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Whether it’s from running, playing sports, or simply walking, ankle injuries are common—and they can worsen if left untreated. Don’t wait! We’re here to help you regain strength and prevent future injuries. With the right therapy, you’ll reduce pain and build the stability you need to keep moving confidently.
Ankle pain is a common issue that can affect anyone- from athletes and active individuals to those recovering from an injury or managing chronic conditions. Understanding what’s causing your discomfort is the first step toward effective relief and recovery. This guide explores the most common causes and symptoms of ankle pain, how physical therapy (PT) can help restore strength and mobility, and practical ways to prevent future injuries. With Confluent Health’s expert care, you can move with confidence again- free from pain and limitation.
Ankle pain refers to any discomfort, stiffness, swelling, or tenderness in or around the ankle joint- the critical connection point between the foot and the leg that bears the body’s weight and allows for movement and balance. This pain can develop suddenly from an acute injury, such as a sprain, fracture, or ligament tear, or gradually due to chronic conditions like tendonitis, arthritis, or instability from repetitive stress. Because the ankle bears the body’s full weight with every step, even mild pain can interfere with walking, standing, exercising, and completing daily tasks such as climbing stairs or driving. Over time, untreated ankle pain can lead to compensatory patterns that strain other joints, affecting overall mobility and independence.1
Ankle pain is remarkably common. Accordingly to the American Academy of Orthopaedic Surgeons, ankle sprains alone affect more than 25,000 people each day in the United States.2 Similarly, research published in the British Journal of Sports Medicine found that ankle injuries account for approximately 20% of all sports-related injuries, impacting athletes and active individuals across all ages.3 Beyond sports, degenerative conditions such as osteoarthritis and tendon overuse injuries are increasingly prevalent among older adults, contributing to chronic pain and reduced balance.1 These issues not only affect physical performance but can also diminish confidence, limit social participation, and impact emotional well-being- underscoring the importance of early and comprehensive treatment.
Understanding the underlying cause of ankle pain- and addressing it early through evidence-based care such as PT- can help restore strength, balance, and mobility while preventing re-injury. With professional guidance from specialists like those at Confluent Health, patients can return to their routines safely and regain the confidence to move freely again.
Ankle pain can arise from a wide range of causes, spanning from acute injuries to chronic conditions that develop over time. One of the most common causes is an ankle sprain ,which occurs when the ligaments supporting the joint are stretched or torn-often due to a sudden twist or roll of the foot.2 Fractures may cause intense pain, swelling, and bruising, while tendonitis-inflammation of the tendons surround the ankle-is often seen in runners or individuals engaged in repetitive movements.4 Arthritis, including osteoarthritis and rheumatoid arthritis, is another frequent cause, leading to stiffness, swelling, and reduced range of motion (ROM), particularly in older adults. Additionally, overuse injuries from prolonged standing, repetitive impact, or improper biomechanics can contribute to gradual tissue wear and chronic pain.
Several risk factors increase the likelihood of developing ankle pain. Age plays a role, as cartilage and ligaments naturally lose elasticity over time. Activity level also matters- both high-intensity athletes and sedentary individuals are at risk for different types of strain. Improper footwear, such as shoes without adequate arch or ankle support can alter body alignment and increase stress on the joint. A history of previous ankle injuries can weaken ligaments and muscles, leading to chronic instability and a higher risk of reinjury.
Certain underlying conditions can also cause or worsen ankle pain. Chronic ankle instability often develops after repeated sprains, causing the joint to give way during activity. Nerve compression, such as in tarsal tunnel syndrome, can produce tingling, burning, or numbness around the ankle and foot. Meanwhile, autoimmune disorders like rheumatoid arthritis or lupus may trigger systemic inflammation that affect joint tissues, leading to persistent discomfort and stiffness.1
Ankle pain can present through a range of common symptoms: noticeable swelling, stiffness in movement, bruising around the joint, feelings of instability, and a reduced ROM- all of which can interfere with walking, standing, or participating in daily activities. For example, a slight ROM limitation and bruising are typical early signs of a sprain.4
On the other hand, there are key red-flag symptoms that warrant immediate evaluation: severe pain especially at rest, an inability to bear weight, visible deformity of the ankle, or signs of infection such as redness, warmth, or fever.4
These warning signs highlight the importance of timely assessment and intervention, particularly by a specialist such as a PT, to address potential serious injury and safeguard long-term joint health.
In many cases, PT is the first and most effective step in evaluating and managing ankle pain, as PTs are highly trained to assess, diagnose, and treat a wide range of ankle issues. They can identify the source of discomfort, develop a targeted treatment palms, and help restore mobility and strength- often without the need for immediate imaging or a doctor’s visit. You may need to see an orthopedic physician if symptoms persist despite PT, injuries keep recurring, pain worsens, or your PT recommends further medical assessment. Early intervention with PT can prevent long-term complications and support faster recovery.
