The ankle joint is essential to the body’s balance and is put under a lot of pressure every day, whether it is during walks or sports activities. As such, the ankle is linked to many conditions including sprains, bursitis, Achilles tendinitis and arthritis.
If you are suffering from ankle pain, make an appointment for a physiotherapy or occupational therapy consultation.
Bones, ligaments, muscles, internal and external malleolus: understanding the anatomy of the ankle
The ankle joint plays an essential role in the stability and balance of the body. It is made up of several bones. These bones include the talus, fibula and tibia, etc. These bones are attached by numerous ligaments, which are responsible for holding the ankle and foot together.
You’ve probably already felt the inside and outside of your ankle and noticed a small bony ball on each side? These bony structures are called the medial malleolus (internal) and the lateral malleolus (external).
Tendons are another essential structure in the ankle because they connect the muscles to the bone, and transfer the energy from the muscles to the bone when they contract.
The ankle allows movement (flexion/extension, adduction/abduction, pronation/supination) and load transfers when a person is in motion (walking, running).
Swollen ankle, foot and ankle pain while running or resting: how to identify a trauma?
Many conditions can affect the ankle, and some of them cause similar pain or symptoms, making it difficult to identify the injury.
Examples speak for themselves. A swelling or small round lump on the back of the ankle near the Achilles tendon could be a sign of Achilles tendinitis or bursitis.
So how can you tell what the problem is and how to treat it?
In fact, it is impossible to self-diagnose on your own. The only way to know the cause and severity of your pain is to consult a healthcare professional.
If you have suffered a trauma or are experiencing symptoms, you can make an appointment with your doctor first, or directly with a physiotherapist or occupational therapist.
Both disciplines aim to treat the patient’s pain so that they can continue or return to their activities in a safe and sustainable manner.
Why does your ankle hurt? Different conditions related to the ankle
Ankle pain is usually related to an injury, which is itself related to physical activity and therefore to trauma, but it can also be caused by diseases, such as osteoarthritis.
Ankle sprain: what are the symptoms? Can you walk with a sprain?
Ankle sprains are one of the most common ankle injuries because they can occur at any time in our daily lives. All it takes is a misstep on the sidewalk, your foot is twisted inward, the ligaments are damaged and you end up on the ground.
Ankle sprains are also common in sports that involve sudden changes of direction (basketball, soccer), or in distance sports, especially when played on rough roads. Wearing special shoes, such as heels, can also increase the risk of falling.
But first, what are sprains? A sprain occurs when one or more ligaments are stretched. It is also commonly referred to as a strain.
A sprain can be classified according to three grades: grade 1, which is the stretching of the ligaments; grade 2, or the partial tearing of the ligaments; and grade 3, which is the complete tearing of the ligaments. We talk about mild, moderate or severe sprains.
Foot pain or ankle pain is the main symptom of a sprain. You should note that the pain may be more intense with a simple stretch than with a complete tear, due to the rupture of ligaments.
The pain may be felt during rest or motion and may be accompanied by redness, a sensation of heat, instability or loss of mobility. Depending on the severity of the injury, it may be difficult to place the injured foot on the ground.
A mild sprain will usually resolve itself naturally, but in order to know the extent of the injury and to receive the appropriate treatment, you should consult a health professional as soon as the injury occurs.
Achilles tendinitis: what is it and what are its symptoms?
Tendinitis is a condition that affects the tendons of muscles. It usually occurs when the tendons’ ability to adapt to stress is exceeded and leads to irritation or inflammation.
We refer to it as tendinitis because of the supposed inflammatory period of the injury, but we should call it a tendinopathy
Ankle tendinitis generally occurs in the Achilles tendon. It is commonly known as Achilles tendinitis. The Achilles tendon is located at the back of the ankle (you can actually feel it when you touch it!) and is responsible for propelling the body.
Achilles tendinitis is usually related to overuse of the tendon. It is most common in sports that involve running or jumping. It also affects many runners.
It can occur when someone increases the intensity of their training too quickly, when their footwear is inadequate, or when stretching and warm-up exercises are not done rigorously enough.
However, Achilles tendinitis is not limited to athletes, because workers who have to walk a lot in their jobs are also at risk.
Similar to sprains, pain is the main symptom of tendinitis. This pain is usually localized, just behind the ankle. Moving usually causes pain, especially when propelling the body forward, and it decreases afterwards.
There may also be morning stiffness, and in some cases redness or swelling.
It is very important to treat Achilles tendinitis in order to facilitate its healing and most of all avoid aggravating it. Untreated or poorly treated tendinitis can lead to tendon rupture.
Achilles tendon rupture
Partial or complete rupture of a tendon occurs when its capacity to adapt to stress is exceeded. In other words, it happens when the tendon is no longer able to absorb all the energy it receives. It is generally caused by a sudden and brutal tension.
