A Guide for Understanding and Soothing Ankle Pain

You might not always realize it, but your ankles work hard throughout the day. Whether you’re standing at the bus stop or trying to hit that 10,000-step goal, your ankles allow you to stand, walk, run, and participate in all types of exercise. So when ankle pain strikes, your daily routine might quickly become an uphill battle.

In this article, we’ll discuss common causes and treatment options for ankle pain so you can take the next step toward living pain-free.

Understanding Sudden Ankle Pain Without Injury

If you experience sudden ankle pain without injury (or, at least, an apparent injury), you might be dealing with an underlying medical condition or a structural issue in the foot.

Certain underlying medical conditions can flare up suddenly, causing ankle pain without a clear cause. One possible example is arthritis—although it usually develops gradually, arthritis can cause flare-ups, triggering pain, swelling, and stiffness in the affected joints. Another example is lupus, an autoimmune condition that can cause joint pain and foot swelling.¹

Ultimately, it’s important to discuss concerns and/or pain without injury with a physician.

Exploring Common Causes of Pain Without Swelling

Sudden ankle pain without injury or swelling can stem from structural foot issues, like having high or low arches. The arch is the curve on the bottom of your foot, and it helps absorb shock when you stand, walk, or run. Having high or low arches can increase the impact on your ankles, potentially leading to ankle pain without an injury or swelling.

• High arches don’t provide as much surface area to absorb impact, which can lead to stress in the rearfoot (the back of the foot and heel) and forefoot (the toes and metatarsals), as well as general ankle instability.² Having high arches can also strain the Achilles tendon at the back of the foot, which can trigger pain in the back of the ankle above the heel.³
• Low arches lack arch support and, as a result, often place excessive impact on other areas of the feet, ankles, and shins. They can also contribute to ankle instability.⁴

The Role of Ankle Tendon Pain and Overuse

The foot and ankle are made up of a combined 26 bones, which are attached to muscles by numerous tendons.⁵ These tendons allow the feet and ankles to move while providing strength and stability. With their considerable role in the ankle’s overall function, tendons are often involved in ankle pain cases—especially when an overuse injury is afoot.

A common cause of ankle tendon pain is tendonitis, the term used for tendon inflammation. Tendonitis can affect any tendon in the body, including the Achilles, peroneal, and posterior tibial tendons.

• Achilles tendonitis involves the Achilles tendon, which links the heel bone to the calf muscles. It’s common, especially in athletes—an estimated 24% of competitive athletes develop Achilles tendonitis.⁶
• Typical symptoms include heel and ankle pain, stiffness, tenderness,swelling around the tendon and pain in the back of the ankle above heel. These symptoms tend to worsen after exercise, walking uphill, or climbing stairs.⁷

• Peroneal tendonitis affects the peroneal tendons, which extend along the outer lower leg to stabilize the ankle and foot. Running and activities involving jumping or sudden changes of direction, like basketball and soccer, can make you more susceptible to peroneal tendonitis.
• Common symptoms include ankle pain along the lower outer leg, pain that worsens with exercise, and swelling around the tendons.⁸

• Posterior tibial tendonitis impacts the tendon that extends from the calf muscle to the bones in your foot. It’s often caused by repeated stress on the feet and ankles—having high or low arches or an abnormal gait can also make you more vulnerable to this condition.
• Typical symptoms include swelling along the calf and inner ankle, tenderness (particularly when you flex your foot), and foot or ankle weakness.⁹

Treating Ankle Pain When Walking and After Activity

Ankle pain often strikes during and after physical activity. If you experience ankle pain when walking, take a break and gently stretch your ankles and calves. If the pain persists, it’s wise to rest at home and seek professional care if it doesn’t resolve with basic remedies.

Soothing Ankle Pain After Running

Ankle pain after running is common—not a surprise when you consider that the ankles bear up to 13 times your body weight when you run.¹⁰ This doesn’t mean you should quit running altogether, but your ankles do deserve some extra TLC.

To soothe ankle pain after running, follow the tried-and-true RICE protocol:

• Rest: Take a break from running until your ankle pain improves, opting instead for low-impact movement like swimming and yoga.
• Ice: Applying an ice pack to the painful ankle for up to 20 minutes can help bring down any inflammation and temporarily numb your discomfort.
• Compression: Wrapping your ankle in an elastic bandage can help stabilize the joint, prevent further swelling, and discourage fluid buildup.
• Elevation: Elevate your ankle above heart level after your run to further reduce swelling.

Pinpointing Pain in the Back of the Ankle Above the Heel

Pain in the back of the ankle above the heel is a telltale sign of Achilles tendonitis, which occurs in an estimated 10% of runners.¹¹ But it can also point to heel bursitis (inflammation of the bursa around the Achilles tendon), or posterior ankle impingement, which triggers a locking sensation and pain in the back of the ankle.¹²

Your Go-To Ankle Pain Treatment Options

Ankle pain treatment options range from at-home remedies to topical treatments to professional care from a physician. Evaluating the severity of your pain and how long it persists can help steer you toward the appropriate treatment option.

Topical treatments can help relieve minor aches and pains in muscles and joints. Biofreeze Pain Relief Gel and Biofreeze cooling pain relief cream are two convenient options you can apply directly to the affected area. Key benefits of topical treatments for ankle pain include:

• Localized relief: Only apply it where you need it.
• Menthol-based active ingredients: Some topical treatments use menthol-based ingredients for pain relief.
• No prescription required: Many pain relief topicals are available over the counter.
• Fewer systemic side effects: Topicals have been shown to have a lower risk of systemic side effects due to limited absorption into the bloodstream.¹³

At-Home Remedies and Ankle Pain Relief Exercises

At-home remedies, including cold therapy, heat therapy, compression, and elevation, can help relieve pain and discomfort. Alongside these remedies, staying active with gentle ankle pain relief exercises can help you get back on your feet. Here are a few to try:

• Ankle circles: Slowly rotate your ankles clockwise and counterclockwise.
• Heel raises: While standing, slowly raise your heels from the floor, hold for a few moments, lower, and repeat.
• Assisted calf stretch: Wrap a towel or band around the ball of your foot and gently pull it toward you until you feel a stretch in the calf muscle.

When It’s Time to See a Doctor

In some cases, ankle pain requires a formal evaluation and professional treatment plan to completely heal. It may be time to schedule that doctor’s appointment if you experience:

• Severe, intense ankle pain that occurs after an accident or disrupts your daily activities
• An inability to put weight on your ankle or walk normally
• Severe swelling or bruising
• Pain that persists longer than a few days

When in doubt, contact your doctor about any worrying ankle pain to ensure you’re on the path to healing.