to involve immobilization and limited weight bearing, followed by a gradual progression of weight bearing and physical therapy. The goal here is to provide the cartilage and bone with enough stress-free time to heal, and then to strengthen the area with physical therapy.

If conservative care fails or you have a more severe lesion, surgery may be recommended. The main goal of surgery is to restore the natural shape and gliding surface of the talus so that movement is smooth and there is no locking. This can also help to prevent or limit the eventual onset of arthritis. Surgery is usually performed arthroscopically, and may also involve debridement of loose bone and cartilage, fracture fixation or even bone grafting in serious cases. Your surgeon can walk you through the specifics should surgery be necessary.

So if your ankle is locking up or freezing, don’t just hope it will go away on its own. Reach out to an orthopedic specialist in your area, and get the proactive treatment you need to take care of the problem once and for all.

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