Athletes have the highest risk factor for Achilles tendon rupture, especially for those whose sport involves a lot of ankle mobilization and step propulsion. Runners and soccer players are commonly affected by this injury.
Achilles tendon rupture can also happen to people with a rather sedentary lifestyle who get into sports, and directly put a high training load on their body.
The impact that tears the tendon is usually felt as a sharp and sudden pain. It is felt behind the ankle, and can go up to the calf.
There may also be swelling and redness. A ruptured Achilles tendon can make it difficult to walk, but it is not necessarily the case. A loss of strength may be experienced.
Medial or lateral malleolus fracture
Ankle fracture (medial or lateral malleolus) can happen in many ways. It can be caused by a fall, a bad landing or an inward or outward twist of the foot, but high intensity or fatigue during sports can also lead to a fracture.
You will feel pain in the foot/ankle when a fracture occurs, but you may still be able to walk in the first few minutes after the impact. However, it is common to have difficulty walking, putting the foot down and standing on the ground in the following hours.
Pain is likely to come with numbness and swelling.
A fracture should be treated as soon as possible, as structural damage can be significant and may require surgery in some cases.
Bursitis: what are the symptoms?
Bursitis is sometimes confused with tendinitis, but it doesn’t affect the same structure. Bursitis occurs when one or more bursae of a joint become inflamed.
What is a bursa, you might ask? Well, it looks like a small sac of liquid that acts as a cushion around the joint. Their role is to facilitate movement and reduce friction/rubbing.
Bursitis occurs when the stress absorption capacity of the small pockets is exceeded. It usually happens when a sports practice or work activity puts a lot of stress on the joint.
The symptoms include localized pain behind the heel, and feeling of heat or swelling of the ankle.
Osteoarthritis: what are the symptoms?
As mentioned before, ankle pain is usually related to a sports-related injury, but not always. Osteoarthritis is one of these cases.
Before getting into the nitty-gritty, it is important to distinguish between osteoarthritis and arthritis, two conditions often confused with each other.
Arthritis, as the suffix “itis” indicates, refers to the inflammatory condition. Osteoarthritis, on the other hand, is the progressive degeneration of cartilage. Risk factors for developing osteoarthritis can include age, joint overuse, being overweight or having surgery.
In some cases, osteoarthritis can be the result of a trauma that causes premature wear of the cartilage.
Pain is felt when moving the joint, but can also appear at rest. Osteoarthritis can greatly impact a person’s daily life, depending on the individual and their condition.
For example, going up or down stairs, which involves putting all of your weight on one leg, can be painful and difficult.
Tarsal tunnel syndrome
Tarsal tunnel syndrome is an injury that affects the tibial nerve. This nerve runs through the foot and up into the calf.
This injury is the result of compression of various structures on the nerve, which causes long-term inflammation/irritation.
A fractured foot, poor posture or poor foot pronation when walking are risk factors.
The main symptom of tarsal tunnel syndrome is pain on the inside of the ankle (at the medial malleolus). This pain is usually increased when wearing shoes, because of the compression it inflicts on the joint.
Other symptoms include numbness, a burning sensation under the foot and discomfort.
How can you naturally relieve ankle pain?
If you have just suffered a blow, a fall, or if your sport activity is causing you intense ankle pain, a few solutions can relieve you.
The first thing to do after an impact or pain is to stop the activity you are doing and to rest your joint. However, this rest must be partial; it is essential to keep your body moving!
Applying ice is also recommended if there is inflammation to reduce the pain. You should apply it for short periods of time, depending on your tolerance.
However, there are limitations to the “natural” treatment, especially in the case of a severe sprain or fracture, which is why we strongly recommend that you consult a health professional as soon as the symptoms appear.
What should you do if you suffer from ankle pain? Physiotherapy or occupational therapy treatment
The best thing to do when an injury occurs, or if you notice ankle pain, is to make an appointment with a healthcare professional. You can visit your doctor or make an appointment with a physiotherapist or occupational therapist.
Both physiotherapy and occupational therapy treat lower extremity injuries to reduce pain and help patients return to their normal activities.
Your therapist will develop a treatment plan based on your condition, your injury and its severity. So, physiotherapy treatment always begins with an evaluation to understand the specific characteristics of your injury and the extent to which it affects your daily life.
The first part of the treatment is about pain management, while maintaining the mobility of your ankle joint, and making sure not to add to the pain. Indeed, partial rest is essential to promote healing.
Different modalities can be used, depending on your symptoms, such as taping or manual therapy.
Afterwards, you will be asked to do joint rehabilitation exercises, such as stretching or mobility exercises.
Education is also part of the treatment, be it pain management exercises to do at home, or advice on how to practice sports (or other activities) safely and prevent future foot or ankle pain.
If you are currently experiencing ankle pain, make an appointment directly with one of our physiotherapists or occupational therapists. A first consultation will help us identify the extent of your injury and develop an appropriate treatment plan, if necessary.