Ankle problems

You have many muscles that pass around the ankle joint. The main muscles are Gastrocnemius, soleus, tibialis anterior, tibialis posterior and the peroneals. These muscles then attach to different bones in the leg and foot via structures called tendons.

There are numerous ligaments around the ankle which contribute to the stability of the joint. The ligaments of the ankle work together to prevent excessive movement.

• Why do I have ankle pain?
   
• How can I help myself?
   
• I have just injured myself …
• I have had a problem for over 3 months that is not getting better …
• When should I seek medical attention?
   
• What treatments are available?
   
• How do I get help?
   
• Helpful links

 

►	Why do I have ankle pain?

Ankle pain can be caused by a number of structures in and around the ankle joints themselves. How the pain started and where in the ankle the pain is can help make a diagnosis. Often pain is not related to an injury or ongoing damage in the structures of the ankle, but is due to persistent or chronic pain.

As there are a number of possible causes of ankle pain, a thorough examination by a healthcare professional may be required to make an accurate diagnosis.

 

►	How can I help myself?

There are a number of things that you can do to help manage your pain before seeking help from a medical professional. Below are some ways that you may wish to try to help manage your ankle pain.

 

I have just injured myself …

If you have suffered an acute ankle injury you may be suffering with pain, swelling and bruising. In this instance the best treatment is;

• Rest – Whilst it is important to keep the ankle moving it is also important to have a period of relative rest from strenuous activity.
   
• Ice – Using a cold pack around the area of pain and swelling can help manage your symptoms.
   
• Compression – Using a soft tubi-grip bandage can help manage the swelling.
   
• Elevation – when resting, keeping the leg elevated can help manage the swelling.
  

 

If you are experiencing pain following your injury then it is important to take appropriate pain medication. You can discuss what medication is most appropriate for you with a pharmacist at your local pharmacy. If these medications do not provide adequate relief then you may need to see a GP to discuss prescription pain medications.

 

I have had a problem for over 3 months that is not getting better …

If your pain has persisted for longer than 3 months, this does not mean that there is ongoing damage to the structures in and around the ankle. We know that there are a number of reasons why pain can persist without ongoing damage. When pain does persist, there are a number of things that you can do to help manage your symptoms. Below is a list of things you may wish to try;

• Regular exercise – the NHS recommends 150 minutes of moderate aerobic exercise and 2 to 3 days of strengthening exercise per week for people between the ages of 19 and 64 years of age. Muscles and joints need regular movement to remain healthy.
   
• Weight loss – Evidence has shown that a small amount of weight loss can help significantly reduce pain in weight bearing joints.
   
• Pain medication – Pharmacists at a local pharmacy will be able to advise you on over the counter pain medications that will be most appropriate to you. If these do not provide adequate relief then you may need to speak with a GP to discuss prescription medications.

 

►	When should I seek medical attention?

If you have sustained a traumatic injury to the ankle you may have injured the bone, ligaments or muscles in the area. If you are unable to bear weight through the ankle or have lots of swelling and bruising then you will need to attend a local urgent care centre.

If you are suffering with pain in the calf that is accompanied with redness, swelling, and warm skin then you need to attend a local urgent care centre.

If your ankle pain continues to persist after you have adopted some of the self-help measures discussed in section How Can I Help myself?, then you may wish to see your GP who can discuss what the next stages in managing your pain should be.

 

►	What treatments are available?

The treatments available for ankle pain are dependent on your diagnosis. An examination by a healthcare professional will help identify what structures are involved and what is the best treatment plan for you.

Treatment for ankle pain can include;

• Exercise rehabilitation
• Manual therapy
• Soft tissue therapy
• Hydrotherapy
• Acupuncture
• Ultrasound therapy
• Insoles and footwear modifications
• Taping
• Self-management strategies
• Injection therapy
• Surgery

 

►	How do I get help?

If you wish to seek further advice and help in the diagnosis and management of your ankle pain then you will need to make an appointment to see your GP. Your GP can then make a decision with you about what would be the next steps going forward in managing your pain. At this time your GP may consider sending you for investigations including x-ray, or they may wish to refer you to the Surrey Integrated Musculoskeletal service at Ashford & St Peter’s Hospitals, or to a physiotherapist.

 

►	Helpful links

There are a number of websites that you may find useful regarding taking care of your back: