Patients suffering from ankle pain commonly seek physiotherapy. Pain is usually caused by local structures within or around the ankle, however, in rare cases, pain may be referred from other sources (such as the lower back).

The most common mechanism of injury in patients suffering from sudden onset ankle pain is a ‘rolled ankle’. This is typically due to an inversion movement whereby the foot and ankle turn inwards. In these cases, damage to the lateral ligament of the ankle most commonly occurs. However, other structures may also be involved, which can cause conditions such as fractures.

Gradual onset ankle pain often occurs in those patients involved in sports or activities that involve excessive walking or running (particularly with rapid changes of direction, on uneven surfaces or in inappropriate footwear). In these cases, overuse injuries to the tendons around the ankle are common. One of the most common causes of gradual onset pain located at the front of the ankle is tibialis anterior tendonitis. Gradual onset pain located at the outer aspect of the ankle is often due to peroneal tendonitis, whilst gradual onset pain located at the inner aspect of the ankle is often due to tibialis posterior tendonitis. Gradual onset pain located at the back of the ankle is often due to achilles tendonitis. With gradual onset ankle pain, the most likely cause of symptoms may be degenerative changes in the ankle, such as arthritis.

There are numerous other causes of pain, some of which present suddenly due to a specific incident, others which develop gradually over time. Below are some of the more common causes of pain in the ankle region with a brief description of each condition to aid diagnosis.

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