Ankle pain can be injury to any of the ankle structures including your ligaments on the inside and outside of your ankle. These ligaments keep your ankle stable and must resist your whole body’s weight. These ankle injuries are very common, not only in sports, but accidents do happen. Acute ankle injuries occur suddenly, usually by twisting or turning over on your ankle. Strong tendons run on either side of your ankle that adapts to surfaces you walk on, tilting inwards and outwards like a synchronized orchestra. Ankle pain is a problem we treat daily at our practice, and just like a mechanic that just knows all the components that needs to work in harmony, we’re human body mechanics. We offer the best proven ankle pain treatment, so let us fix it.

Everyone has twisted their ankle at some point in their lives, stumbling over a mat, or misjudging a step. Are your Ligaments torn? Is it a Tedonitis or even Fractured? Ankle pain can be caused by any of the muscles, tendons or joints, so let’s look at the different types of structures in your ankle and the causes, types and symptoms of a variety of ankle injuries.

What causes my ankle pain?

In order to understand where your ankle pain is coming from, you’d have to determine how you injured it, or if you can remember an incident at all.  Some are outright obvious like a slip on floor or a twisted ankle, meanwhile others are subtle and creeps up on you – getting worse day by day. So, it’s easier to establish how the pain started and changed until now. Any changes in your ankle pain helps narrows down the culprit and targets treatment so much better.

Your ankle consists of various types of tissue, some elastic like tendons, or strong cables like ligaments, some tissue can generate movement & force like muscles. We rely on your ankle ligaments to keep you stable to stand, tendons to coordinate your ankle how to tilt when you walk, and muscles to generate power to run. The structures in your ankle is quite vulnerable to injury, especially overuse injuries. There are more than 52 structures in your ankle that can be the source of your pain, some problems are more common that others, but just to be safe – we test them all.

Sore, aching ankles? Your ankle wont hurt for no reason, clearly something is wrong that needs to be looked at. So let one of our expert’s trained eye determine the cause your ankle pain and give you the treatment options.

Get to the root of your ankle pain

Different structures, cause different types of ankle pain, although these are not concrete it’s a good guideline to which structure produces what type of pain

  • Muscle — Dull ache or stiffness, sharp pain with contraction
  • Nerve — Numbness, tingling, weakness, electrical stabbing feeling
  • Tendon — Burning pain with certain specific movements, pain comes & goes
  • Joints — Cramp, constant stiff feeling, worse after rest, better with movement
  • Fat pad — Pinching pain, pressure increases or decreases pain immediately
  • Bursa — Pain only comes on after being active, better with rest
  • Bone — Constant pain, sharp pain with certain movements
  • Arteries — Pins & Needles, dead leg feeling, heavy feeling
  • Cartilage — Sharp pain when at certain point, painful arch of movement
  • Ligament — Pain at the end of range, unstable, clicking
  • Referral from other joints — Difficult to pinpoint pain, vague painful area

Causes of Ankle pain

  • Trauma – Ligament sprain, Muscle strains, Fractures
  • Overuse – Tendonitis, arthritis
  • Pinched nerves – Sciatic nerve branches of Posterior tibial nerve, Fibular nerve and calcaneal nerve
  • Referral from other joints – Foot or the calcano-Cuboidal and -Navicular joints.
  • Circulatory system – Arterial & Venous occlusions, DVT & Atrial failure

Ankle Pain in the …

Ankle pain in the Front

Ankle Impingement

It is when a bony growth at the front of ankle ankle bone restricts normal ankle range of motion. Impingement means tissues have become trapped between bones. A bony spur at the front causes ankle pain over the front of your foot. The tissue is pinched between the talus and Tibia.

Tibialis anterior tendon inflammation

The tibialis anterior muscle is a large muscle that runs down the front & outside of your shin. It lifts your ankle upwards. Tendinitis of the Tibialis Anterior tendon is a condition when ankle tendon become inflamed and irritated. Pulling your ankle & foot up while pressing on the front of your ankle, you’ll feel the tendon bulge under your fingers causing ankle pain.

Torn Anterior Inferior Tibifibular Ligament

Ankle ligament injuries are serious, Ligaments are made of very thick connective tissue that provides stability to your ankle joints. This is a specific ligament in the front of your ankle keeps your tibia and fibula together, if torn your two lower leg bones will separate when you walk on it. A torn AITF ligament needs treatment sooner rather than later as it causes long term soreness to linger around your ankle.

Extensor Digitorum Longus tendinitis

Extensor digitorum is a muscle that lifts your toes up. Runners gets pain over the front of their ankles, when they tighten their shoes too tightly. This restricts the glide of the tendons that run over the top of your foot, and front of your ankle. Stretching by pointing your toes gives a dull burning pain. Treatment is quite simple and easy.

