Common Ankle Injuries

The ankle is a hinge joint which primarily moves in only one plane, but because it is also structured to move in other rotational and sideways directions, it can be prone to injury. In addition, the ankle is very important for any weight-bearing sport or physical activity so ankle injuries can have a significant impact on athletes. Overuse ankle injuries are common in sports that involve running and jumping, such as long-distance running, dance, track and field, and basketball. Acute traumatic ankle injuries are common in sports that involve contact, collisions, twisting and pivoting, such as soccer, rugby and football. Ankle injuries may include strains, sprains or tears of ligaments and tendons. They can also include tendonitis, stress fractures, dislocations and contusions.

Achilles Tendonitis

Inflammation at the back of the heel and ankle where the Achilles tendon attaches to the heel bone. Typically caused by overuse in athletes that do a lot of running, jumping or walking, in combination with biomechanical issues (muscle tightness and weakness), techniques problems and improper footwear. Symptoms include pain at the back of the heel, swelling and tightness. Besides acute injury management, treatment typically includes physiotherapy, chiropractic, massage therapy, better footwear, technique changes. Injections are NOT typically done for this injury.

Stress Fracture

Microscopic cracks in the bone(s) of the ankle caused by overuse and repetitive stress on the bones. Most commonly involves the fibula bone (lateral malleolus) at the outer side of the ankle, but can also include the medial malleolus, distal tibia and talus bones. Typically seen in physical activities that involve a lot of running, jumping or walking. Symptoms include pain and swelling, and difficulty weight-bearing. Treatment typically requires a period of immobilization in a boot-cast, followed by physiotherapy, massage therapy and chiropractic to address any biomechanical problems. Treatment also requires correcting running and jumping technique issues, better footwear, ankle brace, training adjustments and optimizing nutrition and bone health.

holding ankle injury with both hands

Ankle Sprain

Tearing or overstretching of the ligaments that give stability to your ankle. Typically occurs by suddenly twisting or “rolling” your ankle while running or jumping especially when changing directions or being thrown off-balance. Common in athletes in sports such as soccer, basketball, volleyball, football, etc. Symptoms include pain (location of pain depends on the type of sprain), swelling, bruising, instability and difficulty weight-bearing.

Acute injury management is very important for acute ankle sprains, and seeing a physiotherapist early-on is key to a safe and faster recovery. The physiotherapist will also guide your rehab to regain full strength, range of motion, balance sense and prevention strategies. Bracing, taping and sometimes a walking boot-cast may be needed. Ankle sprains only rarely require surgery and typically only if there is chronic severe looseness in the ankle.

back view of person going over on their left ankle

High Ankle Sprain (Syndesmotic Sprain)

Special type of ankle sprain that can be more difficult and troublesome. This sprain occurs a bit higher up in the ankle than the typical ankle sprain, involving the ligaments that hold the leg bones (tibia and fibula) together. Typically occurs from a forceful twist of the ankle and foot into external rotation and dorsiflexion, and is the most common ankle sprain in hockey players. Symptoms include pain and swelling that is just above the ankle joint, feeling unstable and difficulty weight-bearing. Besides acute injury management, treatment often includes a period of immobilization in a boot-cast, followed by physiotherapy to regain strength, range of motion and balance sense. Surgery is needed in severe cases.

Ankle Instability

Looseness of the ankle resulting in recurrent ankle sprains. Typically results from having had many ankle sprains in the past or just having had one severe ankle sprain causing ligament tearing. May also be related to having loose ligaments genetically. Other contributing factors include poor balance sense and weakness of the muscles in the ankle (especially the peroneal tendons). Treatment includes physiotherapy to address biomechanical problems (especially peroneal muscle weakness and poor balance sense), ankle bracing, and sometimes surgery is needed to stabilize the ankle.

Ankle Fracture

Break in one of the bones of the ankle, most commonly the fibula but also can involve the tibia and talus bones. Caused by a traumatic injury involving a twist, a fall, or an impact to the ankle. Symptoms include severe pain, swelling which is often rapid, and inability to walk or bear weight. Besides acute injury management (LINK), treatment includes immobilization in a cast or a walking boot followed by intensive physiotherapy to regain range of motion, strength and balance sense. Surgery is sometimes needed, occasionally on an urgent basis, depending on the type of break and which bone is involved.

Anterior Impingement

Pinching of the soft tissue and bones at the front (anterior) of the ankle joint. Typically caused by repetitive or traumatic dorsiflexion of the ankle, and sometimes related to ankle bone spurs. Symptoms include pain at the front of the ankle, pinching feeling, swelling and decreased range of motion (limited dorsiflexion). Besides acute injury management, treatment includes physiotherapy, correcting biomechanical issues, bracing and sometimes requires immobilization in a boot-cast or possibly surgery.

Posterior Impingement

Pinching of the soft tissue and bones at the back (posterior) of the ankle joint. Typically caused by repetitive or traumatic plantarflexion of the ankle. Sometimes related to anatomic abnormalities that cause compression at the back of the ankle. Symptoms include pain posterior the ankle, pinching feeling, swelling and decreased range of motion (limited plantarflexion). Besides acute injury management, treatment includes physiotherapy, correcting biomechanical issues, bracing and sometimes requires immobilization in a boot-cast or possibly surgery. Surgery is sometimes needed in severe cases when there is an anatomic abnormality.

