Malléoles: what is it?

The malleoli are protruding bony structures located at the level of thejoint that connect the leg and the foot. Each ankle has two malleoli, a kind of bony protuberance of the tibia and fibula (fibula). The medial or internal malleolus, palpable under the skin, is located at the lower end of the tibia, on the inner side of the ankle. The lateral or external malleolus, located at the lower end of the fibula, more protruding, emerges from the external side of the ankle. It also presents a gutter vertical allowing the passage of the tendons of muscles fibulars on its posterior border. These two bony tuberosities are connected to theastragalus (or talus), bone of foot, by ligaments, to form the ankle joint.

The malleoli: “Achilles heel” of athletes

The malleoli are very stressed bones because they participate in the movement three-dimensional ankle. In addition, an impact on these protruding parts is very painful.

If the foot is positioned inward (inversion), it is possible that the ankle ligaments attached to the external malleolus are stretched beyond their limit and tear, thus causing a sprain (20% of sports injuries) .

In the practice of sports groups (football, handball, rugby, basketball), a fracture of the malleolus can occur due to a sudden change of direction, poor reception during a jump, poor support on the ground, torsion kick or a hit (tackle). In this type of case, the external malleolus is most frequently affected. The treatment is based on immobilization, or even surgical intervention and depends on the probability of rupture of the ligaments of the syndesmosis (joint fibrous between the tibia and the fibula stabilized by four ligaments attached to the malleoli).

Following a sprain or repeated effort, pain may appear at the back of the lateral malleolus, which may suggest fibular tendinopathy of the ankle.

How to protect the malleoli?

There is specialized equipment used by athletes to protect the malleoli. The aim is to support the malleoli with a layer of silicone protecting against trauma and possible shocks. In the professional environment, particularly in the construction or transport and logistics trades, shoes safety standards in force (EN ISO 20345) are rising and include protection of the malleolus (additional requirement AN).