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Managing Pain in the Back of the Ankle

April 2, 2024 · In: Body Region Support, Foot/Ankle, Science-Backed Education

Countless individuals navigate through their days with grappling pain in the back of the ankle, making everyday activities that much more challenging. Whether it’s a sharp pain as you take your first steps in the morning or a persistent throb that accompanies you throughout the day, the quest for relief can feel like a daunting task. Especially when you have tried so many remedies and nothing seems to work. This article will address ankle pain and its potential triggers—ranging from arthritis and bursitis, ankle sprains and fractures, to Achilles tendinitis. This article will help you discover effective strategies for pain management and prevention, with a spotlight on the pivotal role of physical therapy and the empowerment that comes from building ankle strength.

**This is not medical advice. Please consult your medical provider for more information.

pain in the back of the ankle

Anatomy of the Ankle

When you experience discomfort in the back of your ankle, it’s essential to understand the complex anatomy. There are a total of 28 bones in the foot which work together to provide stability and support for walking and running. Numerous joints allow for multiple planes of motion. And the many ligaments, especially around the ankle, provide even more stability. Recognizing the intricate nature of the ankle’s anatomy is important in addressing and managing pain effectively. Targeted treatments will address the root cause of your discomfort.

Common Causes of Pain in the Back of the Ankle

When you notice that persistent ache at the back of your ankle, it’s crucial to understand that this discomfort can stem from a plethora of sources. From the wear and tear of arthritis to the acute distress of ankle sprains, the causes are as varied as our daily activities. Whether it’s the inflammatory pain of bursitis or the chronic nuisance of tendinopathy, getting to the root of back ankle pain is essential. This section will delve into the common culprits such as Achilles tendinitis, the debilitating effects of ankle fractures, and how conditions like plantar fasciitis play a role.

Moreover, we’ll explore how physical therapy can not only alleviate pain but also protect your ankle against future injury. Through a comprehensive review of related conditions and paired with an understanding of ankle strength and mobility, this article will unveil effective strategies for managing and preventing pain in the back of the ankle.

Arthritis and Its Effect on Ankles

Arthritis is not just a single condition; it encompasses over 100 variants, including osteoarthritis (OA) and rheumatoid arthritis (RA). Each type affects the body’s joints differently. OA and RA will often affect the ankles.

Arthritis can lead to pain, swelling, and reduced mobility. Osteoarthritis results from chronic wear and tear, whereas rheumatoid arthritis is an autoimmune disorder, both contributing to discomfort and chronic pain in the ankle.

If you’re experiencing persistent pain in the back of the ankle, it’s crucial not to ignore what your body is trying to tell you. Consulting a healthcare provider for a proper diagnosis and treatment plan could be the first step towards managing your condition and reclaiming your mobility and quality of life.

Bursitis: A Painful Inflammation

Bursitis is a condition that occurs when the bursae, the small sacs cushioning your bones, muscles, and tendons near joints, become inflamed. Imagine these bursae like tiny pillows, designed to prevent friction. If these fluid-filled sacs become swollen and irritated, movements of the foot and ankle and weightbearing become much more challenging (and painful).

Specifically, in the back of the ankle, bursitis can turn every step into a painful reminder of its presence. This inflammation can stem from repetitive movement or standing long periods of time, making even the simple act of walking a challenge. The pain, often worsening with activity, not only limits movement but also signals an imbalance or strain that needs addressing.

Whether from overuse in daily activities or the demands of a job, bursitis in the back of the ankle can be excruciating. While bursitis can be stubborn and take time to treat, there are effective treatment plans from physical therapy to help manage the pain.

The Impact of Ankle Sprains and Fractures

Depending on the degree of injury, twisting or rolling your ankle can lead to either an ankle sprain or even more severe – an ankle fracture. Imagine the ligaments that support your ankle being stretched beyond their limit, or the bones that form the joint being subjected to forces they can’t withstand.

Ankle sprains are notorious for their role in sports injuries, affecting people regardless of age or activity level. The foot turning inward in an awkward motion can stretch or tear the ligaments along the outside of the ankle. Whereas the foot turning outward would stress the ligaments along the inside of the ankle. The ligaments along the outside of the ankle are more commonly injured. Depending on the degree of the injury and the location of the sprain, the resulting pain can also be experienced along the back of the ankle.