Peroneal Tendonitis

Inflammation of the peroneal tendons which are located at the outer (lateral) side of the ankle. Typically caused by abnormal foot biomechanics, improper footwear, ankle instability, ankle sprains, repetitive overuse (e.g., running, jumping, walking), and soft or uneven playing surfaces (e.g., sand). Symptoms include pain and swelling at the outside (lateral) part of the ankle. Besides acute injury management (LINK), treatment includes physiotherapy, chiropractic and massage therapy to address any biomechanical issues, adjustments in training and technique, proper footwear, orthotics, bracing and sometimes specialized injections.

ankle with bruising
runner holding ankle in pain

Tibialis Posterior Tendonitis

Inflammation of the tibialis posterior which is located at the inner (medial) side of the ankle. Typically caused by abnormal foot biomechanics, improper footwear, ankle instability, ankle sprains, repetitive overuse (e.g., running, jumping, walking), and soft or uneven playing surfaces (e.g., sand). Symptoms include pain and swelling at the outside (lateral) part of the ankle. Besides acute injury management, treatment includes physiotherapy, chiropractic and massage therapy to address any biomechanical issues, adjustments in training and technique, proper footwear, orthotics, bracing and sometimes specialized injections.

Ankle Bursitis

Inflammation and swelling in a bursa (fluid-filled sac) typically located at the medial (inner), lateral (outer) and posterior (back) parts of the ankle. Typically caused by direct contact or pressure on the bursa (e.g., tight skates or shoes), and can be related to acute trauma or chronic overuse. Common in hockey players and figure skaters. Symptoms include local swelling (like a small ball of swelling) and pain that is typically worse on direct contact to the area. Besides acute injury management (LINK), treatment includes footwear or skate modifications, physiotherapy, orthotics, anti-inflammatory creams and medications, compression, fixing underlying biomechanical issues and sometimes require specialized injections.

Achilles Tendon Rupture

Complete tear of the Achilles tendon which attaches that calf muscle to the back of the heel bone. Typically caused by a sudden contraction of the calf muscle especially when suddenly and forcefully pushing off or landing from a jump. Symptoms include feeling “pop” at the back of the ankle, severe and sudden pain, swelling, weakness and difficulty weight-bearing. It is very important to identify this injury at an early stage since delayed diagnosis and treatment can result in chronic pain, weakness and disability. Besides acute injury management, treatment requires immobilization in a boot-cast with a heel lift and then a progressive program of less immobilization and gradual recovery of range of motion and strength. Although surgery is not as common for this injury as it was in the past, surgical repair is still sometimes required. Physiotherapy is very important in the recovery process that takes many months to fully regain function and ability to exercise.

Ankle Osteoarthritis

Degeneration of the ankle cartilage layer which acts like a shock absorber. Contributing factors include older age, previous serious injuries (e.g. ankle instability, ankle fracture, severe syndesmosis sprain), heredity/genetics, and certain professions or activities that put abnormal straining on the ankle. Symptoms include pain, swelling, mechanical symptoms (e.g., grinding, catching, clicking), stiffness, and decreased range of motion. Treatment is multi-factorial and includes losing excessive weight, strengthening, appropriate exercise, pain medication and creams, anti-inflammatories, physiotherapy, bracing, supplements, injections and may eventually require ankle replacement surgery if severe.

Specific treatments for ankle injuries may vary based on the individual’s condition and the severity of the injury. Seeking professional medical advice for an accurate diagnosis and tailored treatment plan is recommended for optimal recovery.

Services

SPORTS MEDICINE

Our physicians specialize in sports medicine and are certified with the Canadian Academy of Sport & Exercise Medicine (CASEM). They provide expert medical care for high performance athletes, recreational athletes and active individuals.

PHYSIOTHERAPY

Our physiotherapists focus on sport- and activity-specific rehabilitation. Our goal is to return you to your activity as soon and as safely as possible.

CHIROPRACTIC

Our chiropractors utilize functional assessments to diagnose and determine the appropriate treatment plan and therapeutic methods. These techniques include Active Release Technique (ART), Athletic Movement Assessment (AMA), Diversified chiropractic Manipulation technique.

MASSAGE THERAPY

Our Registered Massage Therapists use preventative and restorative therapies to help you maintain, rehabilitate and improve physical function or relieve your pain.

ATHLETIC THERAPY

Our Certified Athletic Therapists use a full range of treatments to rehabilitate, prevent injury and help you return safely to your sports and other activities.

FOOT ORTHOTICS

Our pedorthists are trained in assessing, casting, design and fitting of foot appliances (orthotics) and in fitting of footwear to reduce painful and debilitating conditions of the lower limbs and feet.

BRACING

Our bracing professionals help fit you with a stocked or custom brace so that you may be able to return to sports or recreational activities sooner and safer.

DIETITIAN & NUTRITION

Our Dietitian and Sports Nutritionist helps to promote good nutrition habits that can help you maintain your energy levels, weight and muscle mass and can lower your risk of certain diseases.

Looking for pelvic health services that work?

Request An Appointment

Contact Us

Ready to schedule your next appointment and meet our Sports Medicine Physicians

Stay Connected

Contact US

Scroll to Top