Best 5 Exercises for Chronic Ankle Pain

Ankle pain is a condition we see daily in our clinic; it affects people of all ages and activity levels. It can be caused by many factors and can be mild or severe. Ankle pain can be caused by trauma or gradual wearing of the soft tissues and bones. Chronic ankle pain can impact daily activities and affect your quality of life. Mostly it stems from previous injury to the ankle that has not healed in an adequate way.

The ankle joint is made up of three bones: the tibia, fibula and talus. Ligaments and tendons connect these bones, providing an anchor point for muscles and stability. Any damage or disease to these structures can lead to ankle pain.

A common underlying problem to chronic ankle pain is previous ankle sprain injuries. This happens when the ligaments on the side of the ankle are stretched or torn and can possibly lead to pain long after the injury. Chronic ankle sprains can occur if you fail to rehab the primary sprain. This can cause long term pain and discomfort even if the ligaments have healed. Think of it like this, once you’ve sprained your ankle, you’re much more likely to re-sprain it again (around 75% of ankle sprains are recurrent) and this can result in chronic pain.

Another cause of ankle pain is osteoarthritis; this occurs over time and affects the cartilage that aligns the small bones in the ankle. It usually occurs following an old fracture. Rheumatoid arthritis, an autoimmune disease, can also affect the ankle joint. These two conditions can leave the ankle stiff and painful during physical activity.

Another common cause of ankle pain is Achilles tendonitis, which occurs when the tendon becomes inflamed or damaged due to changes in load/activity. The Achilles is the strongest and largest tendon in the body; it connects the calf muscles to the hell bone. Some symptoms of Achilles tendonitis include swelling, pain, stiffness and weakness at the back of the ankle.

Overuse injuries can also progress to chronic ankle pain. Athletes that engage in repetitive movements like running are susceptible to this due to the strain on the ankle. Overuse injuries can also lead to tendonitis as discussed.

Other factors that could lead to chronic ankle pain are ankle impingement syndrome, this occurs when some of the bones and ligaments rub against each other. This could result from scar tissue formation on the ligament leading to pinching in the joint.

The two peroneal tendons that run behind the lower leg bone behind the ankle bone (peroneus brevis and longus) can also become injured if the ankle turns inwards. Mostly this injury can heal well with early detection however it can become chronic if left untreated.

Osteochondral defects can occur at the talus bone causing potential long-term pain. This is mostly indicated when the cartilage is damaged and loose within the ankle. Most often this injury affects the outside of the ankle. Patients often complain of a deep pain, locking and popping of the ankle with activity.

Treatment for chronic ankle pain will depend on many factors such as the severity of pain, underlying cause, activity levels and age. Often conservative treatments like physiotherapy, over the counter medication, activity modification and mobility and strengthening exercises are recommended. At Surrey Physio, we also perform steroid injections for ankle pain. However, sometimes the most effective solution is to see a physio or osteopath and rehabilitate your ankle.

If conservative treatments are not effective, surgery may be recommended to repair or reconstruct the damaged ligaments or tendons in the ankle. Mostly this involves minimal invasive procedures like an arthroscopy. Furthermore, chronic ankle symptoms may require an ankle fusion, this is where the ankle joint is permanently fused. An ankle replacement can also be an option; this is where the ankle joint is replaced by an artificial one. However, in 20 years, I’ve not seen this performed even once.

At Surrey Physio we have a team of experienced physiotherapist and osteopaths that can help manage your symptoms. No matter the severity we have a treatment plan that can help you. We use in depth examination and treatment options to suit your needs. We work with you to achieve you goals and get you back to what you love doing the most.

We have come up with the 5 most effective exercises for chronic ankle pain. Try them and see how you go… obviously generic exercises will not work perfectly for everyone, so seek advice from our team first if you need it…

Ankle and Foot Movement Exercise

Sitting bare foot, lift your foot off the floor. Use your toes and ankle to draw letters of the alphabet. Start with "a" and then progress right through the alphabet to "z". Keep each letter and movement controlled and specific.

Try 3 rounds 3 times daily

MWM Dorsiflexion on Step

Place your foot on a step or stair. Rock forward over your foot to bend your ankle, and return to the start position. This is a mobilisation for your ankle and calf stretch.

Try 3 sets of 10 reps 2 daily

Heel Raises while Sitting

Sit upright on a chair, with your feet flat on the floor. Slowly raise your legs up onto your toes. Hold, and gradually control the movement back down to the starting position. This is a useful calf pump exercise to improve circulation to your lower legs, as well as improving mobility of the ankle joints.

Try 3 sets of 10 reps 2 daily

Star Excursion Balance Exercise

Place some tape on the floor in a star shape. The angle between each arm of the star is 45 degrees. Stand in the middle of the star on one ankle. This is usually your weaker or injured side. Reach as far along each arms of the star as you can without losing balance or putting your foot down. This is an excellent balance exercise.

Try 3 rounds 3 times daily

Ankle Eversion Isometric Exercise

Place your foot next to a door frame and resist pushing your foot outwards towards the door frame. This is an isometric strengthening exercise for the foot and ankle.

Hold for 10 sec and repeat 10 times 3 times daily

Prevention is important when it comes to chronic ankle pain. Keep your ankle mobile, but strong. Work on strengthening and stability exercises. If you are suffering with chronic ankle pain, seek advice from one of our amazing team members at Surrey Physio.

(Therapists reading this page, these videos are provided by Rehab My Patient – the best exercise prescription software for therapists to prescribe exercises www.rehabmypatient.com. If you are a patient needing advice, call Surrey Physio to book a telephone/video consultation with one of our expert physios or osteopaths, or book in face-to-face for an appointment. You can call us on 0208 685 6930 or book online by clicking the link at the top of the page).