Bone Growth Below the Inner Ankle: Causes and Solutions

A bony prominence beneath the medial malleolus?

Both of my feet have a bony prominence below the inner ankle, with the right side being slightly larger.
Two years ago, my right foot underwent eversion, and the doctor at that time mentioned it was due to bone impingement, but no specific treatment was provided.
Over the past year, I have noticed a significant limitation in the inversion angle of my right foot compared to my left, accompanied by tightness and a locking sensation, which can sometimes be quite uncomfortable.
Recently, I had an X-ray, and the doctor diagnosed it as talar exostosis, possibly developed during childhood, stating it would not affect my range of motion and advised me not to worry too much.
Although both feet have this bony prominence, the limitation in inversion angle is more pronounced in my right foot.
None of my friends have a similar bony protrusion, but my mother and brother do, while my father does not.
I researched online, and it does not seem to resemble navicular bone exostosis, as my prominence is located posterior and inferior to the inner ankle.
I would like to ask if that bony prominence could be hereditary? What is its medical term? Are there any methods to address the limitation in inversion angle? Is it affecting the inversion angle? Thank you!

Chen Yi, 20~29 year old female. Ask Date: 2020/05/30

Dr. Chen Yongxue reply Orthopedics

Hello, based on your letter, it is possible that you have a condition related to flatfoot affecting the navicular bone.
You may want to consult an orthopedic clinic for further evaluation.
Thank you.

Reply Date: 2020/05/30

More Info

Understanding the causes and solutions for bone growth below the inner ankle, particularly in the context of your symptoms, involves a multifaceted approach that considers both anatomical and biomechanical factors. The prominence you describe beneath the inner ankle, particularly if it is more pronounced on one side, may be attributed to a condition known as "os trigonum" or could be related to other forms of bone growth such as "talar bone spurs" or "exostosis."

Causes of Bone Growth Below the Inner Ankle
1. Anatomical Variations: Some individuals naturally have variations in bone structure, which can lead to noticeable protrusions. These variations can be hereditary, as you mentioned that family members also exhibit similar characteristics. Genetic predisposition plays a significant role in the development of certain bone structures.

2. Previous Injuries: You noted that your right foot experienced an inversion injury two years ago. Such injuries can lead to changes in bone morphology due to the body’s healing response. The trauma may have stimulated bone growth in the area as a protective mechanism, leading to the development of bone spurs or other bony prominences.

3. Biomechanical Factors: The limited inversion angle you are experiencing could be a result of the bony growth itself, which may physically restrict movement. Additionally, altered biomechanics due to the asymmetry between your feet can lead to compensatory changes in gait and foot mechanics, further exacerbating the issue.

Solutions and Management
1. Physical Therapy: Engaging in a structured physical therapy program can help improve the range of motion in your ankle. A physical therapist can provide exercises tailored to increase flexibility and strength in the surrounding muscles, which may alleviate some of the tightness and discomfort you are experiencing.

2. Orthotic Devices: Custom orthotics can be beneficial in correcting any biomechanical issues related to your foot structure. These devices can help redistribute pressure and improve alignment, potentially enhancing your range of motion and reducing discomfort.

3. Activity Modification: If certain activities exacerbate your symptoms, it may be wise to modify your routine. Low-impact exercises, such as swimming or cycling, can maintain fitness without placing excessive strain on your ankle.

4. Surgical Options: In cases where conservative management does not yield satisfactory results, surgical intervention may be considered. This could involve the removal of bony growths or addressing any underlying structural issues that are contributing to your limited range of motion.

5. Regular Monitoring: Since you have already undergone X-ray imaging, it is essential to continue monitoring the condition. Regular follow-ups with your healthcare provider can help track any changes in the bone structure and assess the effectiveness of the management strategies you are implementing.

Conclusion
In summary, the bony prominence below your inner ankle could be a result of anatomical variations, previous injuries, or biomechanical factors. While it may not significantly impact your activity level according to your physician, addressing the limited inversion angle and associated discomfort is crucial for your overall foot health. Engaging in physical therapy, considering orthotic support, and possibly exploring surgical options if conservative measures fail can help you manage your symptoms effectively. Always consult with a healthcare professional for personalized advice tailored to your specific condition.

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