Pain at the back of ankle

Achilles tendonitis

Overstretch & traction injury to the Achilles tendon of the calf muscle group.  Achilles tendonitis is an overuse injury causing pain, inflammation, and or degeneration of the Achilles tendon at the back of your ankle. This repetitive contraction with excessive force causes micro-tears in the Achilles tendon. Pain & stiffness is mostly in the mornings and at the start of training, then it eases off, but returns after you’ve cooled down. Squeezing the tendon is a dead giveaway. Treatment usually takes as long as you’ve had the pain.

Achilles tenosynovitis

Its inflammation of the sheath or layer surrounding the Achilles tendon. Very similar to Achilles tendinitis, but needs an MRI or Ultrasound to differentiate. Walking on your toes or stretching your calf muscles will bring on the ankle pain.

Torn Achilles tendon

Sudden sharp pain in the Achilles tendon, often described as if being shot in the leg. A loud snap or bang is heard when it happens. Sudden sharp pain that subsides quickly, may leave you thinking ‘its not that bad’, until you feel the weakness. Treatment is usually surgical.

Sever’s disease

Only found in Children aged 8-15 that do a lot of sports or overactive. Pain & tender over the back of the ankle which gets worse with exercise. Squeezing the sides of the back of the heel will bring on the pain. Often linked to a child’s growth spurt, when the muscles and tendons can’t keep up with the bone growth.

Insertional Achilles tendonitis

Insertional Achilles Tendonitis occurs at the back of the heel where the Achilles tendon inserts into the heel bone. The injury is similar to Sever’s disease in children but affects adults. A lump develops over the back of your ankle where the Achilles anchor onto your heel. Pain & swelling at the back of your heel & ankle gets worse with training or exercise.

Retrocalcaneal & Achilles bursitis

Ankle bursitis is inflammation of a fluid filled sac or cushion (bursa) over the a bony point at the back of your calcaneus & Tibia, and your Achilles tendon. This condition occurs when the bursa becomes irritated, compressed or infected. With repetitive bending & straightening of your ankle it triggers the bursa to get inflamed and painful. The treatment is focused around the ankle and restricts movement for a short period, but there’s much to be done to make sture it doesn’t come back.

Posterior ankle impingement

It is when a bony growth at the back of your ankle restricts normal ankle range of motion. The tissue is pinched between the talus and Tibia. Impingement means tissues have become trapped between bones. A bony spur on the Tibia or Talus protruding backwards causes posterior ankle pain. Most pain at the end of the movement when your foot is fully pointed.

Fibula Stress Fracture

Repetitive strain and excessive training may cause a stress fracture of your fibula. The bony tip of the fibula is a common site of these ankle injuries. This type of pain is dull and constant, irrespective of rest or load. Applying pressure over the back or tip of your fibula will increase your ankle pain. Stress fractures are not visible on normal X rays, but a skilled Physio will be able to detect & treat it.

Referred pain form the Sciatic nerve

Due to irritation of the nerves that runs along the back of your leg and provides the skin & muscle its ‘power’. Abnormal compression and irritation on the Sciatic nerves that supply your leg, will give you nerve pain over your ankle. The pain may be contained to the back or spread upwards to your calf & knee, depending on the branches of the nerve that are pinched.  Nerve pain will have a tingling quality ,and feels like pins & needles, numbness or weakness. A pinched Sciatic nerve is a serious problem and needs treatment.

Referred pain

This is caused by an injury or problem elsewhere such as your shin, (fibula & tibia) foot joints. The pain you’re experiencing is pain that radiates from other joints nearby. Treatment involves looking at all the structures that might refer pain to your ankle, it’s a long list, so be patient.

Outside ankle pain is Lateral

Sprained Ankle

The most common ankle injury is a sprained ankle. This is when you twist your ankle and the outside ligaments are overstretched causing them to tear. There a 3 major ligaments on the outside of your ankle what suddenly swell and become painful. This type of ankle sprain happens when your foot twists inwards, stretching or tearing the ligaments and tendons on the outside of your ankle. Too often cracks in the small bones of your ankle cause complications if not picked up early on.

Ankle swelling gets worse over the first few days, then a blue bruise becomes visible. It’s important to eliminate the possibility of fractures in this early stage to guide the treatment plan. Our physiotherapist will send you for ankle X-rays if necessary.

Peroneal tendonitis

Peroneal tendonitis is inflammation of the peroneal tendons which run behind the bony knob on the outside of your ankle. This is a overuse & traction injury to the tendons of the Peroneal muscles.  These tendons pull your ankle outwards, and stretched when your ankle turns inwards. When these tendons are overloaded repeatedly, your ankle becomes painful. Usually the pain feels worse in the mornings, then disappear as your body warms, only to return in the afternoon, or after your jog.

