Ankle Pain – what’s the cause?

We treat many people with ankle pain successfully by fully diagnosing what the cause of the problem is and which structure is affected. There are many reasons people are affected and specific issues can affect different age groups. Many people are aiming for the 10,000 steps a day, others run regularly increasing stress on the ankles and others just lead a normal life but still suffer with problems.

When running the forces going through the ankle on each step are significant, especially if you are overweight your ankles may not have the support structures to deal with the stresses.

Here are a few examples of ankle problems:


The most common ankle injury is an inversion (twisting in of the foot/ ankle which sprains the ligaments in the lateral aspect (outside) of the ankle. The ATFL anterior talofibular ligament is the most common but there are other ligaments which can be injured. The best initial treatment is ice and rest for the first few days, then heat and ice as you need to try and speed the healing process up by increasing blood flow to the area. Hands on treatment very early – within a few days reduces the healing time significantly on average by about 80%.

Tendons can also suffer injuries, the peroneal tendon is on the lateral aspect these can be torn or split. On the medial aspect the tibialis posterior can be stressed when running or jumping and can be strained or lead to medial tibial stress syndrome (shin splints), this can be caused from an injury or due to over-pronation.

Fracture is normally caused by a force injury and is indicated when you have difficulty putting weight on the foot or ankle.

An injury can happen anytime during sport or in daily life, however why do you get pain as part of daily life?

Muscle imbalances
As mentioned shin splints can be caused by over pronation which can be a functional problem or a biomechanics issue, if the issue is due to weakness in the muscles in the tibialis posterior or gluteus medius – which helps with the control of the rotation of the leg or the calf or hamstrings are tight – we address these issues by either strengthening a weakness or lengthening a tightness.

People often train without adequate preparation, we all think we can do what we did when we were 20, even when we are 60. Also change of surface, eg running off road then to run on road. We must ensure we train up to the physical challenges we set ourselves to avoid stressing our bodies.

Post fracture
People often don’t receive a full rehabilitation after an injury eg an inversion or a fracture to the ankle. The ankles are very good at producing and maintaining scar tissue leading to a reduction in range on the joint then this can lead to further injuries. Manual therapy treatment quickly eases even chronic restrictions in joints allowing correct movement and a reduction in pain.


Osteoarthritis commonly affect joints in old age especially if you have had a previous fracture.
There can be extra bone growth reducing the space in the joints and a loss of articular cartilage. Manipulation treatment and mobilisations will help settle this pain. Osteoarthritis in the big toe joint can also significantly affect the ankle as It causes the whole foot mechanics to alter. We effectively treat and settle arthritis with specific treatment techniques.

Running shoes are advised to be changed every 500 miles according to the manufacturers, it is very important to get the correct pair, we offer advice and can refer you to Alexander sports who can assess you for the correct pair of trainers, they also offer a 10% discount to our customers. We have a gait analysis facility in our clinic and can video you walk or run in slow motion helping diagnosis. We also provide orthotics which work very well.

Achilles Tendinopathy

The Achilles is a very strong tendon but very commonly suffers with thickening and pain. It deals with up to 12 times body weight forces going through it but is susceptible to inflammation and pain. The inflamed achilles is stubborn. We have specialised techniques to help settle this pain as quickly as possible. Including deep frictions, specific exercise programmes, acupuncture and treating the biomechanics which are causing the problem.

There are other issues which affect the ankle including Haglunds deformity, bursitis, stress fractures, neural irritation, ankle impingement amongst many other problems we can deal with.

We ascertain the CAUSE of your problem to cure the pain.
If you have ankle pain Call Today 01962 714 979