Understanding Ankle Pain: Common Causes and When to Seek Treatment
Can you remember the last time you stubbed your toe? If you are like most people, you probably have some soreness for a few days. But the real question is how often do you really stub your toe? In our Merrick clinic, we see many patients with ankle pain, and we’re not talking about the immediate pain of a twisting injury or soreness a few days later. We’re talking about ankle pain that comes and goes or makes every step an exercise in misery. You shouldn’t have to resign yourself to hobbling through Merrick or sacrificing a family outing at Norman J. Levy Park just because your ankle hurts. Most people figure it is just a minor sprain and that “walking it off” is the answer. But just how often does “walking it off” actually work?
Typically the first thing you notice is stiffness and soreness, which then becomes a pattern of not trusting your ankle and always bracing for the next sharp pain. While it’s common to hope that ankle pain will eventually “go away on its own,” this “wait and see” approach only increases your risk for long-term problems.
The most important step you can take to improve your odds for successful ankle pain therapy is to get a definitive diagnosis. What’s wrong? Will this ever feel normal again? The answers to these questions—and so many more—can give you a greater sense of control and direction, not just in your ankle pain treatment but in your life in general. So let’s dive into some of the most common causes of ankle pain and the options for treatment in Merrick.
Common Causes of Ankle Pain
First, we know that people think of sports or some dramatic slip on the sidewalk when they picture an ankle injury. In our practice, most ankle issues come from simple daily activities, with some injuries from sports and workouts thrown into the mix. But what exactly happens to your ankle when you injure it? Let’s take a closer look.
Sprains: When Ligaments Are Stretched Too Far
Sprains are the most common cause of ankle pain. They occur when you overstretch the ligaments that support your ankle joint. Ligaments are thick, elastic fibers that connect one bone to another, much like a bungee cord. A slight pull will cause microscopic tears in the ligament fibers. In contrast, a sudden twist can result in a partial tear or even complete rupture.
We typically grade these injuries by the amount of tearing:
- Grade 1 (Mild): The ligament is stretched, but only a few microscopic tears occur. You may have mild tenderness and swelling but should be able to bear weight, though it will likely be painful to do so.
- Grade 2 (Moderate): The ligament is partially torn. Moderate pain, swelling, and bruising will be present. Weight-bearing will be difficult and painful, and you may feel as though your ankle is loose or unstable.
- Grade 3 (Severe): The ligament is completely torn. This is a severe injury with significant pain, swelling, and bruising. It is impossible or very difficult to bear weight on the injured foot, and your ankle will feel extremely unstable or wobbly.
Strains: The Muscles and Tendons
The other major group of tissues that cause ankle pain are strains, which are injuries to the muscles or tendons. The Achilles tendon is the classic example of tendonitis, which is what it feels like when you pull the band of connective tissue at the back of your heel. But what about that sharp, stabbing pain on the outside of the ankle? Or that dull, aching sensation in the back of your calf? These are often muscle or tendon strains, which can be the result of overuse, a sudden forceful contraction or push-off, or faulty mechanics that have been developing over time.
Accurately distinguishing between a sprain and a strain is an important part of ensuring that you receive the best treatment. These terms are often used interchangeably, but they involve different tissues and structures and will benefit from slightly different care. With an accurate diagnosis, we can begin to map out the ideal treatment plan from the moment you arrive for your initial evaluation.
Home Management Strategies for Ankle Pain Relief
OK, so you’ve injured your ankle. What’s the first thing you do? Before you grab the golf clubs and head to Bethpage National Golf Club to “walk it off,” hear us out. You are better off stopping this progression before it starts, and for the first 24 to 48 hours after the injury, the best treatment is what we call “R.I.C.E.” Many people have heard this time-tested method, and for good reason:
- Rest: Rest means taking off the weight and stopping the activity that caused the ankle pain.
- Ice: Wrap an ice pack in a thin towel and apply it to the area for 15-20 minutes every 2 to 3 hours. Cold therapy helps to decrease swelling and provides temporary pain relief.
- Compression: Wrapping the ankle in an elastic bandage helps support it and decrease swelling. The bandage should be snug but not tight enough to cause numbness or tingling.
- Elevation: The final step is to elevate your foot on a pillow so it is higher than your heart. Keeping it propped up will further help with swelling and pain.
But let’s say you diligently follow these steps for a few days and see little or no improvement or the pain seems to come right back as soon as you stop icing and elevate. At that point, it’s time to seek out a professional ankle pain treatment, instead of simply hoping for the best.