At later stages the tendon disintegrates and pain becomes worse with exercise and improve with rest. This type of ankle pain treatment involves laser, strapping and much, much more.

Avultion fracture

This is when a piece of bone is ripped out by a tendon or ligament. This is the anchor onto the bone and will cause considerable pain with severe swelling in and around your ankle. These are more common in teenagers and children because their bones are softer. A forceful contraction or pull can dislodge a piece of the Tibia or Fibula.

Sinus tarsi syndrome

The sinus tarsi is a small bony canal which runs into the ankle under the talus bone. Damage & narrowing to the sinus tarsi ‘channel’ is caused by overuse or an ankle sprain. Your ankle pain is difficult to pinpoint but it’ll be somewhere just in front of the bony knob on the outside of your ankle. Walking on a sloped surface like pavement will bring on the pain on the outside & front of your ankle. Turning your ankle inwards makes your pain worse.

Peroneal tendon dislocation

Your peroneal tendon runs behind the bony knob on the outside of your ankle. Tearing of the sheath that should keep it in place causes the tendon to snap forwards & backwards over the bone causing a range of problems, just like a rope is scraped over a rock – it never ends well.

Dislocation or slipping can be felt on the outside of your ankle. The pain gradually builds up and swelling around the outside will become visible. Your ankle will feel tender where it passes behind and under the bony knob on the outside of your ankle. If non-surgical treatment fails, surgery is the next step.

Talar stress fracture

The Talus is the bone at the top of your ankle which your Tibia sits on. If your pain gradually comes on over the outside of your ankle, it may be a sign of a stress fracture. Pressing over the inside of you ankle will cause sharp stabbing pain. Usually there’s very little swelling. These types of fractures don’t show up on X-rays, a bone scan or CT scan will be necessary, although some times picked up on normal X-rays if the bone healing has already begun.

Complex regional pain syndrome

This is damage to the smaller nerve branches in the ankle and foot causing severe hypersensitivity, pain, numbness, itching, pins and needles over your ankle. This hypersensitivity to any pressure & touch, a breeze or even just putting on socks produce agonizing pain over your ankle. Treatment focuses on desensitizing the nerve endings around your ankle joint.

Inside ankle pain

Deltoid ligament sprain or tear

This is a tear or overstretch of the ligaments on the inside of your ankle. Usually after a fall where your foot twists outwards – this causes the inside ligaments to be strained causing pain and swelling around the inside of your ankle.

Tibialis posterior tendonitis

A Tibialis posterior tendonitis is where the tendons are inflamed due to constant irritation from repetitive overload on the tendon. If the tendon is unable to heal, it’ll become degenerative, which is irrecoverable damage to your tendon. The tibialis posterior tendon runs just behind and below the bony nob on inside of your ankle.

Pain on the inside of your ankle usually feels worse at the start of exercise, then disappear as it warms up, only to return after you have cooled down. The ankle pain may also radiate under the foot arch, and more likely to affect older females who do a lot of walking or running.

Flexor hallucis longus tendonitis

Flexor hallucis longus tendinopathy or flexor tendonitis is inflammation or degeneration of the flexor tendons in your ankle causing pain on the inside of your ankle. This happen when the tendon is subjected to excessive or repetitive stress. Specifically, pain along the length of the tendon as it passes around the back of the bony nob on inside of your ankle and into to the arch of your foot. Ankle pain treatment focuses on gradual loading and building capacity.

Pinched Medial calcaneal nerve

This is when the medial calcaneal nerve or some of its branches become irritated & trapped between tendons, fat pad & muscles on the inside of your ankle. The pain is a sharp stinging feeling that radiates across the inside of your ankle, outwards to the center of your heel. Walking is particularly painful causing you to limb. When the nerve pathway is restricted be surrounding structures, it sends abnormal signals of pain up your nerve.

Tarsal Tunnel Syndrome

Its caused by pressure on the posterior tibial nerve as it passes around the inside of your ankle. Usually it causes a burning, sharp pain that radiates to the arch of your foot. You’ll feel pins & needles, numbness, itching over the sole of your foot. The compression point must be identified and treated to ensure your ankle pain doesn’t return.

Talar stress fracture

The Talus is a bone that sits on top of your calcaneus, and below your Tibia. A stress fracture of the talus is a hairline crack in the bone caused by overuse. The pain on the inside of your ankle usually gets worse over time, and exercise flares-up your pain, especially running & jumps.

