Acute ankle pain occurs suddenly from direct impact or twisting. Acute injuries include sprains, strains, and fractures. Chronic ankle injuries develop gradually over time, often through overuse. If you are not sure what your injury is, why not try our sports injury symptom checker.
Acute ankle injuries (sprains, strains & fractures)
Acute ankle injuries occur suddenly, usually by twisting or turning over on your ankle. A Sprained ankle is most common and involves tearing or stretching of ligaments. Bone fractures and injury to cartilage may also occur. Symptoms include sudden severe pain, with rapid swelling and sometimes bruising.
Read more on ankle sprains & fractures.
Medial ankle (inside)
Medial ankle pain refers to the inside of the ankle. This is more likely to be (but not always) gradual onset from overuse. The most common causes are:
View all causes of pain on the inside of the ankle.
Lateral ankle pain (outside)
The most common acute injury causing pain on the outside of the ankle is a sprained ankle. Chronic causes of lateral ankle pain develop gradually either from overuse or from an acute injury which failed to heal properly. The most common causes are:
View all causes of pain on the outside of the ankle.
Anterior ankle pain (front )
Pain at the front of the ankle is more likely to develop gradually, rather than from a sudden twisting or trauma. The most common causes are:
View all causes of pain at the front of the ankle.
Back of the ankle & Achilles
Pain at the back of the ankle is usually (but not always) related to the Achilles tendon. There are a number of conditions affecting the Achilles tendon which have similar symptoms. A suspected torn Achilles requires urgent medical attention.
Read more on Achilles tendon pain
If you have experienced a lower leg injury of any kind it is important you follow a full treatment and rehabilitation program. Simply resting until it is no longer painful may not be enough if you want to avoid recurrent injuries. This is especially true of fractures and sprained ankles.
- These are important in the early stages of rehabilitation.
- The aim is to regain full, pain-free movement in the joint.
- Initially isometric or static exercises which involve no movement of the joint.
- You contract your ankle muscles against a fixed resistance that allows little or no movement.
- When pain allows, dynamic exercises are done. These involve movement and are often done using an elastic resistance band.
- Finally, functional and sports specific exercises should be done. These bridge the gap between basic rehabilitation exercises and full fitness levels a competitive athlete requires.
- Proprioception is especially important for lower leg injuries.
- It relates to your bodies coordination and its ability to sense the position of limbs.
- Lower leg injuries damage proprioception making injuries more likely to recur.
- Doherty C, Delahunt E, Caulfield B et al. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med 2014;44(1):123–40.
- Bahr R, Bahr IA. Incidence of acute volleyball injuries: a prospective cohort study of injury mechanisms and risk factors. Scand J Med Sci Sports 1997;7(3):166–71