When To See Ankle Pain Treatment Near Me
When is the best time to start physical therapy after an injury? In our practice, the question often is “when not to start physical therapy?” Because we care for so many people who developed long-term problems after “waiting it out,” we strongly urge you to seek professional guidance at the first signs of trouble. There are, however, some absolute red flags that an injury needs a professional’s attention.
Red Flag Warnings
Come in right away if you experience any of the following:
- Inability to Bear Weight: If you can’t take at least 4 pain-free steps after the injury or surgery.
- Visible Deformity: If the ankle is obviously out of place or bent in an unnatural position or a bony bump is present.
- Significant Swelling: If the ankle immediately and dramatically swells up, or swelling spreads up your leg.
- Numbness or Tingling: If you have any loss of sensation in your foot, it could mean a nerve has been injured and needs to be evaluated.
- Popping or Snapping Sound: A loud “pop” at the time of injury is always a warning sign.
The Dangers of Ignoring Persistent Pain
So what’s the worst that can happen if you simply ignore an ankle sprain? The problem isn’t usually the initial injury or pain but the development of chronic ankle instability. We see many people seeking ankle pain treatment for instability or “giving way,” which often results from a sprain that was never treated years before. When a ligament heals in a loose position, it causes a loss of normal joint stability, leading to a cycle of re-injury. The ankle just feels weaker, and it gives out more easily. The other problem is that your body is very smart and will adapt to a weak or unstable ankle by compensating in other ways, which often leads to knee, hip, or even low back pain. With proper ankle pain treatment and therapy, we can break this cycle.
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Physical Therapy for Ankle Pain
At Summit Physical Therapy, we don’t simply try to manage your symptoms; we go a step further to help you achieve an ankle that is stronger and better than it was before. In other words, we want you to actually be better. Let’s look at a few of the techniques we use in ankle pain treatment.
Manual Mobilization
You will find that the joint is usually quite stiff after an ankle injury. While this makes sense from a protective standpoint, joints that do not move easily cause pain and limit the exercises we can do for recovery. Manual mobilization is a hands-on therapy technique where we use skilled manual techniques to help restore your ankle’s natural range of motion. This can have an immediate effect on pain and mobility.
Proprioceptive Retraining
This may be the most important aspect of treatment for long-term success. If you have ever felt “clumsy” after an ankle injury, it’s because the sensory nerves in the ligaments that tell your brain where your foot is in space have been damaged. We use specific exercises that challenge your balance and position sense, such as single-leg standing, to retrain that connection. This is what truly restores your confidence and minimizes the risk for future sprains. This targeted ankle pain treatment is how we can ensure that you will truly be able to return to your life.
Final Thoughts
Ankle pain doesn’t have to be a permanent way of life. You should be able to move, walk, and run without the fear that your ankle is going to give out on you. The single most important decision you can make for the long-term health and mobility of your ankle is to seek professional help. If you are ready to say goodbye to ankle pain in Merrick, Summit Physical Therapy is ready to welcome you with open arms. Let’s not let a temporary problem become a permanent one. Call today to schedule your first visit for ankle therapy and get back to the things you love.
FAQs on Ankle Pain
How long will it take to recover from an ankle sprain?
Time to recover from an ankle sprain depends on the severity of the injury and individual factors. We typically see anywhere from a few weeks to several months, and we will give you an idea of the time frame after your initial evaluation.
Do I need a doctor referral for physical therapy for ankle pain?
In New York, we have something called Direct Access laws, which allow patients a certain number of physical therapy visits without a referral. However, if you have insurance, your provider may have their own rules, so our office can also help you verify your benefits before you arrive.
Will I be in pain during physical therapy for my ankle?
The whole point of physical therapy is to reduce your pain and restore your function, not to make it worse. While some of our exercises and stretches will be difficult and may cause mild discomfort, we will always work within your tolerance levels. We highly encourage communication, so if you are uncomfortable, let us know!
Is it too late for me to treat an old injury?
No way! It is never too late to get care and experience the benefits of physical therapy treatment. We can help to restore ankle mobility, improve old scar tissue, and retrain strength and balance to reduce your pain and improve function. Even if it has been years since your initial injury, it is not too late.
What shoes are best to wear with ankle pain?
Choose supportive, stable footwear, such as a sturdy heel, good arch support, and a wide base for your foot. The biggest shoe offenders are flip flops and high heels, which place your ankle in vulnerable positions during your recovery.