Medial malleolar stress fracture

The medial malleolus is the nob on the inside of your ankle. It’s rare, but possible. Pressing over the inside of you ankle will cause sharp stabbing ankle pain. Usually there’s very little swelling – as seen with other types of stress fractures. These types of fractures don’t show up on X-rays, a MRI or CT scan will be necessary.

Tibialis posterior tendon dislocation

It occurs when the tibialis muscle pulls the tendon out of its retinaculum. The retinaculum is a shield of tissue which holds your tendon in place on the inside of the ankle. You’ll find clicking & snapping of the tendon forwards and backwards over the bony nob on the inside of your ankle. Turning your foot inwards causes more damage to the Tibialis Posterior tendon.

Posterior ankle impingement

An ankle impingement is when a bony growth blocks your ankle’s range of movement. Tissues are pinched between the two bones which causes swelling, leading to a cycle of tissue inflammation. The ankle pain gradually gets worse, as the range gets less. So, trying to point your foot or walk on your toes will be painful. X-rays will show extra pieces of bone like bony spurs on the talus or end of your tibia. The ankle pain feels like a sharp sting or pinch over the back of your ankle that radiates to the inside and outside of your ankle.

Ankle Arthritis

This is the pivot point of your ankle joint. The Talus’s top is covered by cartilage to ensure smooth ankle movements. Over years this cartilage becomes worn down and erodes the protective cartilage and fluid in the joint becomes more viscus & thick which restricts ankle motion. Pain in and around your ankle joint is worse in the mornings or after rest and starting to move takes a while to ‘warm up’ your ankle joint. Treatment focuses on slowing the destruction and maintaining the ankle range to prevent the pain from escalating.

Ankle fracture

Any fracture of the ankle bones must have treatment under supervision of a medical professional, because of the high risk of not healing at all or the bones healing skew. This leaves you with a very weak, unstable and stiff ankle joint.

Talar dome fracture

A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage.

Talar dome lesions are usually caused by an injury, such as an ankle sprain. If the cartilage does not heal properly following the injury, it softens and begins to break off. Sometimes a broken piece of the damaged cartilage and bone will float in the ankle.

Symptoms of ankle pain

Mild

  • Deep, dull ache in your ankle
  • Able to pinpoint your pain
  • Still able to walk without pain
  • Pain comes & goes
  • Moving your ankle into certain positions produces expected pain
  • Stiffness in your ankle
  • Slightly swollen
  • Mild tenderness over the area
  • No bruising
  • Pain at the end of range

Moderate

  • Twisting movements increase pain
  • Sharp stabbing ankle pain
  • Ankle Swelling (Within 24 hours)
  • Blue or bruise
  • Pain through the whole range of movement
  • Limited range of movement. You can’t move as far as you could before.
  • Unstable
  • Pain worse when taking weight on the affected leg
  • Hesitant to balance on one leg
  • Climbing stairs with difficulty
  • Loss of strength
  • Pins & needles, or loss of sensation, in over your ankle

Serious

  • Severe, constant pain not improved by any change in position, heat or medication
  • Pins and needles or a sensation of tingling & numbness in your ankles
  • Audible Pop or crack
  • Severe and immediate swelling and bruising
  • Either no pain, or severe pain that subsides quickly
  • Sharp pains when trying to move
  • Ankle feels ‘locked’ – stuck in a certain position
  • Cannot put weight on the affected leg – too sore
  • Too painful to stand on one leg
  • Hesitant to climb stairs

How bad is my ankle pain?

Size – The larger the area of your ankle pain, is better, because muscles in your calf stretch from below your knee to your heel. Pain tends to radiate along your calf muscles and affect large areas. Muscles heal easier & recover faster.

Colour – Bruising in & around the outside, back and inside of your ankle is quite common after a injury, because of the high concentration of blood vessels in your calf. These capillaries rupture & leak plasma that pools in your ankle. Blue discoloration closer to your foot is more concerning for it involves your ankle ligaments.

Swelling – Ankle Swelling is your body’s way of healing itself by sending cells to heal the tissue. More swelling could mean more tissue damage, however not all ankle injuries swell. Injury to tissue that develops over a few weeks doesn’t swell, because the tissue trauma is continuous and repetitive, so your body stops the inflammatory reaction. Swelling limits circulation of nutrients and removal of waste products that can slow down healing and increase ankle pain.

Area – Ankle pain at the back of your ankle are more restrictive during walking, while pain at in the front of your ankle limits you from walking up an incline and movements like climbing down stairs. If your ankle pain causes you to limb you must be more concerned. Sharp pain over a small area makes it easier to pinpoint structures near your pain. Vague, dull & deep ankle pain can take longer to identify the root cause.

