It starts in a way many people will recognise. You roll your ankle stepping off a curb, landing awkwardly during a run or coming down from a jump during sport. It swells, hurts, maybe bruises and after a few days you can walk on it again. So you move on.
But weeks or even months later, something still doesn’t feel quite right. There’s a lingering ache, a sense of weakness or that uneasy feeling that your ankle could ‘give way’ again.
Ankles are one of the most commonly injured joints in the body, yet many people don’t realise how important appropriate rehabilitation can be following an injury. Ankle sprains account for approximately 5% of emergency department presentations in Australia each year, highlighting just how common these injuries are.
Common Causes of Ankle Pain
Ankle pain can arise from a variety of conditions, not just a single sprain.
The most common cause is a lateral ankle sprain, which typically occurs when the foot rolls inward and the ligaments on the outside of the ankle are stretched or torn. These injuries can range from mild ligament stretching through to more significant tears.
Other possible causes of ankle pain include:
- Chronic ankle instability following previous sprains
- Achilles tendinopathy
- Peroneal tendon irritation or injury
- Anterior or posterior ankle impingement
- Osteoarthritis or inflammatory joint conditions
- Referred pain from the knee, hip or lower back
Biomechanical factors may also contribute. Changes in the way a person walks or moves, reduced joint mobility, altered pelvic mechanics or leg length differences may influence how forces are distributed through the lower limbs.
Because the ankle functions as part of a larger movement system, identifying contributing factors beyond the ankle itself may be an important part of assessment.
Why Proper Recovery Matters
Ankle sprains are often underestimated. Many people assume that if they can walk on the injury, it has healed.
However, without appropriate rehabilitation, some people may continue to experience symptoms including:
- Recurrent ankle sprains
- Ongoing feelings of instability
- Reduced balance or proprioception
- Stiffness or reduced mobility
- Difficulty returning to previous sporting or recreational activities.
Following an injury, people may also unconsciously change the way they walk or move to protect the ankle. These altered movement patterns may place additional stress on other areas such as the knee, hip or lower back.
Appropriate assessment and rehabilitation aim to restore movement, strength and balance while helping reduce the risk of recurrent injury.
How Chiropractic Care May Help
Chiropractors are trained to assess and manage musculoskeletal conditions involving both the spine and the extremities, including the foot and ankle.
Depending on the findings of an individual assessment, chiropractic management may include:
- Joint mobilisation or manipulation where clinically appropriate
- Soft tissue techniques
- Rehabilitation exercises to improve strength, balance and proprioception
- Assessment of gait and movement patterns
- Advice regarding activity modification, footwear or self-management strategies
- Assessment of contributing factors involving the knee, hip, pelvis and lower back.
Where clinically indicated, your chiropractor may also recommend referral for imaging or to another healthcare provider if additional investigation or co-management is required.
Rather than focusing only on the painful ankle, assessment may also consider the way the entire lower limb functions during walking, running and other daily activities.
Research suggests that conservative management incorporating exercise rehabilitation, alongside manual therapy where appropriate, may improve pain, function and ankle mobility in some people with persistent ankle dysfunction. Treatment recommendations should always be individualised following a clinical assessment.
What About a Fresh Ankle Sprain?
During the first 48-72 hours following an ankle sprain, measures such as protection, relative rest, ice, compression and elevation may assist with managing swelling and discomfort for some people.
If symptoms are severe, you cannot bear weight, there is significant deformity, numbness or a fracture is suspected, prompt medical assessment is recommended.
Once serious injury has been ruled out, a chiropractor can assess the ankle and, where appropriate, develop an individual management plan aimed at supporting recovery and rehabilitation.
Don’t Ignore Persistent Ankle Pain
Although ankle sprains are common, ongoing pain, repeated sprains or feelings of instability should not simply be accepted as ‘normal.’
A thorough assessment may help identify contributing factors and determine the most appropriate management approach. Chiropractic care may form part of a broader conservative management plan for some people with ankle pain or recurrent sprains.
If you’re experiencing persistent ankle pain or repeated ankle injuries, speak with your chiropractor or another qualified healthcare professional to determine the most appropriate care for your individual circumstances.
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