PTs assess ankle pain through a comprehensive evaluation that focuses on function rather than just structure. This typically includes functional movement tests, gait analysis, and strength and flexibility assessments to pinpoint weaknesses, imbalances, or compensatory patterns contributing to pain. By targeting these factors, PT can often improve symptoms without relying on extensive imaging.
In certain cases, diagnostic tests such as X-rays, MRIs, CT scans, or ultrasound may be warranted-especially if a fracture, severe ligament injury, or other structural problem is suspected-but imaging isn’t always required and may not provide the best guidance for rehabilitation. A PT-led approach prioritized restricting movement, stability, and strength for lasting improvement.
Ankle pain can often be managed effectively with non-surgical treatments, which are usually the first line of care. PT is highly effective in reducing pain, restoring ROM, and improving strength, balance, and stability. PTs design individualized programs that include stretching and strengthening exercises to support healing, prevent reinjury, and optimize functional movement, In some cases, medications such as NSAIDs (nonsteroidal anti-inflammatory drugs) or corticosteroid injections may be used to reduce inflammation and provide short term pain relief.
Surgery is generally considered only when conservative treatments fail or in cases of severe injury. Surgical interventions may be necessary for fractures requiring stabilization, significant ligament tears, or chronic instability that cannot be addressed with therapy alone. Common procedures include Open Reduction and Internal Fixation (ORIF) for fractures and ligament repair or reconstruction for more complex ankle injuries.6 Post-surgical PT is essential to restore mobility, strength, and long term joint function.5
While there’s no guaranteed way to completely prevent ankle pain, taking proactive steps-like choosing supportive footwear, strengthening the surrounding muscles, and maintaining mobility can significantly lower your risk. There is no single “best” shoe for everyone; what works best depends on your foot shape, activity level, and comfort. When selecting footwear focus on proper fit, stability, and how the shoe feels during movement rather than the specific brand or style. Visiting a specialty running or footwear store can be helpful, as trained staff can assess your gait, arch type, and biomechanics to guide you toward the most supportive options.
In addition to footwear, regular strength and flexibility training is key to preventing ankle injuries. Exercises such as calf raises and Achilles stretches, ankle circles, and single leg balance drills can improve joint stability and reduce risk of injury. It is also critical to engage in appropriate warm-up and cool-down prior to initiating physical activity. These routines should include dynamic stretching and gentle mobility work to help prepare the ankles for activity and prevent stiffness afterward. Finally, lifestyle adjustments such as maintaining a healthy weight, progressing activity intensity gradually, and avoiding sudden changes in footwear or training surfaces can help protect your ankles and promote long-term joint health.
For those experiencing chronic or recurring ankle pain, day-to-day management focuses on maintaining mobility, reducing discomfort, and supporting overall well-being. Coping strategies may include modifying activities to avoid aggravating movements,using supporting footwear or braces, and incorporating regular stretching and strengthening exercises to keep the ankle joint flexible and stable. Elevating the ankle, and using compression sleeves can also help manage flare-ups and reduce inflammation. Over-the-counter anti-inflammatory medications may provide short-term relief, but they should be used under guidance from a healthcare provider.
Chronic pain can also take a toll on mental and emotional health. Frustration, stress, or anxiety related to ongoing discomfort and activity limitations are common. Seeking support through counseling, mindfulness practices, or group exercise programs can help maintain a positive outlook and encourage adherence to recovery routines. Working closely with a PT ensures you have guidance not only for pain management but also for rebuilding confidence in your movement and activity levels.
At Confluent Health, PT for ankle pain focuses on restoring mobility, strength, and confidence through evidence-based, personalized care. Each treatment plan begins with a thorough evaluation to identify the root cause of pain, whether it’s from injury, overuse, or chronic instability- so therapists can design a program tailored to the patient’s unique needs and lifestyle.
Confluent Health’s approach emphasizes active recovery, combining manual therapy, targeted exercises, and functional movement retaining to help patients regain full use of the ankle and prevent future injuries. Therapists also incorporate balance training, gait analysis, and proprioceptive exercises to improve stability and coordination, key factors in long-term joint health. In addition, patients benefit from education on movement mechanics, footwear choices, and activity modification, empowering them to take an active role in their recovery.
Through its network of leading PT clinics nationwide, Confluent Health integrates advanced techniques with compassionate, patient-centered care- helping individuals return to the activities they love safely and efficiently.
Yes, your physical therapist can help balance you participating in sports while treating your injury.
Yes, your PT can give you individualized recommendations on braces and footwear that will fit your needs.
The duration of ankle pain depends on the causes and severity. Mild sprains or overuse injuries may improve within a few days to a few weeks, while more severe injuries or chronic conditions can last several months without proper treatment.
Some minor ankle pain may resolve on its own with modified activity and gradual progression into loading and ROM..
Targeted exercises-such as stretching, strengthening, and balance activities- can support healing, improve stability, and reduce the risk of future injury. A PT can design a personalized program to safely restore function.
You should see a PT if pain persists beyond a few days, limits your mobility, recurs frequently, or interferes with daily activities. Early intervention by a PT can help restore function, prevent complications, and reduce the likelihood of chronic ankle problems.