Motion & Sore ankles

Stiff – Ankle Stiffness followed by pain is regressing and getting worse. Seek help. Although, pain followed by stiffness is a good sign of tissue healing, specifically scar tissue formation. Scar tissue is hardening wound tissue that tends to shorten and pull on structures surrounding the injured site. This is more pronounced in muscle strains & tears, where the normal slide of muscles is restricted during a contraction.

Range of movement – Difficult moving your ankle through its range is a big problem. A painful arch means the structure injured only takes tension over that specific range i.e Only painful when you point your foot the last 5 degrees. Ankle pain over a smaller range of movement is not necessarily better. This may point to connecting joint surfaces being injured. If you feel pain only at the end of your range its less severe and easy to fix. When your ankle pain stops the range completely and too painful to move you should definitely come see us as soon as possible.

Monitor over time:

Intensity – When you grade your pain from 0 – 10. You may think it’s not that bad because it’s not that painful. On the contrary, pain intensity is not a sign of how severe your tissue injury is for example, complete ruptures of ligaments are less painful than partial tears. When fibers are stressed while it’s anchors are completely loose, there’s not much pain, but fibers that are partially torn will produce severe ankle pain. People have different pain thresholds, so be careful to ignore your ankle injury.

Frequency – Pain that’s fleeting or intermittent short burst of pain must not become more frequent and constant. This shows that the tissue damage is not getting any better. Pain that only lasts for a few seconds tend to heal faster, so the longer your pain lasts the faster you should get to us.

Latency – If your pain lags to come on and builds up over the day you must be very cautious. This is a sign of a relapse of your tissue pathology. It’s difficult to judge what makes it worse, because the pain only comes on a few hours after your activity, and not during.

Loading – Pushing through your ankle pain while you are walking, climbing stairs and jogging is not fine. Putting compromised tissue under strain is dangerous. Would you tow a car with a partially torn cable? No! Because it just needs that final pull or jerk that could cause catastrophic tissue damage. Loading soft tissue without knowing what it’s able to handle is dangerous & reckless.

Diagnosis of Ankle pain

Our physiotherapists know and understand the intricacy of the anatomy of your ankle. There are many structures to test, and we even consider the complex biomechanics of your foot & knee movements. We’ll accurately diagnose which structures are involved, and to what degree.

During your evaluation, we’ll be stretching & stressing the soft tissue structures like muscles, ligaments, nerves and tendons. This way we can diagnose muscle tears, ligament sprains, tendinitis’s and nerve irritations. We’ll test different aspects like muscle strength, range of motion, flexibility and stability in order to confirm how severe your tissue damage is, which will dictate your ankle treatment plan.

Gathering information through our evaluation allows us to make a diagnosis based on your individual injury. Then we’ll customize the treatment to your specific needs. Therefore our physiotherapists are the best at diagnosing ankle pain & ankle injuries.

The Process of Diagnosis:

There is a misconception that medical practitioners are able to know exactly that’s the problem the moment we see our patients. They tend to point to their ankle and say, “treat it”. As if we already know what’s the problem by just looking at it. Sorry to disappoint, but unfortunately this is not how it works. Let me explain:

Diagnosis is a process of exclusion, not inclusion. Medical professionals are taught a process of elimination and deduction to identify the most possible diagnoses for your ankle pain. The better you can describe & elaborate on your pain, the better picture you’ll give your Physio to narrow down the cause of your ankle pain.

The practitioner uses their skills to eliminate diagnosis’s it’s not and zoom in on your problem. This elimination brings us to only a few possibilities to what could be causing your ankle pain. Then we test & assess all our possibilities to get to the root cause. In many cases your main problem is not at the site of your pain due to compensation and guarding. We encourage you to be honest, open and explain in as much detail about what you’re feeling – to clarify, carry on or change your Physio’s approach.

Physiotherapist treatment

We have seen many patients with ankle pain and provide the best possible treatment for a faster recovery. Pain and stiffness after an ankle injury prevent you to move and you might feel hesitant to move, or scared you’ll damage it even more. We know that you’re anxious about the unknown, so that is why we are here to guide you and give you all the answers.

Your ankle pain treatment will be tailored according to various factors, but just to give you a broad idea, the focus of our treatments are. Firstly to establish which structures are injured in your ankle, and how bad is it. This puts the scope of the problem into full perspective. Usually there’s a knock on effect, where a few structures are involved, but we must determine what’s the order of priority.

Secondly, we must protect your ankle from further injury and stop it form getting worse. Thirdly, we set the ideal conditions for ankle tissue to recover. Now we can even accelerate and speed up your recovery and get tissue to heal. The last aspect of our process is monitoring your progress as you progress, making sure you achieve the goals and milestones. Our treatment program must change as you adapt and your ankle get better.

