Ultimate Guide on Physiotherapy For Ankle Pain

Ankle-related pain is a common complaint that affects people of all ages and activity levels. It can range from a dull ache to a sharp, stabbing pain, and can limit your mobility. Various factors can cause ankle injuries, including ankle sprains, improper ankle exercises, and health-related conditions.

Ankle sprains account for a significant portion of ankle pain, particularly among athletes. In fact, according to the American Academy of Orthopaedic Surgeons, roughly 85% of all ankle injuries are sprains. Likewise, these are prevalent foot and ankle pain conditions in Singapore.

Fortunately, physical therapy for ankle pain offers a safe and effective way to manage your symptoms and get you back on your feet. This article explores this treatment method and explains the underlying cause of this condition.

What Causes Ankle Pain?

There are many potential causes of ankle pain, some more serious than others leading to chronic pain. We'll look at some of the most common causes people deal with.

Bone and Joint Issues

• Ankle Fractures

A break in one of the bones in your ankle or foot can cause significant pain, swelling, and bruising. Fractures can happen from a sudden impact, like a fall, or from repetitive stress on the bones (stress fractures).

• Ankle Arthritis

Both osteoarthritis, the "wear-and-tear" arthritis, and rheumatoid arthritis, an autoimmune disease, can affect the ankle joint. This can lead to pain, stiffness, and swelling that makes walking difficult.

• Previous Ankle Injury

Even a seemingly healed sprain or injured ankle can leave scar tissue behind. This scar tissue can contribute to future ankle pain and instability, making your ankle feel less supportive.

Soft Tissue Injuries

• Achilles Tendonitis

This overuse injury affects the tendon connecting your calf muscle to your heel bone. It often causes pain and inflammation, especially when you first start moving in the morning or after a period of inactivity.

• Tendon Injuries

Injuries to other tendons around the ankle, besides Achilles tendonitis, can also cause pain and limit your movement. These can happen from sudden movements or overuse.

• Overuse Injuries

Repetitive activities like running, jumping, or even certain sports can strain the muscles, tendons, and ligaments in your ankle. This overuse can lead to pain, inflammation, and a general feeling of achiness.

• Ankle Impingement

When the bones or soft tissues in your ankle joint rub abnormally, it can cause pain and stiffness. This impingement can happen due to swelling, bone spurs (extra bits of bone growth), or even improper mechanics in the way your foot and ankle move.

Other Causes

• Osteochondral Defects

These are small cracks or chips in the cartilage that cushions the bones in your ankle joint. They can cause pain and instability, especially when putting weight on the ankle.

• Ankle Surgery

Any surgery on the ankle joint can leave behind scar tissue and stiffness. Physiotherapy can help with recovery in these cases.

• Ill-fitting Footwear

Shoes that don't provide enough support or are the wrong size can put stress on your ankles and contribute to pain. This is especially common with shoes that are worn out or don't properly match the activity you're doing.

Ankle Pain Treatment

There are several approaches to treating ankle pain, most of which focus on non-invasive methods to promote healing. Here's a closer look at some of the most common approaches.

Medication

Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help manage pain and inflammation in the short term. However, it's important to follow dosage instructions carefully and not rely on them for long periods without consulting a healthcare professional.

Additionally, prescription-strength anti-inflammatory medications may be helpful for more severe pain and inflammation, particularly if your doctor suspects a condition like arthritis.

Activity Modification

Sometimes, the best medicine is rest. Reducing or modifying activities that aggravate your ankle pain can give your body the chance to heal. This might involve:

• Taking a break from high-impact activities: Running, jumping, and other strenuous activities can put stress on your ankle. Consider switching to low-impact exercises like swimming or cycling while your ankle recovers.
• Using walking aids: A cane or crutches can help take some weight off your injured ankle, allowing it to heal and reducing pain during walking.
• Wearing a brace: Depending on the severity of your injury, a doctor might recommend a supportive brace to help stabilise your ankle joint and prevent further damage.

Physiotherapy

This is a non-surgical and often long-term approach that focuses on restoring mobility, strength, and stability to your ankle joint. A qualified physiotherapist like Phoenix Rehab develops a personalised treatment plan for ankle sprain physiotherapy based on your specific condition and goals. These may involve a lot of things, and we'll let you in on what you might expect.

What is Involved in Physical therapy for Ankle Pain?

Thankfully, physical therapy for ankle pain offers a much less invasive solution than surgery for injuries ranging from a mild ankle sprain to a chronic and more severe sprained ankle.

Treatment options vary for different healing phases of the ankle injury. Below is a breakdown of some common methods.

Manual therapy

This hands-on approach is a mainstay in the early phases of healing (acute and subacute phases, roughly the first 6 weeks). A physiotherapist will use massage and joint mobilisation techniques to improve mobility in your ankle joint and promote healing in the surrounding soft tissues (muscles, tendons, ligaments) of your foot and ankle. This helps reduce pain, stiffness, and inflammation.

Strengthening exercises

As your injury progresses into the subacute and chronic phases (after 6 weeks), regaining strength and stability in the muscles around your ankle joint becomes crucial for long-term recovery. Your physiotherapist will design exercises that target these muscles, particularly the calf muscles.

They may use your body weight along with resistance bands and other specialised equipment. The intensity and complexity of these exercises will gradually increase as your strength improves.

Balance exercises

Incorporate balance exercises throughout the healing journey, especially in the later stages (subacute and chronic phases) to help prevent future ankle injuries. These exercises might involve standing on one leg and navigating uneven surfaces. Progression will depend on your individual needs – starting with basic exercises and gradually increasing difficulty as you improve.

Someone recovering from a recent sprain (acute phase) might initially focus on exercises that improve range of motion (how far your joint can move).

In contrast, someone with chronic ankle pain (chronic phase) might progress to more weight-bearing exercises that strengthen the joint and improve stability for activities like walking, running, or jumping. These exercises will challenge your proprioception (your body's awareness of joint position and movement) and help prepare your ankle for the demands of daily life.

A qualified physiotherapist will always guide you through proper form and starting position to ensure you perform the exercises safely and effectively. They will also monitor your progress and adjust the exercises as needed to optimise your recovery journey.

Conclusion

Ankle pain usually goes away on its own depending on the underlying cause. Nonetheless, it can be a real drag on performing your daily activities. Physiotherapy offers a drug-free and surgery-free path to recovery. By working with an experienced physiotherapist, you can regain ankle mobility, strengthen the supporting muscles, and improve your balance, all while reducing pain and preventing future injuries.