First Health Physical Therapy | Ankle Injuries
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Ankle Injuries

Pathological Conditions

Ankle Osteoarthritis

Most cases of ankle osteoarthritis are related to a previous ankle injury. The injury may have occurred years before there is evidence of osteoarthritis in the ankle. Injury can damage the cartilage directly, or it can alter the mechanics of the ankle joint.


  • Pain in walking, moving, climbing stairs, etc.
  • Joint stiffness
  • Lost flexibility
  • Difficulty walking
  • Joint swelling
  • Reduced range-of-motion

Heel Spurs

Heel spurs are common in patients who have a history of foot pain caused by plantar fasciitis. In the setting of plantar fasciitis, heel spurs are most often seen in middle-aged men and women, but can be found in all age groups. The heel spur itself is not thought to be the primary cause of pain, rather inflammation and irritation of the plantar fascia is thought to be the primary problem.


  • Painful
  • Tenderness
  • Immobility
  • Pain increases from movement

Pronated Foot/Flat feet

A pronated foot is one that rolls inward when walking or running and does not properly pass the weight over the foot. This creates a biomechanical problem that stresses the foot and lower leg. The knee and hip are affected as well because of the inward rotation of the leg.

People with pronated feet are at risk for developing overuse injuries, such as ankle and Achilles tendonitis, shin splints, heel and kneecap pain, and heel spurs. People who have excessive pronation are said to have flat feet. They are particularly sensitive to overuse injuries such as stress fractures and tendonitis. The problem of pronation or ‘flat feet’ will not go away for you were, most likely, born with it.


  • Imbalance
  • Pain
  • Wear and tear in other part of your body
  • Arch pain
  • Heel pain
  • Ankle Sprains
  • Achilles Tendonitis
  • Knee Pain

Pes Cavis/High Arch

Pes Cavis/ High Arch are caused by a bone or nerve condition. Highly arched feet tend to be painful because more stress is placed on the section of the foot between the ankle and toes. This condition can make it difficult to fit into shoes. People who have high arches usually need foot support. A high arch may cause disability.


  • Shortened foot length
  • Difficulty fitting shoes
  • Foot pain with walking, standing, and running

Traumatic Injuries

Fractures/ 5th Metatarsal

Ankle fractures happen when one or more of the bones that make up the ankle joint are separated into pieces. There may be ligaments damaged in the process as well. The more bones that are broken, the more unstable the ankle becomes. It can range from a simple break in one bone, which may not stop you from moving, to many fractures, which will eventually push your ankle out of place. It would then be advised that you do not put any weight on your ankle for three months.

Types of Ankle Fractures

Lateral malleolus: the bump on the outer part of the ankle

Medial malleolus: the bump on the inside of the ankle

Posterior malleolus: the bony distinction of the tibia; rarely injured on its own.

Lateral and Medial malleolus are the more common injuries.

Bimalleolar fractures: two of the malleoli bones are broken.

Trimalleolar fractures: all three malleoli bones of the ankle are broken.

These fractures derive from a large amount of force, disruption of the ligaments, or a dislocation, and causes instability.


  • Cannot bear weight on the ankle.
  • Pain
  • Numbness in the foot or ankle.
  • Bone pieces visible outside the skin
  • Inability to move toes
  • Inability to move ankle
  • Cold foot
  • Color of foot changes to blue


Ankle dislocation occurs when a bone in the ankle joint is out of place. Ankle dislocations are uncommon and generally occur with ankle fractures.


  • Intense pain
  • Swelling and bruising
  • Visible deformity of the ankle
  • Soreness and pain
  • Foot immobility


Talar is a small bone that sits between the heel bone and the two bones of the lower leg, the tibia and fibula. It is an important attachment between the foot, the leg and the body. It helps transfer weight and pressure across the ankle joint.


  • Acute pain
  • Inability to bear weight
  • Swelling and tenderness

Sprain (High and Low Ankle)

Ankle sprains happen when the foot twists, rolls or turns past its normal range of motion. Your ankles sprain when the foot lands unevenly on a surface with force. The motion causes the ligaments to stretch beyond normal range.


  • Swelling
  • Stiffness
  • Pain and tenderness
  • Cold and numbness
  • Inability to walk
  • Incapable of bearing weight on foot
  • Bruising

Syndesmotic Injury

Syndesmotic injury also known as high ankle sprain occurs in a result of an ankle eversion. When the ankle joint twist outwards, the ligaments that surround the ankle joint are stretched or torn.

Repetitive Injuries

Ankle Tendinitis

Ankle tendinitis can be caused by trauma or inflammatory arthritis. It is an inflammatory condition that affects active and individuals with flat-foot. It often affects the posterior tibialis tendon. The posterior tibialis tendon runs underneath the knob in your ankle, and its role is to raise the arch of the foot.


  • Pain and tenderness in the tendon
  • Swelling
  • Redness and heated feeling around the tendon
  • Pain in the area in the morning and at night
  • Pain worsens during or after activity or exercise.
  • Pain in the area in the mornings and at night (advanced tendonitis)
  • Stiffness
  • Incapability to bend your ankle

Achilles Tendonitis

Achilles tendonitis, also referred to as Achilles tendinopathy. Sometimes it occurs over a period of a few days. If it turns out to be chronic, it’ll occur over a longer period of time. This condition can also be either at the attachment point to the heel or in the mid-portion of the tendon Healing of the Achilles tendon is often slow, due to its poor blood supply. It is caused by an overuse injury. Too much activity, too soon causes the condition. For example, increasing activity, giving yourself less recovery time, changes in footwear, running uphill or over-pronating can all be causes of Achilles tendonitis.

Achilles tendon bursitis

Achilles tendon bursitis is a common foot pain in athletes, predominantly in runners. A bursa is a small sack of fluid that sits between a tendon and a bone to help the tendon move smoothly over the bone. In this condition, the bursa is inflamed due to constant impact and trauma to the area.


  • Tenderness and swelling
  • Pain in the back of the heels, when running uphill or on soft surfaces.
  • Spongy resistance when pressing on both sides of the heel.