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The common causes and treatments for ankle pain

Problems with the ankle can often cause pain at the front of the ankle, the inside of the ankle, the outside of the ankle and even into the foot, or a combination of these. There are many ligaments, muscles and tendons around this area that can be a source of pain, as well as the bones in the joint itself. The two main types of injury to the ankle are acute or chronic.

Chronic ankle pain

In medicine, ‘chronic’ refers to a pain that comes on slowly, getting worse over time. Chronic ankle pain can be caused by several common issues, including tendinopathy, stress fractures and osteoarthritis.

Tendinopathy is due to the tendon (which joins the muscle to the bone) being overloaded. This can occur for example when starting a new activity or increasing load on the legs suddenly and can cause the tendon to become inflamed and painful around the ankle and lower leg. Usually the pain is worse in the morning and feels better as the day goes on.

Stress fractures can occur from repetitive force such as running or jumping, or can occur with normal walking if bones are weakened, for example, by osteoporosis. Pain comes on gradually and is aggravated by putting weight through that part of the foot or ankle, along with swelling.

Osteoarthritis can also occur at the ankle. Osteoarthritis is a condition that affects the cartilage of the bone surfaces gradually, leading to symptoms such as stiffness, swelling and pain. These symptoms can commonly be felt after periods of inactivity such as sitting for long periods or waking up in the morning.

Some symptoms of the ankle, such as clicking of the ankle, are normal and not a cause for alarm. But if you develop a painful ankle that is associated with any of the following, you should see your GP or physiotherapist urgently:

  • Very severe pain
  • Pain which wakes you at night
  • Feeling generally unwell
  • Numbness or burning in your foot
  • Calf pain and tenderness

Acute ankle pain

Acute ankle injuries occur suddenly, usually due to high loading or excessive movement of the joint.

One of the most common injuries to the ankle is a sprain, caused by ‘rolling’ your ankle. This occurs when your foot turns inwards and the ligaments on the outside of your ankle are stretched. A sprain can happen as a result of walking on an uneven surface or landing awkwardly on your foot.

Pain, swelling and bruising are common after this type of injury; and will vary depending on the severity. In these cases, remember to use the R.I.C.E.R method to reduce the swelling, bruising and pain, enabling a quicker recovery:

  • REST the joint, limiting movement
  • Apply ICE for 15 minutes every 2 hours to reduce swelling
  • Apply gentle COMPRESSION, such as a compression bandage
  • ELEVATE the area above heart level, to reduce the amount of pain and swelling
  • REFER, by going to see your GP or physiotherapist for guidance and management

Fractures can also occur with sudden high loads and excessive movements being placed through the ankle. If you are experiencing pain over your outside ankle bone, and you are unable to put weight through your foot, you should see a physiotherapist or GP promptly, as an x-ray may be needed to ensure there is no fracture.

Ankle conditions such as these can be managed at all stages, however seeking help earlier will help you to take care of it faster. Your healthcare practitioner will provide you with advice, treatments and exercises in order to assist recovery and healing, strengthen the muscles, and return you to normal function so that you can get on with your recovery.

Your GP or physiotherapist might refer you to a specialist if they think it is needed. For example, other assessments may be required, such as MRIs or x-rays. These are only used if a fracture is suspected, if the extent of your injury is unclear, or if further information is required in order to manage your rehabilitation. You may also be referred for a surgical opinion if your GP or physiotherapist believes it is necessary.

At Ramsay Health Care, we work with multidisciplinary teams made up of orthopaedic surgeons, medical staff, specialist nurses, physiotherapists and exercise physiologists. For more information, contact us.