Ankle pain refers to any kind of pain or discomfort affecting any part of the ankle. Ankle pain can happen for many reasons. The most common causes include injury, arthritis and normal wear and tear. Depending on the cause, you may feel pain or stiffness anywhere around the ankle.

Anterior impingement

The anterior impingement syndrome of the ankle is a strangulation that can be caused by soft tissue, like the joint capsule or scar tissue, and hard tissue which refers to bone tissue. It's location is the anterior side of the ankle in the talocrural joint.

This can result from overuse of the tibialis anterior muscle and pain develops in the tendon which attaches the muscle to the bones in the ankle and foot. Symptoms include pain, swelling and stiffness which becomes worse on activities such as running and walking up hills and stairs.

Physiotherapy techniques which help this condition include manual therapy, advice, massage, taping, ultrasound, examining your walking/running pattern, exercise programmes and acupuncture.

This joint is the connection at the lower end of the small outside bone of the lower leg (fibula) with the main shin bone (tibia). This joint can be sprained following an ankle injury and can cause pain at the front of the ankle.

Physiotherapy techniques including advice, exercise programmes, manual therapy, acupuncture and taping can help this condition.

The main difference between osteoarthritis and rheumatoid arthritis is the cause behind the joint symptoms. Osteoarthritis is caused by mechanical wear and tear on joints. Rheumatoid arthritis is an autoimmune disease in which the body's own immune system attacks the body's joints. It may begin any time in life.

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Complex regional pain syndrome (CRPS) is a broad term describing excess and prolonged pain and inflammation that follows an injury to an arm or leg. CRPS has acute (recent, short-term) and chronic (lasting greater than six months) forms. CRPS used to be known as reflex sympathetic dystrophy (RSD) and causalgia.

Symptoms: Depression (mood); Pain

These possible causes include are summed down:

The Achilles tendon is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture). Achilles (uh-KILL-eez) tendon rupture is an injury that affects the back of your lower leg.

Achilles tendinopathy is a condition that causes pain, swelling and stiffness of the Achilles tendon that joins your heel bone to your calf muscles. It is thought to be caused by repeated tiny injuries to the Achilles tendon.23 Nov 2020

Symptoms: Pain; Swelling (medical)

Treatments: Exercise.

Treatments: Exercise.

Posterior ankle impingement is an uncommon problem that results from activities that utilize excessive pointing of the toes (or straightening of the ankle), most commonly dancing and ballet. Posterior refers to the back side of the ankle.

Accessory soleus muscle is a rare anatomical variation in the posteromedial aspect of the ankle. It is an anomalous muscle that mimics soft tissue tumour. It may be a cause of exertional pain and swelling secondary to increased physical activity, especially in athletes.

Fractures of other parts of the ankle will tend to cause pain throughout the ankle and a lot of swelling. If you have injured your ankle and have a lot of swelling and pain and standing on the leg is difficult without pain, we advise you seek urgent medical attention to confirm if you have sustained a fracture to the ankle. We can recommend top London foot and ankle consultants to you. If you do have a fracture it is likely you will have to have the ankle joint fixed in a cast or boot for a period of time. Physiotherapy is important during this time to maintain strength in the rest of the leg. Following removal of the cast or boot physiotherapy is vital to regain full movement, strength and stability around the ankle and help you return to activities you were doing before the fracture.

An ankle deltoid ligament injury is a serious injury which is relatively rare. It refers to an injury which is sustained to the ligament on the inside of the ankle. The medial ankle ligament - also known as the deltoid ligament - is tissue which provides a key role in stabilising the ankle joint.

This is pain in the tendon which joins the tibialis posterior muscle to the inside of the foot. This muscle helps you to rise up onto your toes and turns the sole of the foot inwards. There are different degrees of severity of the condition. If overused over a long time can lead to rupture of the tendon. There will be pain on the inside of the ankle along the tendon which will be worse when doing weight bearing activities. Swelling is quite unusual. Rising up onto the toes may be difficult. If rupture is suspected, we can recommend a top London ankle consultant to review you

Physiotherapy techniques which can help include advice, massage, acupuncture, soft tissue techniques, exercise and taping.

The flexor hallucis longus muscle bends the big toe downwards and helps you to rise up onto your toes. The tendon joins the muscle to the big toe. Tendinopathy can occur due to overuse, a tear to the tendon and from inflammation of the tendon. Common causes include sports that involve excessive rising up onto the toes such as ballet. There will be pain along the tendon and when rising up onto the toes.

Physiotherapy techniques which can help include advice, manual therapy, soft tissue techniques, massage, ultrasound, taping and acupuncture.

Tarsal tunnel syndrome (TTS) is a compressive neuropathy of the posterior tibial nerve. The tunnel lies posterior to the medial malleolus of the ankle, beneath the flexor retinaculum. Symptoms include pain radiating into the foot, usually, this pain is worsened by walking (or weight-bearing activities).

Sinus tarsi syndrome (STS) is a clinical condition characterized by ongoing pain in the anterior (front) lateral (side aspect) of the ankle—between the ankle and the heel—which is usually a result of traumatic injuries.

A Pott's fracture is a break to the lateral (outside), medial (inside), malleoli. These are the bony protrusions on either side of the ankle. It is often caused in the same way as an ankle sprain, so can be difficult to tell apart initially.

Pain felt on the inside of the ankle may be coming from other parts of the body ie. trigger points in other muscles or from a problem in the pelvis, lower back, hip or knee.

This condition as the name suggests is complex. The pain is often constant and of a burning type. The body part affected is often very sensitive to touch and just a stroke can cause pain. There can be changes in temperature and colour of the body part and on occasions growth of excess hair and swelling. The ankle can be affected by this syndrome and the pain can extend up the leg and over the foot. The exact cause of it is not clearly known and can happen with no cause but there can be an event before it occurs such as a fracture. ‘The sympathetic nervous system’ has been shown to be involved which controls blood flow and skin temperature.