Similarly, the signs of an ankle fracture are typically irretractable pain, swelling, and bruising. If a few steps cannot be taken, immediate medical attention may be necessary.

These types of injuries directly impact your ankle mobility and can transform simple activities into daunting hurdles, making effective pain management and physical therapy crucial for healing and preventing future ankle injuries.

Achilles Tendinitis: Another Painful Inflammation

Achilles tendinitis is inflammation of the Achilles tendon. This condition puts a significant strain on your movement, making even the simplest tasks challenging. The Achilles tendon, the largest and strongest tendon in your body, is required for walking, running, and jumping. It attaches your calf muscle (the gastrocnemius) to your heel bone (the calcaneus).

The Achilles tendon becomes inflamed often due to overuse. The pain, characterized by a sharp or aching sensation at the back of the ankle, can intensify when you move or first wake up. Standing for long periods of time can also aggravate the pain. For those who lead active lives or participate in sports, Achilles tendinitis and tendinopathy can feel like a significant setback. However, understanding the role of this tendon and the impact of these conditions is the first step towards a pain-free ankle.

Other Articles Related to Ankle pain

  • Ankle Pain When Walking? Why it Hurts and How to Fix It
  • How to Fix Weak Ankles: The Ankle Support You Need
  • Weak Ankles Running? Stabilization and Strengthening for Pain Free Running
  • Why Single Leg Stability is Important for Daily Function
  • 5 Reasons Why Balance Exercises are Important for Runners

How Physical Therapy Can Help

When you’re grappling with persistent pain in the back of your ankle, it might feel like you’re navigating a world of discomfort and frustration. Physical therapy can guide you towards reclaiming mobility and reducing pain. Through a blend of targeted exercises and personalized treatment plans, a physical therapist can address the root causes of your ankle pain, be it arthritis, bursitis, Achilles tendinitis, or tendinopathy.

Even if you don’t have a current ankle injury, a physical therapist can help your foot and ankle against future injuries. This “prehab” approach holistically supports your journey towards a more active and pain-free lifestyle. By engaging in physical therapy, you’re not just treating symptoms; you’re embarking on a proactive path of healthcare tailored to your unique needs, ensuring your ankles have the support and strength need to function at optimal levels.

Building Ankle Strength to Prevent Injury

Strengthening the muscles around your ankle is key. This provides extra support to the ligaments to protect against ankle injuries. Remember, consistency with exercises is essential for building strength and reducing your risk of future injuries. If you experience increased pain, consult with a healthcare provider.

Short Foot

The goal of this exercise is to lift the arch of the foot. Sit with your feet firmly on the ground without shoes on. Place a theraband directly under the ball of your foot just below your big toe. You should feel the bone pushing firmly into the ground.

Think about bringing your big toe and your heel closer together, resulting in the arch of your foot raising. This should be a small movement. The goal is to not let the theraband pop up, curl or lift the toes, or roll the weight to the outside of your foot. Hold your arch up for 5 seconds and relax. Complete 20 repetitions.

This exercise can be particularly challenging so stay consistent and keep practicing!

Seated Heel Raise

Make sure to perform this without shoes on so you can feel the ground underneath you. Sit where your feet are flat on the floor. Place a theraband directly under the ball of your foot just below your big toe. Keep gentle but constant tension on this band.

Push up onto your toes making sure to keep your weight shifted over the 1st and 2nd toes. Don’t let the band pop up from under your foot. Perform 30 repetitions.

Pedaling in Downward Dog

Start in the downward dog position with your hands and feet on the ground and your bum reaching towards the ceiling. Your knees and elbows should be straight.

Next begin your pedaling: lift one of your heels off the ground. Place that heel back on the ground while simultaneously lifting the opposite up.

Perform 30 repetitions on each side.

Single Leg Heel Raise

Make sure to perform this without shoes on so you can feel the ground underneath you.

Lift one leg up as you will only be performing this exercise on one leg. Push up onto your toes making sure to keep your weight shifted over the 1st and 2nd toes.

You may hold onto something for balance as you need to.

Perform 3 sets of 10 repetitions on each leg.

When to Consult a Healthcare Provider

Understanding when to consult a healthcare provider is crucial. If you’re experiencing persistent or severe discomfort, especially following an injury, it’s important not to delay seeking professional advice. Chronic pain, significant swelling, or mobility issues are clear indicators that it’s time to get a thorough evaluation. A healthcare provider can offer a treatment plan tailored to your specific needs, incorporating physical therapy, medication, or more invasive procedures if necessary.