We explain the extent of damage & the intricate details of your ankle pain & how it may cause other problems. Just like assembling DIY furniture, if you miss a step, you spend so much time figuring out what’s wrong rather than just spending that time focusing on recovery.

Well Health Pro

Our team of experts can diagnose, test and treat any kind of ankle pain. Let’s work together to get rid of your pain as fast as possible. We have the best tools, techniques and machines to make sure you get the best value for your money. Our Physios will test a lot of different possibilities why you’re feeling this ankle pain in order to explain what’s going on in your body. It all depends on the results of our tests to determine what needs to be done. All our physios are specialists that can determine the slightest problem coming from your ankle, foot or lower leg, so if you’re uncertain – we can help you.

Our experts determine the priority which problems to fix first. This means that we test movements to see if you have a muscle tear, weakness, instability and much, much more. Ankle pain treatment is our expertise & what we’re best at. We’ll guide you every step of the way.

Ankle pain Treatment

Trying to treat ankle pain without understanding the cause, underlying state of the tissue, and how far along into the recovery cycle the injured tissue is, is just foolish. That’s where we’ve heard people try the weirdest remedies to try and get rid of their ankle pain. But no-one has just taken the effort to test and understand the scope of the problem.

For example a patient comes in with an ankle injury 8 weeks after she slipped, and suspected she has just sprained the ligaments in her ankle, but has no idea to which extent the damage really is. She won’t know if the bone is cracked or a tendon is completely torn off. She used muscle rubs and taking pain meds, with no improvement. This scenario highlights many problems like do you think muscle rubs will do anything for a fracture? Or does the meds numb the pain so she can still walk on a very compromised, unstable, injured ankle.

This brings me back to ankle pain treatment. Treatment cannot be discussed if the tissue damage, structures involved and influence of other factors is not established.

What NOT to do

  • Take medications for longer that 7 days, especially Anti-inflamatories in the first 48 hours.

  • Ignore swelling – clearly something is wrong

  • Stretch through the pain

  • Force through the pain

  • Do not ignore ankle pain that gets worse (it could be a sign of a Deeper problem)

  • Treat it without a proper diagnosis, you may end up causing more harm

  • Leave it untreated

  • Walk, run, jog through the pain

What you should do

  • Follow a POLICE or PRICE protocol.

  • Maintain the pain free range of movement

  • Make an appointment to confirm the diagnosis and determine how severe the tissue damage is.

  • If you’re unsure what it might be – rather get an expert’s opinion

Making the ankle pain worse

  • Walking through the pain

  • Climbing stairs

  • Walking on gravel

  • Driving

  • Rolling your foot in all directions

  • Jogging & Running

  • Wearing shoes with poor support

  • Jumps

Muscle pain

Your ankle doesn’t have a lot of muscles, although their tendons run along this junction and anchor onto your heel or foot. These tendons act like cables to control the movement of your ankle. Considering there are no large muscles close to your ankle, these tendons are very vulnerable to injury when your foot is twisted – the ankle is the weakest link where problems will develop.

The muscles that move your ankle and toes is located in your lower leg & shin. At the front of your shin is the tibialis anterior muscle. Your calf is made up of the soleus and gastrocnemuis muscles and the tibialis posterior muscle deep to these. The peroneal or fibular muscles sit on the outside of your lower leg which has long cable like tendons that run along the outside of your ankle. Your Flexor digitorum muscle runs on the inside of your ankle to anchor on your toes. Muscle tear happen when the muscle tissue is forcefully stretched and pushed past its boundaries.

Ligament tears

Your ankle joint relies on ligaments for stability which connects your heel to shin. Ligaments are injured when forceful movements load them beyond their normal range while being stretched at the same time, like when you twist your ankle. Ligaments are able to withstand great traction, but everything has it’s breaking point.

There are 3 main ligaments on the outside, and 1 Deltoid ligament on the inside. Outside ankle sprains are much more common, because these are smaller and thinner than the inside ankle ligaments. In the front of your ankle are one very important ligament called the Inferior Tibia-fibular ligament, which prevents your lower leg from separating when you stand on it. It’s quite understandable that an injury to this ligament can cause havoc and severe pain in your ankle.

Ankle ligament sprains occur most often in sports where there is quick change in direction or jumping, like soccer, rugby, netball and dance. This doesn’t mean that only active people have the risk of injury, mis judging a stair, tripping over a rock or insensible shoe may all cause an ankle ligament sprain.

Ankle pain, Treatment for sore ankles

Tendon pain

Tendons are cables that anchor muscle to bone. Every muscle has a tendon on either side, where is comes from (proximal tendon) and where it stops (distal tendon). With repetitive overuse or trauma, this anchor site may become inflamed, causing tendinitis (tendonitis) of the tendon attachment. The blood supply to tendons are not as good as muscles, shown in their white appearance.

