Ankle Pain

Ankle injuries

Acute ankle pain occurs suddenly and include sprains, strains and fractures. Chronic ankle injuries develop gradually over time, often through overuse.

Acute ankle injuries (sprains, strains & fractures)

ankle inversion

Acute ankle injuries occur suddenly, usually by twisting or turning over on your ankle, and include sprains, strains, fractures, and cartilage injuries

Sprained ankle – a tear or rupture to any of the ligaments in the ankle. The most common is an ‘inversion sprain’ resulting in injury to the ligaments on the outside of the ankle.

Broken ankle (including Potts fracture) – a fracture of any of the ankle bones. You will have instant pain and swelling, and be unable to weight bear.

Osteochondral fracture – fracture of the cartilage, which sits on top of the Talus bone. They commonly occur in combination with an ankle sprain and may not be diagnosed immediately.

Eversion ankle sprain – a sprain or tear of the ligaments on the inside of the ankle. Less common than a normal inversion ankle sprain and often causes a fibula fracture as well.

High ankle sprain – also known as a Syndesmosis injury, is a tear of the anterior tibiofibular ligament which joins the tibia and fibula together just above and at the front of the ankle.

Medial ankle (inside)

Inside ankle pain

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:

Tibialis posterior tendinopathy – (or tendonitis) is an overuse injury causing pain on the inside of the ankle. Pain is felt on the inside of the ankle which may radiate under the arch of the foot.

Medial calcaneal nerve entrapment – has similar symptoms to that of tarsal tunnel syndrome. Pain radiates from the inside of the ankle, under the heel and into the arch of the foot.

Tarsal tunnel syndrome – nerve compression causing burning pain in the foot, sometimes with pins and needles or numbness. Pain may radiate into the heel and arch of the foot.

Eversion ankle sprain (medial) – is an acute ankle sprain where your foot rolls outwards. Not as common as a normal inversion ankle sprain and often causes a fibula fracture as well.

Broken ankle – is a fracture of any of the ankle bones. You will have instant pain and swelling, and be unable to weight bear.

Lateral ankle pain (outside)

Lateral ankle pain

The most common causes of pain on the outside of the ankle are:

Sprained ankle – a tear or rupture to any of the ligaments in the ankle resulting in injury to the ligaments on the outside of the ankle.

Sinus tarsi syndrome – The Sinus tarsi is a small bony canal which runs into the ankle under the talus ankle bone. Damage to the this can be caused by overuse or from an sprained ankle.

Peroneal tendon dislocation – is repeated dislocation or slipping of the peroneal tendons over the outside of the ankle causes friction, pain, and inflammation.

Peroneal tendonitis – is an overuse injury causing inflammation and/or degeneration of the peroneal tendons on the outside of the ankle.

Anterior ankle pain (front )

Anterior ankle pain

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:

Ankle impingement – is caused by soft tissues at the front (or back) of the ankle becoming impinged by tiny bone growths.

Tibialis anterior tendonitis – also known as tendinopathy is inflammation or degeneration of the tibialis anterior tendon at the front of the ankle.

Back of the ankle & Achilles

Achilles tendon pain

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.

Achilles tendonitis/tendinopathy – inflammation or more often degeneration of the achilles tendon at the back of the ankle.

Achilles bursitis – inflammation of a small sac of fluid called a bursa, at the back of the heel.

Ankle impingement – caused by soft tissues at the front (or back) of the ankle becoming impinged by tiny bone growths.

Torn Achilles tendon – a complete rupture of the Achilles tendon. You may feel you have been struck in the back of the leg at the time. Seek medical assistance as soon as possible!

Sever’s disease – causes pain at the back of the heel in children and adolescents.

Insertional Achilles tendonitis – inflammation of the Achilles tendon at the point it inserts at the back of the heel.

References

  • 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

Ankle Sprain Rehabilitation Program

Our step by step rehabilitation program takes you from initial injury to full fitness.

Iphone app

Recommended products

We recommend the following products for treating ankle sprains:

Cold wrap

Cold compresion wrap

A cold therapy and compression wrap is essential first aid. It reduces pain and swelling and can also be used to apply heat later in the rehabilitation program.

Resistance bands

Resistance bands are important for most sports rehabilitation and enable you to exercise any muscle from the comfort of your own home.

Cold wrap

Cold compresion wrap

A cold therapy and compression wrap is essential first aid. It reduces pain and swelling and can also be used to apply heat later in the rehabilitation program.

Resistance bands

Resistance bands are important for most sports rehabilitation and enable you to exercise any muscle from the comfort of your own home.

Foam roller

A foam roller is an excellent piece of kit which can be used in place of massage to treat calf injuries. They are also excellent when use regularly as part of your warm up to help prevent future injury and improve performance.

Ankle support

Ankle brace

Ankle supports protect your ankle following injury and give support when returning to full fitness. Some have additional support at the sides to prevent sideways movement of the joint.

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