TL;DR

Understanding the underlying causes of pain in the back of the ankle is the first step towards effective pain management. Physical therapy and targeted exercises play a crucial role in improving ankle mobility and strength and can prevent future injuries. This article also provides exercises that are important for foot health.

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Tera Sandona
Tera Sandona

Tera Sandona is a licensed Doctor of Physical Therapy (DPT) and the founder of PT Complete. She helps high-achieving women break out of cycles of chronic pain, stress, and burnout through her Regulate and Rebuild Method, a sequenced approach that addresses the nervous system first and builds strength second. Her work focuses on helping women finally understand their bodies, rebuild strength, and create lasting resilience that fits real life.

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By: Tera Sandona · In: Body Region Support, Foot/Ankle, Science-Backed Education · Tagged: ankle, load intolerance, pain sensitivity

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Meet Tera

Meet Tera
hi, i'm tera!

I'm a licensed Doctor of Physical Therapy and the founder of PT Complete. I built the Regulate and Rebuild Method because most people trying to get back into their body after chronic pain are told to either push through it or rest completely, and neither one actually works. I write from the clinic and from my own body, since I'm working through my own chronic pain story right now, too. When I'm not working, you'll probably find me managing the regular chaos of life or curled up with coffee and a dessert I can't seem to quit.

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On a good day, it’s tempting to do everything you’ On a good day, it’s tempting to do everything you’ve been saving up, and that’s usually when the crash comes.

A good day can be a test, just a small one. Add a little more than your usual (a few extra minutes, one more set), then notice how you feel that night and the next morning. If you’re steady, you have information about what your body can take. If you’re not, you have that information too, and it points to a smaller step next time.

Everything on this list comes from the same idea: strength gets built at the speed your body can absorb.

Save this for your next good day, or send it to the friend who goes all out when she finally feels good, then pays for it later.

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Filled with one amazing trip and tons of food
When you’ve been hurting long enough, your body ge When you’ve been hurting long enough, your body gets very good at saying stop, and it doesn’t always say it because something is being damaged. Sometimes it’s the pain and sometimes it’s the fear the pain left behind (both are real, and they can feel identical from the inside).

For years you may have moved around one movement, avoiding the exact position that causes pain, and sometimes you’re still doing it after the movement has stopped hurting (I still catch myself doing it too).

That makes sense because your body learned the pattern while the pain was real. It can keep bracing before you’ve even started moving. Sometimes you recheck and the pain isn’t there.

What I see clinically is that stop signals get treated as pain by default, when some of them can be learned protection that’s outlasted the pain. The two can feel identical from the inside. Both deserve respect.

Sometimes the useful move is a small, careful test: try the movement once, slow and small, see what’s there. If the pain isn’t there, keep going. Stop if the pain is there and sharp or progressively getting worse.

Telling them apart is a skill (and a slow one for most people).

Save this for the next time you catch yourself moving around something that used to hurt.

#chronicpainlife #nervoussystemsupport #painscience
I’ve taken three weeks off working out between tra I’ve taken three weeks off working out between travel and getting sick, and then life just picked back up again before I felt ready for it.

The whole time, my body has been stressed in a way sleep hasn’t fixed, wired and on edge, snapping at small things that shouldn’t be a big deal.

I kept telling myself I’d feel better if I just sat down and worked instead. Sitting still felt like the safer choice.

It wasn’t. It was just a different kind of stress with nowhere to go.

Exercise is technically a stressor too, but the right amount of it can help a nervous system come back down instead of staying stuck in high alert. Too much too fast just adds another demand on a system that’s already maxed out.

This is something I watch play out constantly. Someone’s system is already maxed out and the instinct is to either push through anyway or stop moving completely. Neither one actually gives the nervous system what it needs.

So today I did something easy instead: an arm workout, kept light, with nothing that leaves me flattened afterward.

It’s still real strength work. I’m still showing up. It just doesn’t have to be all or nothing to count.

Starting is usually the hardest part and you’re allowed to start in the messy middle instead of going all in or not at all.

If you’ve ever put off the small version of a workout because part of you decided it didn’t count unless it was the hard one, tell me. I want to know I’m not the only one.

#capacitybuilding #pushcrashcycle #chronicpainawareness #regulateandrebuild #chronicpaincommunity
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