Symptoms of tendinitis is tell-tale, as a tendon is happy when it has good blood supply, when it is working. You will experience pain & stiffness when your ankle has rested and then starts to move, but disappears while you exercise and returns when you cool down again. The most common tendinitis in the ankle is Achilles tendinitis.

Overuse injuries, from repetitive training like a marathon, causes inflammation of the tendons (tendinitis). The tendons act like a rope pulled over a brick. The more the movement, the more friction, the more irritation on the tendon. When the tendons are stretched, it will feel more like a burning pain. The pain will be worst after the activity and stay for longer.

Ankle joint pain

The ankle joint is an intricate design and interplay between three different joints, the talocrural, subtalar and inferior tibiofibular joint. All three these joints need to work in harmony to create free plantar flexion (ballerina feet) and dorsiflexion (toes to shin). Joint pain may cause grinding sounds and restricted movement.

Nerve pain

Like all other joints the ankle is reliant on nerves for motor (allows movement) and sensory (sensation and proprioception) function. The nerves that supply the ankle are branches of the sciatic nerve.  The sciatic nerve branches off to form the tibial, deep and superficial fibular nerves. Injury to these nerves, due to trauma or compression, can cause numbness, pins and needles or weakness. These symptoms may also be present in lumbar radiculopathy , sciatica or piriformis syndrome. When in doubt rather have your symptoms assessed to determine the the extent of your nerve damage.

Ankle injuries and Treatment for ankle pain and sore ankles

Ankle Injuries

Ankle pain is extremely uncomfortable and disrupts the smallest task you must get on with, so stop the madness. Get your ankle looked at and get all the answers you need. Most ankle pain don’t start after a fall or injury, but usually develops over time. Yes, it’s more obvious in sports injuries, but you’re required to carry on with work even though you have agonizing ankle pain. We know what you’re going through.

If you’re suffering, rather get it checked. Please come visit our your physiotherapists if you are feeling any type of ankle pain. Rather do something about it than wait with your fingers crossed and hope it goes away. If you’re expecting tomorrow will be any different than today. Stop waiting and act.

An accurate diagnosis is vital to manage your pain and treat it appropriately, because what works for one problem rarely works for another. Some conditions can take many months or even years to heal when the diagnosis is incorrect, or treatment is neglected. You could end up spending a lot more time & money to fix your problem later on. So be warned…

How to Stop chronic, daily annoying ankle pain

Without Injections, Without taking Painkillers and

WITHOUT having to wear a Support or Brace…

If you’re living with ankle pain what just won’t go away, they’re painful or they ache – it’s very easy to think that it’s “just something that comes with age”, it’s a bit of “wear and tear”, or that it’s nothing and it’ll go away on its own.

You can’t quite point your finger on why you’re feeling the pain in your ankle – but it doesn’t seem to be getting any better!

If that’s happening to you, you’re not alone – we hear this type of thing all the time. In fact, ankle pain is one of the most common problems that we see in our Physio practice. When it comes to living with ankle pain, everybody we see wants to know the answers to these questions:

Why am I still suffering with ankle pain that keeps getting worse

Most people think that when they get ankle pain, it’ll eventually “ease off” and go away on it’s own. That they’ll wake up one morning and like “magic”, your ankle pain will be a thing of the past… But 3 months later you’re still living with the annoying ankle pain, often even worse than it was at the start. Does that sound like you?

Another scenario we see all the time in our physiotherapy practice is when people go to their Doctors, and the well-meaning Doctor tells them to “rest”, “try these painkillers” and “come back in 6 weeks if it’s no better” – but then 6 weeks later, they end up going back to the same Doctor again because it hasn’t got any better, only to be given ANOTHER prescription of even stronger pills, and maybe a ankle guard/ support.

Has this ever happened to you?

Maybe you’re confused because you’ve been told different things, by different people. Maybe you think you have to rest because you’ve been told walking makes ankle pain worse, or that you should be doing ‘this exercise’ and ‘that exercise’ to make it better. It’s very confusing to know exactly what to do – and that’s just to avoid making your ankle pain worse, not to mention getting back to jogging and all the other things you love to do.

And because of this confusion – this often leads people to procrastinate, and put off making a decision about what to do to help fix their ankle pain. Worse, many people just end up accepting it as “part of life” – as if it’s normal, as if it “has” to be that way. Is this how you feel?

We are here to tell you – this is NOT what you deserve. You are made for great things, your ankle pain is just a bump in the road. Make a decision to help yourself be better.

Why is your ankle pain lasting longer than it should?

