Cause and prevention

In all joints, constant maldistribution of stress eventually leads to osteoarthritis, i.e. destruction of the joint. As the first major joint that has to direct ground pressure into the body, the upper ankle joint is exposed to this risk even in the case of a slight misplacement.

Should the calcaneus (heel bone) slope outwards due to a deformed, soft sole in a shoe, the force on the inside of the talus (ankle bone) increases in line with the slope. This means that the ground pressure is only transferred via a small medial area of the surface of the joint between the talus and the tibia. It is here that the talus forms a small bulge, which is then under extreme pressure.

For this reason, osteoarthritis of the ankle is particularly painful in the medial area. Laterally, slight swelling often develops after even slight strain, as synovial fluid leaks out of the extended lateral part of the ankle joint and spreads into the surrounding tissue. This creates slight compression pain, which can spread around the entire joint.

As with all disorders involving joint wear, long periods of standing and slow walking accelerate the development of the problem considerably; quick steps, like when jogging, give the irritated cartilage the chance to recover between impacts. Strain-free movement strengthens the cartilage's ability to regenerate, and the progression of the osteoarthritis is delayed.

The only effective aid, however, is correction of the direction of ground pressure, whereby the calcaneus is placed straight on the ground. If the strain is permanently physiologically correct, the affected area is able to recover again and enter into recuperation.