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Front of Ankle Pain

Front of ankle pain (anterior ankle impingement) is an affliction or discomfort in the ankle. It can result from an injury to the ankle or other medical conditions of the front of the ankle

According to the National University of Health Sciences (NUHS), the most common cause is a sprain in the ankle. It is the primary factor behind 85 % of ankle injuries. An ankle sprain takes about 7 to 14 days to recover, but a severe injury might take a few months to heal properly.

If you’re having pain in front of your ankle and are worried about the causes, confirmed diagnosis, treatment, and home remedies for it, you’re at the right place. 

Symptoms of the front of ankle pain 

Two bones comprise the “true’ ankle joint – the tibia and talus. Front of ankle pain can be in the form of:

  • Swelling in the ankle
  • Bruise
  • Redness
  • Tingling
  • Numbness
  • Burning
  • Powerlessness and difficulty bearing weight
  • Stiffness
  • Weakness

Read next: Inside ankle pain

Causes of ankle pain:

There can be several reasons/causes for ankle pain. The most common causes tend to be:

Sprain:

The term ‘sprain’ is used to describe the stretching or tearing of ligaments in your body. It happens when you twist or roll your ankle during any activity like running, jumping from a height, or falling. Try to avoid any flip-flops or heels which increase the risk of twisting your ankle. Activities that require repetitive bending of the foot upward (dorsiflexion) can lead to this condition.

Fracture:

The breaking of a bone is termed as a fracture, but it can also affect the area around the broken bone. An ankle fracture can be mild or severe, and mostly occurs during running, jumping, and other harsh games and sports.

Bursitis in front of ankle pain:

Bursitis is the inflammation of the bursae in your body. The fluid-filled sac can cause a lot of pain and irritation in the soft tissue around the ankle bone and often limits the range of motion of the ankle joint.

Footballer’s Ankle:

The painful growth of bone spurs in the front of the ankle is known as footballer’s ankle. It’s usually associated with a sudden trauma to the tendons and ligaments while playing sports like football, volleyball, running, soccer, basketball, and dancing, like ballet. 

Rheumatoid arthritis:

Rheumatoid arthritis is an inflammation causes swelling, stiffness, and pain in the ankle. An early symptom of RA is difficulty climbing stairs, ramps, and inclined surfaces, which leads to further pain while standing and walking as the RA progresses. 

Tendonitis:

Tendons are basically the connective tissues that connect muscle to bone, and tendonitis is the infection and inflammation of those tendons.

A tendon can rupture, causing severe pain in your ankle such as Achilles Tendon Rupture. Achilles Tendinopathy is also associated with ongoing ankle pain.

Osteoarthritis as a cause of front of ankle pain:

The ligaments of the ankle become weaker and weaker over time and this puts a lot of strain on the cartilage in the ankle. You might also notice the muscles around your ankle become weak over time or you have difficulty putting weight on the ankle. Another cause of impingement is the growth of small osteophytes or bony spurs (scar tissues) around the ankle joint that press against the nearby soft tissues. This can restrict foot movement, especially plantar flexion.

Gout:

Gout is a complex and common form of arthritis that can affect anyone. Gout occurs due to uric acid deposits in the body and is characterized by pain and stiffness in the ankle. It prevents ankle dorsiflexion and can often cause chronic pain in the back of the ankle.

Infection:

Some infections like cellulitis and osteomyelitis which attack the bones can also cause pain in the ankle.

 

Related topic: Ankle Arthritis

 

Treatments:

Thankfully, there are several treatments and preventive measures that can be taken to reduce pain from anterior impingement syndrome:

Prolotherapy

The structures in and around the ankles have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that help to heal these structures.

Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is needed to heal them and provide pain relief.

As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.

Rest:

Rest your foot and try to avoid any activities that may put a strain on your ankle. Walking boots or crutches can help you walk without putting weight on your ankle.

Ice:

To avoid swelling, apply ice pack for 15 to 20 minutes after a few hours. This can help reduce pain while reducing pain and making the area numb.

Elevation:

Try to keep your ankle lifted above your heart; this can help with reducing swelling. You can also sleep while elevating your ankle.

Compression:

You can tightly wrap your ankle with a bandage or clean cloth to provide compression.

Suitable footwear:

Be sure to wear the right footwear that doesn’t strain your foot or ankle joint. Don’t wear loose or too tight shoes. Avoid flip-flops or high heels, as they have a high risk of causing a sprain. Supportive footwear is essential if you are a sports player.

Medication:

Non-steroidal anti-inflammatory NSAIDs (ibuprofen and naproxen) can reduce pain. Consult your doctor before taking any medication.

Preventive measures for Ankle impingement syndrome

Prevention is always better than cure. It is imperative to take preventive measures in order to minimize the risk of injury, infection, or disease.

  • Strengthen your muscles: by exercising and maintaining your diet.
  • Maintain your weight: ensure that your ankle is not bearing extra weight to prevent front of the ankle joint pain.
  • Rest: do not push yourself too hard if you are tired. Taking rest is very important, and you must not ignore it! Don’t overuse the affected ankle joint.
  • Wear proper footwear: do not wear shoes that increase the risk of injury or sprain in the ankle.
  • Warm yourself up: stretching and warming can reduce the risk of muscle and ligament stretching. Stretching up your calf muscles can help relieve chronic ankle pain and foot pain.

