Ankle and foot pain overview
Sydney Spine & Sports Centre (S3C) is a ankle pain treatment centre of excellence. Our chiropractors use the highest standards in non-surgical treatments for ankle pain and injury with chiropractic and physiotherapy. Our chiropractors and physiotherapists have the main goal of reducing pain and restoring and improving function.
There are a few different types of ankle pain with varying causes, including:
Lateral ankle pain
Lateral ankle is pain on the outside of the leg. It can occur when an injury does not heal or gradually over time. Other causes include:
- Peroneal tendinitis: This results in inflammation of the peroneal tendons that run behind the lateral malleolus or the bony bit on the outside of the ankle. Pain and swelling is experienced.
- Sinus tarsi syndrome: The sinus tarsi is a bone canal that goes into the ankle under the talus ankle bone. Pain in front of the lateral malleolus will be experienced.
- Impingement syndrome: This is when regular ankle movement is affected because of the bony growth at the front of the back of the ankle. Pain is experienced.
- Peroneal tendon dislocation: The peroneal tendon runs around the back of the outside of the ankle. This dislocation causes pain, friction and inflammation.
- Stress fracture of the talus: The talus bone is the bone at the top of the ankle where the tibia (or shinbone) sits. Gradual pain on the outside of the bone is felt.
- Referred pain: Pain from the spine or the peroneal nerve in the lower leg or tibiofibula joint can refer itself and cause ankle pain.
Medial ankle pain
Medial pain is pain on the outside of the ankle. An injury may be the cause of pain, other causes include:
- Tibialis posterior tendinitis: The tendon passes down the back of the leg and under the foot. Pain may be experienced from an injury or degeneration of the tendon that may move along the line of the tendon.
- Flexor tendonitis: The flexor tendon is the foot that bends the big toe may experience inflammation. Tenderness in the arch of the foot, along the tendon and on the inside back of the ankle may felt.
- Medial calcaneal nerve entrapment: Symptoms include pain that will radiate from the inside of the heel and towards the centre of the heel.
- Calcaneal stress fracture: This is a hairline fracture of the calcaneus bone. Gradual pain will be experienced and increases with weight bearing activities. A chiropractor or physiotherapist can diagnose the injury and treat it to reduce pain.
- Tarsal tunnel syndrome: This is caused by pressure on the posterior tibial nerve and can be very painful. The pain radiates through the arch of the foot, heel and toes.
- Talar stress fracture: This is a hairline crack in the talus bone in the ankle. Pain is experienced and increases when running. The pain is often felt on the outside of the ankle, rather than the inside.
- Medial maleolar stress fracture: This is a hairline fracture to the medial malleolus, which is on the inside of the ankle. Pain and tenderness on the inside of the ankle is felt. This pain increases during running.
- Posterior impingement syndrome: This is when a bony growth at the back of the ankle affects the normal movement of the ankle. This impingement causes pain that is increased when the foot is pointing up.
- Referred pain: Pain experienced in the lower back through can refer pain to the ankle. It is recommended you visit a chiropractor or physiotherapist to seek treatment.
Anterior ankle pain
Anterior ankle pain is pain at the front of the ankle. Causes for this pain include:
- Anterior impingement syndrome: This is when a bony growth at the front of the ankle affects the normal movement of the ankle. This impingement causes pain that is increased when the foot is pointing up
- Tibialis anterior tendinits: This occurs when the tendon of the muscle on the outside of the shin becomes inflamed. Pain is felt when the foot and toes are bent up and when the tendon is being stretched.
- Inferior tibiofibula joint injury: This involves damage to the ligaments that connect the tibia and fibula.
- Osteochondral lesions of the talus: This is when the cartilage that sits on the top of the talus (ankle bone) is fractured. This occurs in combination with an ankle sprain.
- Broken ankle: This is a common injury that may be caused or associated by a sprained ankle. However, the two injuries can occur at separate times. The term “broken ankle” can refer to a fracture of any of the anklebones, with the most common fracture being a potts fracture that affects the inside and outside of the ankle.
- Dislocated ankle: This injury can be severe and can occur in association with a rupture or fracture of the lateral ligaments. A dislocated ankle will require emergency medical treatment. Symptoms will include severe pain and swelling.
- Stress fracture of the fibula: This is a small fracture or hairline crack in the bone. Pain and tenderness are common symptoms associated with this injury, especially during weight bearing.
- Cuboid syndrome: This syndrome is the result of the peroneus longus muscle in the lower leg applying too much force to the cuboid bone, which will cause it to partially dislocate. Pain is the common symptom and this is more likely to be felt on the outside of the foot.
- Greenstick fracture: This fracture most often affects children and is an incomplete fracture. This is caused when one side of the bone buckles partially breaking.
- Tarsal coalition: This is when the tarsal bones in the foot stick together. Symptoms are often felt after intense training or activity with pain felt in the midfoot area. Adolescents mostly experience tarsal coalition.
- High ankle sprain: This is an injury to the ligaments above the ankle joint, which connects the bottom ends of the fibula and tibia of the lower leg.
- Peroneal tendinitis: This refers to inflammation behind the lateral malleolus of the bony bit on the outside of the ankle, which is the peroneal tendon. Swelling and pain are common symptoms that can be felt on the outside of the ankle below the bony bit of the malleolus.
- Sinus tarsi syndrome: The small bony canal, which runs into the ankle under the talus anklebone, is the sinus tarsi. Pain in front of the lateral malleoulus is the most common symptom.
- Navicular stress fracture: A navicular stress fracture is the most common fracture in athletes who frequently sprint, jump or hurdle. An aching pain can be commonly felt in the mid foot and worsens with exercise. A bone scan or MRI is required to determine this fracture, rather than an x-ray that often doesn’t pick it up.