Ankle pain can sneak up on you. It’s one of those maladies that can happen suddenly with one wrong step off a curb, or gradually due to weakness and overloading of a particular structure in the ankle.
Either way, ankle pain can slow you down, so you’re going to want to do what it takes to stay ahead of it.
The ankle joint is formed by the tibia, fibula, and talus bones. Together, these three bones articulate at the talocrural joint, where the foot attaches to the lower limb. This weight-bearing joint allows the foot to hinge forward and backward (plantarflexion and dorsiflexion). The joints just below it allow for side-to-side movements (eversion and inversion). The foot is designed to adapt to the contours of different surfaces, but the ankle helps connect this adaptable surface with the rest of the body.
The foot and ankle work together to provide stability as well as power for when you want to stand or move. Numerous muscles, tendons and ligaments help stabilize, absorb shock, support and propel the joint, as well as working together to absorb ground reaction forces and provide balance and stability. Injury to the ankle can occur at any of these structures when the body is unprepared for a load, either due to the stress on the joint being sudden, unexpected, or too high. Repeated loading with poor body mechanics, frequent ankle rolling, or improper footwear can also contribute to overuse syndromes such as tendinopathies and pain.
Unfortunately, ankle pain usually doesn’t go away on its own. If it’s painful to stand or walk, consider seeing a physical therapist. Try gentle stretches, ice for pain relief (plus elevation if there is any swelling), and simple ankle pumping or ankle alphabets with your feet elevated to get moving a little.
If the pain only comes on with increased activity or you just feel a little “wobbly” in the ankle, you’ll want to stabilize the joint by reinforcing strength in musculature as well as working on the brain’s ability to sense the ankle's surroundings and balance. Keep in mind that footwear, body mechanics, and other factors may be contributing to your pain and you may require a specialist for a complete assessment and personalized plan.
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Your Move:
Balance: Sometimes the best way to help stabilize a wobbly ankle is to try and stay still. This helps your brain and your muscles work together to provide stability to both expected and unexpected perturbations to your system.
If you use one muscle on one side of the ankle, it will move towards the muscle’s pull. If you try and stay still, you’re actually experiencing co-contraction—when muscles on both (or all) sides of the ankle are working together, at the same time, to prevent movement. This is great training for improving balance.
Try balancing on one leg for 30 seconds. If this is easy, there are a few ways to make it more challenging. Try balancing on one leg on an unstable surface like a foam pad, BOSU, or dyna disc, throw a weighted ball around, pass a 10 to 15 pound kettlebell around in circles or simply move your opposite leg forward, sideways and then backwards five to 10 times to challenge your system more.
Strengthen: It’s not always as simple as just strengthening the one muscle that’s weak, but it’s not a bad place to start—especially if you have a more specific pain. Try four-way resisted ankle movements to strengthen the ankle in all four directions: plantarflexion, dorsiflexion, eversion and inversion.
Rachel Tavel is a Doctor of Physical Therapy (D.P.T.) and Certified Strength and Conditioning Specialist (C.S.C.S.)
Rachel Tavel is a doctor of physical therapy, strength and conditioning specialist certified by the National Strength and Conditioning Association, and writer. Her writing has been published in Forbes, Fortune, Men’s Health, Women’s Health, Runner’s World, SELF, Bicycling Magazine, The Huffington Post, and more. She co-authored the book “Stretch Yourself Healthy Guide: Easy Routines to Relieve Pain, Boost Energy, and Feel Refreshed” (Prevention, 2020) and is a Forbes Health Advisory Board Member. Prior to becoming a physical therapist, Rachel was a travel writer living and traveling throughout South America. Connect: www.racheltavel.com, @racheltaveldpt, Email: [email protected].
