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ACT Physiotherapy and Health Services blog offers valuable insights to help you understand your body and enhance your health. We aim to empower you with knowledge to make informed choices and improve your overall wellbeing.

ACT Physiotherapy & Health ServicesBlogPhysiotherapyDiscover the Truth About Ankle Pain: From Sprains to Spinal Issues
A runner grabs her ankle - she has ankle pain.

Discover the Truth About Ankle Pain: From Sprains to Spinal Issues

Ankle pain is a common ailment that affects many people, often occurring unexpectedly and without apparent injury. While most of us have experienced ankle discomfort from activities like hiking, walking, or playing sports, it’s important to understand that ankle pain can arise from various sources, some of which may not be immediately obvious.

Simple Ankle Sprains

Simple ankle sprains or strains are frequently encountered by physiotherapists. These injuries typically heal well without complications when treated promptly and appropriately. The initial treatment phase often involves the RICE method: Rest, Ice, Compression, and Elevation. This approach helps to reduce swelling and promote healing in the affected area.
Following the initial phase, rehabilitation focuses on strengthening the muscles surrounding the ankle. This is often done in conjunction with therapeutic modalities such as laser therapy and ultrasound. These treatments can help reduce inflammation and promote tissue repair. Additionally, electrical stimulation may be employed to further reduce swelling and enhance the healing process.

Non-Healing Ankle Sprains/Strains

In some cases, ankle sprains may not heal properly, leading to ongoing issues. This can result in problems with the sensory receptors located in the skin, tendons, muscles, and fascia. These receptors are responsible for transmitting information to the brain. When damaged or dysfunctional, they may send incorrect or meaningless signals, increasing the risk of balance loss and re-injury. Fortunately, these cases can be effectively treated through sensory re-education and techniques aimed at decreasing receptor sensitivity. Specialized approaches such as P-DTR (Proprioceptive – Deep Tendon Reflex) or the McKenzie Method can be particularly useful when implemented by certified therapists. These techniques focus on restoring proper sensory function and improving overall ankle stability.

Ankle Derangement Mimicking Ligament Sprains

Interestingly, some cases of ankle pain may resemble ligament injuries but are actually due to ankle derangement. This condition can cause pain and dysfunction similar to a sprain, but the underlying mechanism is different. Therapists specifically trained in repetitive movement examination can accurately diagnose these problems and provide targeted treatment.
In many instances, ankle derangement can be effectively addressed with just one or two sessions of proper education, mobilization, and exercises. This approach often leads to rapid relief from pain and a full recovery of ankle function.

Ankle Pain Caused by Lower Back Issues

A less obvious but significant cause of ankle pain can be spinal in origin. Compression of spinal nerves due to conditions such as stenosis or disc injuries can result in radiating pain that manifests in the ankle. This type of pain typically stems from compression of the lumbar nerve roots (L4, L5) or the first sacral nerve root (S1).
The pain may be unilateral or bilateral, affecting one or both ankles. Given this potential spinal connection, it’s crucial to include a comprehensive spinal examination when assessing any case of ankle pain. This thorough approach ensures that no underlying causes are overlooked.

Treatment Approaches

The treatment of ankle pain depends on its underlying cause. However, some general approaches include:

  • RICE method: Rest, Ice, Compression, and Elevation for acute injuries. 
  • Physiotherapy: Treatment may include exercises to strengthen ankle muscles and improve flexibility. 
  • Custom Orthotics: Custom shoe inserts to improve foot alignment and reduce stress on the ankle. 
  • Braces or splints: To provide support and stability to the ankle joint.

Prevention and Long-term Management

Preventing ankle pain and re-injury is crucial for long-term ankle health. Some strategies include:

  1. Wearing appropriate footwear for different activities.
  2. Gradually increasing the intensity and duration of physical activities.
  3. Maintaining good overall fitness and flexibility.
  4. Using proper techniques during sports and exercise.
  5. Addressing any underlying biomechanical issues with the help of a physiotherapist or pedorthist.

In conclusion, ankle pain can arise from various sources, ranging from simple sprains to complex spinal issues. A thorough examination by a qualified healthcare professional is essential to determine the root cause and develop an effective treatment plan.

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