From sports injuries like an ankle sprain to medical conditions, there are many reasons your ankle might be hurting. Here, orthopaedic surgeon DR CHONG XUE LING shares three of the most common culprits – and what you can do to alleviate ankle pain.
Ankle sprain
The most common cause of ankle pain is an ankle sprain. This occurs when the ankle twists or rolls inward or outward, causing the ligaments that hold the bones together to tear or overstretch.
Dr Chong says that you don’t need to be an athlete to tear the ligaments around your ankle joint. All it takes is a quick pivot or an awkward step for that pain, swelling and bruising to ensue.
Luckily, she says these ankle sprain symptoms will usually reduce over time. They can be alleviated with RICE (rest, ice, compression, elevation) treatment, anti-inflammatory medication and wearing an ankle brace. However, the likelihood of long-term instability, especially when walking on uneven ground, remains.
That said, Dr Chong believes it’s worth seeing a doctor early on, even if ankle pain and swelling have improved. “A specialist can assess the severity of the tear, rule out a fracture and ensure proper treatment is provided as early as possible. This can go a long way in preventing further damage down the line.”
Ankle tendonitis
From the strain of constant weight bearing to repetitive movement during sports, our ankles go through a lot. This makes them prone to tendonitis (inflammation of the tendons). Common causes include tendon overuse, trauma or other ankle injuries, wearing shoes without sufficient support, and flat feet and other foot conditions.
No matter the cause, ankle pain is typically the first sign. You may even notice that the ankle pain occurs during activity, then goes away with rest – only to return when activity is resumed. Dr Chong recommends rest and reducing any activities that worsen the pain as the first line of treatment.
“If the condition doesn’t improve with those self-care steps, consult a specialist who can evaluate the condition and advise on treatment options. Treatment options might include oral medication, and a course of physiotherapy to reduce stress on the inflamed tendon and strengthen the other muscles to compensate.”
If these don’t do the trick, she says imaging may be necessary to assess whether there are any tendon tears that need surgical repair.
Arthritis of the ankle
Like other joints, the ankle can be affected by arthritis – the inflammation of a joint and its surrounding soft tissue. The most common type is osteoarthritis, which occurs as a result of joint wear and tear and cartilage breakdown over time.
Arthritis can also occur as part of an autoimmune disease, explains Dr Chong.
“With rheumatoid arthritis, the body’s immune system attacks the joints, causing eventual damage to the cartilage and bones within the joint.”
Regardless of the type you’ve got, she says you can anticipate a gradual onset of pain and swelling, and restricted range of motion or instability. “It usually starts with pain at the extreme range of ankle motion and progresses to pain at any angle of motion. You can also expect pain when putting weight on the ankle.”
Treatment really depends on what’s causing the condition. Modalities for managing it might include anti-inflammatory medications for symptom control, steroid injections and physical therapy. “If conservative treatment options like these don’t suffice, a specialist might recommend a joint replacement or bone fusion.”
Ardmore Orthopaedic Clinic
#10-14 Royal Square Medical Centre,
101 Irrawaddy Road
9830 8206 | ardmoreorthopaedics.com.sg
This article first appeared in the October 2022 edition of Expat Living. You can purchase a copy or subscribe so you never miss an issue!
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