Treatment Options:

Most ankle pains can be treated at home easily, but some severe injuries might require surgery.

Braces & Splints:

Ankle braces reduce pain. There are different braces for different activities. Consult your doctor for the best braces for the lower leg that suit your lifestyle.

Medication:

Many types of medicine can reduce and relieve pain. Anti-inflammatory medication can help in reducing swelling and pain. Consult your doctor for the proper prescription.

Physical therapy:

Regular physiotherapy, designed especially for you by your physical therapist, can be of great help. It offers flexibility to your muscles, ligaments, and tendons. This is a very effective treatment of ankle pain. Deep squatting or lunging is very effective in providing pain relief. Make sure to exercise regularly according to the customized plan. Consulting a sports medicine expert can help devise a rehabilitative training program if you’re an athlete.

Use of orthotics:

These are particular kinds of inserts (in the form of shoes or heels) that are custom-made for you. These orthotic inserts help in the alignment of your ankle.

Corticosteroid injections:

There might be a need for steroid injections in severe ankle pain. Your doctor injects medicine directly into your joint using a needle.

Surgery:

In some cases, your ankle might be subjected to operative treatment. The surgery repairs the torn ligaments and tendons.

Conclusion

If you are suffering from ankle pain that not subsiding even after home remedies and rest, it is very important to consult your healthcare professional. Some imaging tests such as x-ray or magnetic resonance imaging might help them diagnose any abnormality in your foot. Your orthopaedic may suggest a plan of action according to your particular case.

A man with front of ankle pain

Frequently Asked Questions

Why do the fronts of my ankles hurt when I run?

The fronts of your ankles may hurt while running because of tibialis anterior tendonitis. This is the tendon where you feel ankle pain while running due to repetitive and forceful flexion of the front of your foot. Your ankles may also hurt because of running too far, wearing the wrong shoes while running, and overuse of ankle tendonitis, which may cause swelling, inflammation, or bruising.

Will anterior ankle impingement go away?

Anterior ankle impingement can go away with right physical therapy that can help you improve the range of motion. Anti-inflammatory medications can also help you relieve swelling and pain. Moreover, the complete recovery from ankle impingement entirely depends on the extent injury, but typically it takes about 4 – 6 weeks to return to normal activities. If physical therapy or medication doesn’t help you, surgery is the last option to remove the scar tissue or bone that is causing the obstruction.

How do I know if my ankle pain is serious?

Your ankle pain can be serious if:

  • Your ankle pain is getting worse day by day
  • Your pain doesn’t allow you to do your daily activities
  • You feel stinging or tingling in your foot
  • You have swelling or inflammation in your foot – or any sign of infection
  • Loss of sensation in your foot
  • Moreover, if you’ve diabetes, it might be a serious issue!

How do I treat anterior tibialis tendinitis?

You can treat your anterior tibialis tendinitis by:

  • Proper rest
  • Physical therapy
  • Ice massage
  • Anti-inflammatory medications (NSAIDs) 
  • Ankle bracing or stretching your calf muscles

What causes ankle pain without injury?

There are many causes of ankle pain without injury. Some of the common  causes are:

  • Osteoarthritis (can cause pain without any injury)
  • Rheumatoid arthritis (can cause sudden pain in your ankle without injury)
  • Overuse of your ankle
  • Wearing high-heeled sandals
  • Continuing workout sessions after a long-time
  • Footwear changes

Why does my ankle hurt on the top?

There are numerous causes of ankle pain like arthritis (osteoarthritis or rheumatoid arthritis), anterior ankle impingement (most common cause of chronic ankle pain among athletes), or sudden injury or trauma of the ankle.

 

References:

  1. Phillips, N. (2019, November 9). Ankle pain: Causes, home remedies, and prevention. Healthline. Retrieved January 16, 2022, from https://www.healthline.com/health/ankle-pain#home-care
  2. Burns, A., & Burns, A. (2021, August 15). Why you’re experiencing sudden ankle pain without injury. Arizona Foot Doctors. Retrieved January 16, 2022, from https://arizonafootdoctors.com/5-reasons-sudden-ankle-pain-without-injury/
  3. Arthritis, V. (2021). Foot and ankle pain. Versus Arthritis. Retrieved January 16, 2022, from https://www.versusarthritis.org/about-arthritis/conditions/foot-and-ankle-pain/
  4. Begum, J. (2021, October 4). Ankle injuries: Causes, treatments, and prevention. WebMD. Retrieved January 16, 2022, from https://www.webmd.com/fitness-exercise/guide/ankle-injuries-causes-and-treatments#1
  5. Clinic, C. (2022). Ankle pain: Causes, at-home remedies, treatments & prevention. Cleveland Clinic. Retrieved January 16, 2022, from https://my.clevelandclinic.org/health/symptoms/15295-ankle-pain
  6. University , N. (2021, January 22). Youth sports injuries. National University Of Health Sciences. Retrieved January 16, 2022, from https://www.nuhs.edu/patients/health-information/articles/youth-sports-injuries/

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