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Ankle Pain - Causes & Treatment



Definition: ankle pain is either acute or chronic

Symptoms: permanent pain on the inside or outside of the ankle

Causes: abnormal foot mechanics i.e. excessive pronation

Treatment: orthotics, to correct excess pronation and stabilise the ankles


Ankle pain is a common foot complaint. Generally, there are two types: acute ankle pain and chronic ankle pain.

1. Acute ankle pain results from trauma or injury. The most common ankle injury is a sprained ankle. Ankle sprains often occur during sports, running or athletics. The ankle twists which causes damage to the ligaments and tissue surrounding the ankle joint. Although very painful, ankle sprains will usually heal within a matter of weeks by simply resting the foot.

2. Chronic ankle pain is a long-term foot complaint. Pain is experienced either on the inside of the ankle (medial ankle pain) or on the outside (lateral ankle pain). Medial ankle pain is caused by stress on the tendons and nerves around the ankle region. Pain occurs on weight bearing and worsens with activity such as walking, running and sports. In some cases a sharp pain is felt, radiating into the arch of the foot. Typically medial ankle is caused by too much exercise (overuse injury) and/or excessive pronation.
Lateral ankle pain occurs on the outside of the ankle and is also worse during walking, running and exercise. It is often caused by compression of the soft tissue (tendons and ligaments) that wrap around the outside of ankle and it occurs as a result of poor foot mechanics i.e. excessive pronation. To gain a better understanding of this problem, please first have a look at the anatomy of the ankle..

Anatomy of the ankle joint

The ankle joint is made up of three bones which are connected by muscles, ligaments and tendons. The tibia is the large bone located on the inside of the shin. The fibula is the thinner bone on the outside of the shin. The ends of the tibia and fibula are joined together by a strong ligament to form a socket called the ankle mortis. The talus is the highest placed bone of the foot. It has a dome which fits inside the ankle socket (mortis).

Articular cartilage is the smooth shiny tissue present in any place where two bony surfaces come into contact with each other. In the ankle joint, articular cartilage covers the end of the tibia, the dome of the talus and the bottom part of the fibula. Articular cartilage allows the ankle bones to move easily as the ankle bends up or down. The ligaments around the ankle joint are like strong ropes that help connect bones and provide stability to joint. In the ankle there are three ligaments on the outside of the ankle and one broad ligament on the inside aspect of the ankle. It is most common for people to injure the ligaments on the outside of the ankle.

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Pronation and supination

This common foot complaint is mainly caused by abnormal pronation of the foot. Contributing factors are age, weight gain, jobs that require a lot of walking or standing on hard surfaces, badly worn shoes with little support, and also inactivity.

As a result of over-pronation with every step you take the plantar fascia (band of tissue under the foot) is being stretched, resulting in inflammation, irritation and pain at the attachment of the fascia into the heel bone. In some cases the pain is felt under the foot, in the arch area.

Pronation Supination

Continuous pulling of the fascia at the heel bone eventually may lead to the development of bony growth on the heel. This is called a heel spur. During rest (e.g. when you're asleep), the plantar fascia tightens and shortens.

When body weight is rapidly applied to the foot, the fascia must stretch and quickly lengthen, causing micro-tearing of the tissue. Hence, the pain is more severe with your first steps in the morning or after sitting for a long period.


Treatment of ankle pain with orthotics

Orthotics are shoe inserts designed to correct the biomechanics of the foot and ankle. Orthotics can help relieve foot and ankle pain by improving the alignment of the lower limb and providing ankle stability. When the foot over-pronates it will result in over-stretching of the tendons and ligaments on the inside of the ankle and impingement (or pinching) of the ligaments on the outside of the ankle.

Footlogics orthotics correct the problem of over-pronation and help re-align the lower limb. By correcting abnormal foot biomechanics, Footlogics orthotics reduce unnatural friction and pressure in the ankle joint, thus preventing excessive erosion of the articulate cartilage as well as over-stretching of the ligaments and tendons around the ankle.

In addition to orthotics, chronic ankle pain requires assessment by a physiotherapist.