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

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.