Ankle Pain Information
Your ankle muscles and tendons dynamically control, move and protect your ankle joint. In simple terms, your muscles move your foot and stabilise your ankle joint to avoid you overstretching your ligaments. Unfortunately, when your muscles lose control or are not quick enough, your ligaments are not protected, resulting in overstretched ligaments (ankle sprain) or complete ligament rupture. Ouch, that hurts!
However, there are many other types of ankle injuries besides a sprained ankle, and we categorise them by the kind of tissue injured, e.g. bone (fracture), ligament (sprained ankle), muscle (strain or tear), or tendon (tendinopathy or tendonitis).
Ankle pain can arise from traumatic ankle ligament sprains or ankle fractures (broken bones). Plus, ankle pain can be more subtle in origin. Tendinopathies, degenerative arthritis and biomechanical disorders can develop ankle pain over time.
There are a lot of ankle injuries – not just sprained ankles. It is essential to accurately diagnose what is wrong with your ankle to ensure that both your short and long-term treatment achieves your goals as soon as possible.
When Should You Worry About Ankle Pain?
Some cases of foot and ankle pain require urgent attention.
Sudden Onset Ankle Pain
Traumatic injuries that occur at speed or involve a multi-direction component such as twisting may result in foot or ankle fractures or significant soft tissue injuries, e.g. syndesmosis or high ankle sprains.
The Ottawa Ankle Rules determine the need for X-rays in acute ankle injuries.
Ankle X-ray is only required if:
- There is any pain in the malleolar zone; and,
- Any one of the following:
- Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus, or
- Bone tenderness along the distal 6 cm of the posterior border of the fibula or end of the lateral malleolus, or
- An inability to bear weight immediately and in the emergency department for four steps.
Chronic Ligament Instability
Chronic ligament instability in your foot and ankle can cause premature osteoarthritis and joint deformity. Some conditions can be safely rehabilitated without surgery, whereas other conditions, such as a Lisfranc injury, may require surgical repair.
Please consult your doctor or physiotherapist for specific foot or ankle injury advice.
Gradual Onset Pain That Fails to Improve
Stress fractures can be serious. While you may not have had a sudden traumatic injury, the ankle and foot are highly susceptible to stress fractures. Several bones in your foot can have their blood supply compromised by a stress fracture, leading to bone necrosis (death). These potentially life-changing conditions should seek an early assessment from your doctor or physiotherapist.
The good news is that most ankle and foot pain is not sinister and improves with physiotherapy and other non-surgical options.
For specific advice regarding your ankle injury, please visit one of the particular ankle injury information pages on this website, or arrange a consultation with one of our ankle physiotherapists.
Common Ankle Injuries
Welcome to an exploration of common ankle injuries. The ever-present sprained ankle is at the forefront, accompanied by various sources contributing to ankle pain. Fractures, stress fractures, and tendinopathies are part of this landscape, each with implications. Ankle impingement and foot posture issues emerge, and biomechanical issues take centre stage, affecting alignment and eventually fast-tracking ankle arthritis. Even the younger population experiences heel concerns, with Severs disease impacting many young athletes' seasons. This article serves as a concise guide to understanding the complexities of ankle problems.
The most common ankle injury is a sprained ankle, but ankle pain can have numerous sources.
An ankle fracture occurs when there is a break in one or more of the bones. The most common ankle fractures are avulsion fractures of your distal fibula, which can be a side effect of an ankle sprain. All suspected fractures require medical investigation and professional management by your health professional to avoid long-term foot and ankle issues. If your healthcare professional suspects an ankle fracture, you will be referred for at least an X-ray and potentially an Orthopaedic Surgeon.
- Ankle Fracture (Broken Ankle)
- Stress Fracture
- Stress Fracture Feet
- Severs Disease
- Heel Spur
- Shin Splints
While muscle strains are more common in your legs, there are essential muscles that converge into tendons that wrap around your ankle to stabilise your ankle and foot to protect them from sprains and allow you to walk and run. These muscles and their tendon vitally provide a normal foot arch and avoid flat feet. Your muscles or tendons can become injured or inflamed due to overuse or trauma. The inflammation is called tendonitis. They can also tear, completely rupture, or sublux out of place. Medically tendon injuries are known as tendinopathies, and at the ankle may include:
- Achilles Tendinopathy
- Achilles Tendon Rupture
- Peroneal Tendinopathy
- Tibialis Posterior Tendinopathy
- FHL Tendinopathy
- Plantar Fasciitis
Your ankle pain and dysfunction can lead to degenerative conditions such as ankle osteoarthritis. While arthritis usually is a chronic deterioration of your ankle joint, it is crucial to slow ankle arthritis progression. Would you please seek the professional advice of your ankle and foot health practitioner, e.g. physiotherapist or podiatrist?
Biomechanical disorders may result in foot deformation, painful weight-bearing and potentially nerve compression. In simple terms, this is where your foot and ankle do not have normal bone alignment and motion control. Here are a few possible conditions related to poor ankle biomechanics.
- Anterior Ankle Impingement (Front of Ankle Pain)
- Posterior Ankle Impingement (Back of Ankle Pain)
- Pes Planus (Flat Feet)
- Tarsal Tunnel Syndrome
Nerve-Related Ankle Pain
Children & Youth Conditions
Systemic Conditions That May Cause Ankle Pain
Soft Tissue Inflammation
Other Useful Information
Foot, Ankle & Heel Pain FAQs
Welcome to our comprehensive FAQ guide on Foot, Ankle & Heel Pain. In this guide, we aim to address common questions and concerns related to foot, ankle, and heel pain. We will cover various topics, including ankle injuries, heel pain, Achilles pain, foot pain, shin pain, youth injuries, and balance and proprioception. Whether you're experiencing discomfort or seeking preventive measures, this guide will provide valuable insights and advice to help you understand and manage these conditions effectively.
- What are the Common Ankle Injuries?
- Which are the Most Commonly Injured Ankle Ligaments?
- How to Strap an Ankle?
- What Causes Ankle Impingement?
- What is a High Ankle Sprain?
- What Constitutes a "Simple" Ankle Sprain?
- Why Do Your Joints Click?
- What are the Common Causes of Heel Pain?
- How Do You Treat Heel Pain in a Child?
- How Can You Tell the Difference Between Heel Spurs and Plantar Fasciitis?
- What are the Common Causes of Foot Pain?
- How Can You Relieve Foot Pain?
- What are the Disadvantages of Barefoot Running?