Ankle pain can be caused by a variety of different factors. Pain may be caused by muscles, tendons, ligaments or bones, and can also be related to reduced blood supply or irritation of nerves. This pain will present differently depending on the type of tissue involved, and it is important an experienced health professional assesses the pain.
Common ankle conditions are listed below. It is important to remember this is not a substitute for clinical advice, and it is important you see a health professional regarding the best treatment for you.
Ankle sprains are one of the most common injuries. Typically, a sprained or 'rolled' ankle will be painful due to the ligaments on the outside of the ankle being damaged. For most people a sprained ankle will be a minor injury that will heal without any loss of function. A minor sprained ankle may present with pain, swelling, bruising and decreased range of movement within the ankle.
Not all ankle sprains are minor and heal without ongoing issues. Some will become a chronic source of pain and cause ongoing instability within the ankle. It is important to have the ankle assessed if you feel it is unstable, or the pain is not slowly reducing with time. Proper rehabilitation following ankle injuries is important to prevent a chronically painful or unstable ankle joints.
Ankle pain due to osteoarthritis is more common as we age, or after a traumatic injury to the ankle. Osteoarthritis will feel like a vague pain and stiffness that is worse when rising in the morning and in the colder months. There may be a decreased range of motion in the joint and bony spurs may occur. X-rays will reveal a characterisitc joint space narrowing due to the loss of cartilage between the bones.
Treatment usually involves conservative options such as medication, proper footwear, orthotics and physical therapy. If conservative treatment options have failed and the pain is significant, surgery may be considered.
Fractures can occur after 'rolling' the ankle and should be suspected if there is significant pain when standing, and when pushing on the end of the tibia or fibula. Fractures may also occur to the 5th metatarsal when rolling the ankle.
If there is pain that does not reduce as normal after a traumatic injury, a fracture should be suspected, and it is important to see a health professional for a proper assessment.
Tibialis posterior tendinitis
The tibialis posterior muscle connects just below the knee and runs down the back of the leg and inserts on the inside of the arch. It is responsible for holding up the arch of the foot, rolling the foot inwards and helping point the foot down.
The tendon of the tibialis posterior muscle is commonly injured, and may result in tendon pain on the inside of the ankle during activity. This pain may 'warm up' with activity but will become painful once the tendon has been rested.
Overuse of the tendon due to excess walking, running or jumping is a common cause, and foot biomechanics may play a part promoting extra stress on the tendon.
Treatment may involve rest, icing, exercise programs or orthotics to help reduce stress on the tendon.
Tibialis Posterior Tendon
Tibialis posterior tendon dysfunction
Also known as Adult Acquired Flat Foot, Tibialis Posterior Tendon Dysfunction is a progression of tibialis posterior tendinitis where the tendon elongates and the arch lowers. In the early stages the arch may 'feel different' and lower slightly, and as it progresses the foot may collapse. With time the foot can become rigidly fixed in this collapsed position. To prevent further progression of Tibialis Posterior Tendon Dysfunction it is important to seek treatment early.
Treatment may involve strengthening and orthotics, and if the condition has progressed, surgical intervention may be considered.