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Ankle Pain.

One of the most common causes of acute ankle pain is rolling or twisting on the ankle awkwardly. This can result in tearing of one or more of the ligaments around the ankle, which can lead to acute pain, swelling, and a loss of stability around the ankle.

Another condition which can result in ankle pain is ankle tendinopathy. This can involve a gradual onset of pain, usually related to a change of activity or demands on the ankle. Common sources for tendon pain around the ankle include:

  • Tibialis Posterior tendon (can present as pain on the inside of the ankle)
  • Peroneal tendons (can present as pain on the outside of the ankle)
  • Achilles Tendon (can present as pain at the base of the calf or heel)

Tendon pain can also be caused by acute injury such as a direct tear (or rupture) to the tendon, or indirect trauma after an ankle sprain or fracture.

Although not as common as ankle sprains or tendinopathies, ankle fractures can still occur, usually through acute injury to the ankle, and usually resulting in severe pain and difficulty or an inability to weight bear. If you suspect an ankle fracture, please see your doctor as soon as possible for a referral for scans to rule out or confirm the injury.

Treatment for Ankle Pain

Treatment for ankle pain initially involves a thorough assessment to determine the source and severity of injury, and rule out possible fracture.

If the source of your pain is related to a sprain or soft tissue injury, your Physiotherapist can will often provide soft tissue release or other therapeutic treatment modalities to help regain normal ankle range and relieve pain and promote recovery.

For ankle sprains and tendinopathies, treatment also involves the prescription of home rehabilitation exercises to improve ankle strength, balance and proprioception. This can help to improve general function and reduce the risk of re-injury.

If an ankle fracture is suspected, investigations such as x-ray or MRI may be required to determine the severity of fracture and any other associated soft tissue injuries. If indicated, you may be required to wear a brace or moonboot for 4-6 weeks as determined by your GP or orthopaedic doctor while the bone heals. Treatment will then involve a rehabilitation process where the aim is to regain normal strength, function and mobility through the ankle.

Podiatry can also be helpful to assess and treat the ankle and may be involved in designing orthotics or braces if required.


For ankle swelling and pain, RICE is a commonly used method of home treatment:

  • Rest from any aggravating or painful activities to prevent the injury worsening
  • Ice for 10-15 minutes each hour
  • Compression either with compression bandage or compression socks
  • Elevation – keep your ankle supported and elevated to ease swelling

Once pain settles, gentle pain-free movements of the ankle while elevated are encouraged to further reduce swelling and maintain mobility.

You may also need to wear supportive footwear or orthotics while the ankle heals.

If the pain is severe and limiting your ability to weight bear, see a GP or Physiotherapist immediately to determine whether scans are required to rule out a fracture.

More Information

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