Ankle sprains are among the most common musculoskeletal injuries, often resulting from an inward (inversion) or outward (eversion) rolling of the foot that injures one or more ligaments. In Singapore, ankle sprains usually account for up to 85% of ankle injuries.
The most frequently affected ligament in inversion sprains is the anterior talofibular ligament, one of the lateral ligaments of the ankle. Medial ligament injuries from eversion are less common but may occur in severe sprains.
There are various chronic conditions that cause ankle pain. It can be the result of an unresolved fracture, Peroneal Tendon injuries, Posterior Tibial Tendon Dysfunction (PTTD), gout, rheumatoid arthritis, Tarsal tunnel syndrome (nerve compression), infection, and poor structural alignment such as flat foot.
Patients suffering from ankle pain frequently report symptoms of swelling and pain, stiffness, and redness in the affected area. Pain can range from a dull ache to a sharp burning pain that occurs during physical activity, such as standing or walking on uneven surfaces. Depending on the severity of the sprain or injury, bruising, limited mobility, or chronic instability may also occur.
Types of Ankle Pain
Ankle pain can come in different forms, depending on the cause and area affected. Here are common types:
Sprained ankle
Usually caused by overstretching or partial tearing of ligaments, often from twisting or rolling the ankle.
Ankle instability
A lingering sense of weakness or the ankle “giving way,” often after repeated or moderate to severe sprains.
Tendinitis
Inflammation of tendons around the ankle, such as the Achilles or peroneal tendons, leading to pain with movement.
Fractures
Breaks in one or more ankle bones, such as the fibula, causing sharp pain, swelling, and difficulty bearing weight.
Bursitis
Inflammation of the fluid-filled sacs around the ankle joint, often from repetitive motion or pressure.
Arthritis
Wear and tear (osteoarthritis) or autoimmune conditions (rheumatoid arthritis) causing stiffness and chronic.
Nerve-related pain
Such as tarsal tunnel syndrome, where nerves are compressed, leading to burning, tingling, or numbness
Common Causes of Ankle Sprains
- Twisting, rolling, or turning the ankle inward (inversion) or outward (eversion) during movement
- Landing awkwardly from a jump, as in sports like volleyball or basketball
- Walking or running on uneven surfaces
- Wearing improper footwear, especially during physical activity
- Sudden changes in direction, often seen in athletes
- Previous injuries that weaken soft tissues and ligaments
- Lack of warm-up or poor balance before exercise
Symptoms of Ankle Sprains
Swelling and pain around the ankle joint
Bruising or discolouration of the skin
Pain when bearing weight or touching the area
Limited range of motion or stiffness
Instability or the feeling that the ankle might give way
Popping or snapping sensation at the time of injury
Ankle Sprain Management and Prevention
Managing Sprained Ankles
A sprained ankle can range from mild to severe. Acute ankle sprains benefit from early care to reduce swelling and promote healing:
- Rest and avoid putting weight on the injured ankle
- Apply ice to manage acute inflammation in the first 48 hours
- Use compression bandages or a brace to support the area
- Elevate the ankle to reduce swelling
- Non-steroidal anti-inflammatory medication may be used to alleviate pain and inflammation
- Shockwave therapy is typically recommended when pain and swelling persist despite rest
- Return to movement with progressive exercises that restore strength and mobility
However, if the injured ankle shows signs of chronic instability or pain worsens, it is crucial to consult a podiatrist. Depending on the severity of the sprain—ranging from Grade I to Grade III sprains—management may require immobilisation or advanced care. Diagnostic imaging may be needed to rule out fractures and assess ligament or soft tissue damage.
Rehabilitation is crucial in managing sprained ankles, especially for moderate to severe sprains. A targeted exercise plan supports restoration of function and may prevent recurrence.
Leading the Way in Podiatry Care
Preventing Ankle Sprains
Whether you’re active or just on your feet often, prevention helps avoid re-injury:
- Warm up before exercise or physical activity
- Strengthen ankle and lower limb muscles
- Practise balance and proprioceptive exercises
- Choose footwear with good support
- Be cautious on uneven surfaces
- Address recurring issues early
Get Relief from Ankle Pain at East Coast Podiatry
Achilles tendon rupture
Peroneal tendon injuries
Arthritis
Posterior tibial tendon dysfunction
Gout
Tarsal tunnel syndrome (nerve compression)
Fracture
It is advised by ankle specialists and podiatrists to address your ankle pain and sprains promptly. Failure to do so can lead to irreversible deformities of the foot and ankle, and even cause disabilities that negatively affect your quality of life.
To prevent this, see a podiatrist if you have experienced multiple ankle sprains, or frequent ankle instability and weakness.
