Ankle Pain and how to treat it
Ankle pain is a very common problem for individuals of all ages. The most common cause of ankle pain in a younger person is an ankle sprain. In the older group, osteoarthritis is often the culprit. However, there are many other diagnoses that may cause ankle pain, including gout, rheumatoid arthritis, peripheral neuropathy, fracture, tendon rupture, to name a few. When your ankle pain is so severe that you are unable to stand on the affected side, a visit to the doctor or urgent care is needed. When the pain is this severe there is likely an injury that requires medical attention (i.e. fracture, tendon rupture, infection).
If you are dealing with a painful ankle and a known injury (i.e. sprain on the sports field or twisted ankle on the sidewalk), RICE (REST, ICE, COMPRESSION, ELEVATION) is the best place to begin. Once the pain and swelling begin to subside you can start gentle range of motion exercises. A good exercise to start with is tracing the alphabet in the air with your foot, this will encourage you to move your ankle in all directions for at least one minute. If you still feel stiffness after a few days, an appointment with a physical therapist can help. We will evaluate the injury and the deficits in your ankle (i.e. where range of motion is lacking, where strength is lacking, has balance been affected). Often balance is lost following an ankle injury and this is a problem for athletes who need to be able to switch directions quickly. When a balance deficit is not addressed and corrected for you are more like to reinjure your ankle.
If you are dealing with an arthritic ankle you often have a loss of range of motion and pain with walking or prolonged standing. A visit to a physical therapist could help a lot. We would evaluate the severity of the problem (i.e. how much range of motion is lost, can we gain some of the range back, are there weaknesses in the lower leg contributing to the problem, is there a balance deficit). Through the use of manual techniques we often can restore some range of motion, give exercises to address the weakness and balance drills to improve the balance. There also may be the need for an assistive device (i.e. cane) to take the pressure off of the ankle.
If you are dealing with a more severe injury or problem starting with a visit to the MD is needed. Once the problem has been addressed by the doctor and the severity of the problem is resolving (tendon is surgically repaired, fracture is healing, neuropathy addressed medically), then a visit to the physical therapist is very valuable. After having an ankle immobilized it is very stiff, sore and weak and we can work to restore normal function and activities. After getting a diagnosis of neuropathy there are exercises/techniques to help restore some balance.
By Kirsten Transue PT, OCS
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