You thought your pain would go away on its own, but it didn’t

Your doctor told you to rest and take painkillers. The painkillers relieved the pain, but didn’t heal your ankle injury. As soon as the painkillers wore off, your ankle pain returned.

A friend told you that “everybody experiences ankle pain as they grow older, you should just accept it”.

Other healthcare professional’s advice and treatment didn’t help.

YouTube exercises and home remedies didn’t help relieve the pain, or in some cases made your ankle pain ten times worse

You thought enough rest would eventually heal the problem. However, afterwards your ankle feels even more stiff and tight than before

Does this sound like you?

If any of these have happened to you – we would love to help you. The fact that you’ve tried any or all of these things already is actually a good thing, because when you know what doesn’t work – you are closer to finding the thing that does!

We invite you to come and see us. Why? Because we do things differently. We’ll do a thorough assessment and test all the possible causes. After we’ve diagnosed your problem, and explained what it’s going to need to heal, we’ll make sure you understand why this is happening.

If you’re looking for solid advice on how to start solving your problem. This is an opportunity to get an expert’s advice about your situation. Our goal is to help you make the right decision about what to do next.

What you can do to get rid of your ankle pain quickly?

Decide to get help

So many people rest for weeks, hoping that the pain will ‘just go away with time’, but 6 weeks down the line they’re still putting up with it, and nothing’s changed… Or the ankle pain & swelling gets even worse. You may even cause other problems. Lack of treatment could end up costing you more time (for recovery) & money the longer you wait.

Do the right exercises

One of the best things to help ease your ankle pain is to do the right series of progressed exercises- as advised by your Physiotherapist. The right kind of activities can reduce your pain, and help your healing. Above all, exercises ensure that problems don’t come back. However, the wrong kind of exercises have the potential to increase the pain in your ankle even more.

Get hands-on Physio treatment

Physiotherapy is proven to improve the lives of people suffering from ankle pain. Ankle pain could be affecting your physical performance in a professional or private life, you may not even notice. It could even threaten your independence or get in the way of spending quality time with your family & friends. Physiotherapy can enable you to live the life you desire as quickly as possible.

Ask our experts

If you would like to know how we can help you, we invite you to book a FREE, no-obligation, risk-free “Call me back” phone call.

Note: This Free Call is a service we offer to people who are nervous or unsure. You might not know if Physiotherapy is the right treatment for you. If you are unsure, please fill out our online form. We will contact you to find out what is wrong and how we can help. There is no financial obligation or risk on your part. You have nothing to lose except your pain.

Choose to see a Well Health Pro Physiotherapist to help you Get rid of your ankle pain – in the next few days?

  • We quickly put an end to the cycle of pain and stiffness.

  • We’ll find and treat the origin of your ankle pain.

  • Pain can rob you of sleep & rest. We can help you to enjoy sleeping at night and living with more energy each day

  • We will provide you with the perfect set of exercises that will speed up your recovery

  • Using painkillers in the long-term can be harmful to your health. We help you lower or completely stop your need for painkillers to manage pain

  • Our physiotherapists help you avoid dangerous & costly surgeries, and painful injections

  • We reduce visits to specialists or doctors

  • Ankle pain can limit the activities you enjoy with your family & friends. We can help you get back to enjoying quality time with family & friends that ankle pain has taken from you.

  • We can help you to finally return to walking up & down the stairs, and getting out and about without that annoying ankle pain stopping you

What your patients say:

I had an ankle injury for 8 weeks, about 10 session later I was back on the field, no ankle pain. Needed to be ready & they did it! Extremely knowledgeable and guided me a long the whole recovery process to get rid of my ankle pain fast. Really impressed.

J Oosthuizen

I thought I just sprained my ankle, but the Physio tested my ankle – Well, it was fractured. Took X-rays & everything. I was very anxious on the impact of my ankle injury to my running, but they reassured me and told me their ankle treatment plan. Back on the road now. Definitely recommend them.

T Meyer

My experience so far has been great. Struggling with chronic ankle pain is always a challenge. I appreciate their hands on and informative approach! Thank you for not giving up from the get go. Not everyone is willing to really listen, understand and help. Great practice and beautiful rooms that makes you feel at ease and comfortable. Thanks

N Brand

This is the best physio I have ever been too. She is very thorough, and I felt she made a huge impact in a very short period of time. I won’t ever go to anyone else. Its money well spent for a lot of ankle pain relief.

J Theunissen

Amazing service, took my son because of an ankle injury. We were treated with respect and he is healing fast.

E Mahlangu

Nina is a super qualified physiotherapist with skills identifying the problem and working towards fixing it. She is professional and puts your mind at rest regarding the road ahead of my ankle injury. Definitely recommend them for ankle pain treatment.

F Nel