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The Softening & Breaking of Your Ankle’s Cartilage - What You Need to Know

Updated: Aug 21


The world of sports has been a cornerstone of the entertainment industry since it was introduced by the ancient Greeks nearly 3000 years ago. It has borne names like Michael Jordan, Wayne Gretsky and countless others, each with their own story and list of accomplishments. However, these legends aren’t without their scars, as sports result in millions of injuries every year. Twenty percent of sports injuries are sprained ankles, which, if not treated properly, can result in much more severe conditions. One such condition is talar dome lesions, which refers to damage that is done to your ankle’s cartilage. We’ll be taking a closer look at this condition, what causes it, and what you can do if it is affecting you.


What Is a Talar Dome Lesion?

If you take a look at your ankle joint, which is located at the bottom of your shin (tibia)

you’ll see the top of the talus bone, which is dome-shaped. Within this dome, there is cartilage which allows your ankle to move smoothly. This is what gives you the range-of-motion and flexibility you are used to. When this cartilage becomes damaged, you get a talar dome lesion. If the cartilage does not heal properly following an injury to the ankle joint, it will soften up and break off causing ankle pain. If you suspect that you have a talar dome lesion, it is important to book an appointment with us, your local podiatrist located in Meridian Idaho to get an assessment done of your ankle.


What Causes Talar Dome Lesions & What Are The Symptoms?


The most common cause of talar dome lesions occur in patients who experience a traumatic injury to the ankle. This could be an ankle sprain from weight bearing forces, a traumatic landing with an ankle twist, or trauma from an automobile accident. It can also occur in individuals who wear inappropriate footwear or have poor foot biomechanics that put them at risk.

It is unlikely that you will experience any symptoms right away, as talar dome lesions can take months to years to develop. If and when you do suspect that you have a talar dome lesion, look out for the following symptoms.


  • Pain that develops deep in the ankle that does not go away.

  • Pain that gets worse when bearing weight on the foot and goes away with rest.

  • An ankle that gives out or locks when you are doing regular activities.

  • An ankle that catches or clicks when walking.

  • Swelling in the ankle when the foot is in use that goes away with rest.


How Are Talar Dome Lesions Diagnosed?


This type of foot injury can be difficult for a podiatrist to diagnose right away, just simply because the pain you are experiencing will be hard to pinpoint within the dome. When you visit with a foot doctor, they may question you about injuries to the area and ask if you have pain within the joint. If you are experiencing clicking or limited motion within the ankle area, it is important to let your podiatrist know as this may be a sign of talar dome lesions.


If your ankle or foot doctor cannot come away with a 100% accurate diagnosis, they may order additional testing to evaluate the extent of the problem. This can include x-rays, magnetic resonance imaging, or anesthetic injections to see if the pain is indeed coming from your joint.


What Type of Treatments Are Available?


The type of treatment plan that will be crafted for you depends on the severity of the talar dome lesions that you have. If the lesion is stable and does not have any loose pieces of cartilage or bone coming off from it, then you may not need surgery to fix the problem. Non-surgical options include any of the following:


  • Full immobilization of the foot and leg. Your ankle doctor may want to place you in a cast to help protect the talus from any further injuries. This will allow the talus to heal, but you will be required to only engage in non-weight-bearing exercises that have limited to no range of motion to them.


  • Anti-inflammatory medications. Non-steroidal anti-inflammatory medications like ibuprofen will be recommended to help reduce any inflammation in the talus dome and make pain symptoms manageable.


  • Ankle braces. You may be required to wear an ankle brace after the injury has healed to keep you from re-injury.


  • Physical therapy will be recommended to you to strengthen the area and increase your range-of-motion again. This may also include the use of ankle taping, ice/heat treatment, exercises, orthotics, dry needling, and soft tissue massages.


If you go through the non-surgical route to fix the talar dome lesions and it is unsuccessful, you may be required to have surgery to remove the loose bone and cartilage fragments. A podiatrist that has training in foot surgeries can help with this. They will remove the loose fragments, which will in turn help create an environment for healing within the joint.


Are There Any Complications With This Condition?


One of the unfortunate and painful complications of talar dome lesions is arthritis within the joint.You may develop arthritis if the damage to the cartilage within the ankle joint is severe. If you do, this can result in inflammation, swelling, and limited range of motion. You may be required to use braces, complete physical therapy, use anti-inflammatory medications, or undergo further surgery as a result.

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