Reviewed by Simon Shen, D.C., Physician Brandon Yew and Dr Andre Budihardjo, MM

5 Common Ankle Injuries and How to Recover from Them Quickly

Published November 27, 2022| 7 min read

Ankle injuries can cause extreme pain and discomfort. A multi-faceted approach to treatment supports complete healing of the affected area.

A young man tending to his ankle injuries after a workout.

Ankle injuries can happen to anyone, irrespective of age or level of physical activity. However, certain factors can make you vulnerable to sprains or strains. These include:

Excessive body weight
Muscle and ligament fatigue

Poor leg muscle conditioning
A prior ankle sprain or strain
Use of inappropriate footwear
Not performing a warm-up session before physical activity
Being a woman above 30 or a male teenager between the ages of 15 to 24

Learn more about 5 common types of ankle injuries and the methods that can help treat them.

Tendonitis

Thickened tendons, ankle pain, swelling, redness, or warmth around the tendon are the primary symptoms of tendonitis. These stem from an inflammation of the peroneal tendons, which run along the outer ankle bone and sides of the foot.

The problem should be treated promptly to avoid subluxation – a partial dislocation of a joint – or a tendon rupture. Subsequently, these can cause ankle weakness or instability, excruciating pain, and a stabbing sensation in the tendons.

Treating tendonitis

The RICE – rest, ice, compression, and elevation – method is a popular way to treat tendonitis and other ankle injuries. Apply an ice pack or cold compress to an affected area for 20 minutes every two hours. The ankle should also be wrapped in a compression bandage and lifted above a person’s heart level.

A soft cast or boot encourages healing by immobilising a person and taking weight off their tendons. Non-steroidal anti-inflammatory drugs may help reduce pain and inflammation. Physical therapy will improve strength and flexibility in the ankle and foot.

If these options fail, a healthcare provider may propose surgery. A synovectomy is a minimally invasive procedure to remove damaged external layers of tissue from the tendons.

A woman compressing her injured ankle using an ice pack. — RICE (rest, ice, compress, elevation) is the first-line treatment for ankle injuries like tendonitis, ankle impingement, or a sprain.

Anterior Ankle Impingement Syndrome

This injury can develop if you’ve suffered ankle damage due to inflammation. It makes the ankle’s soft tissue swell, reducing elasticity which brings about impingement. Impingement is described as the excessive friction between joint tissues that limit the range of motion.

If someone has arthritis, the body will respond by forming extra bone tissue (osteophytes) on the front of the ankle bones. Subsequently, these osteophytes will impinge on each other or pinch the soft tissues.

Treating anterior ankle impingement

The RICE method and physical therapy are the primary options for restoring the range of motion. Corticosteroid injections, anti-inflammatory medication, and creams can help calm inflammation, pain, and swelling.

Surgical treatment to remove an osteophyte or a soft tissue can be considered if a person’s symptoms are attributed to impingement. The procedure can be performed arthroscopically or by opening the ankle joint.

Fractures

Pain and severe bruising best describe a fracture. “Often, the injury will occur in the distal fibula, slightly above the lateral malleolus (outer ankle bone). It’ll also increase the risk of an avulsion fracture, which sees ligament insertion points breaking off from the bones,” explains Dr Simon Shen, Real Health Medical’s Doctor of Chiropractic.

Treating a fracture

A healthcare provider may prescribe protective footwear or a cast to alleviate the pressure on the leg. The latter provides the additional advantage of keeping the foot in a fixed position.

Sometimes, surgery to insert specialised pins, plates or screws into the ankle may also be performed. These can help keep the small bones of the foot and ankle together while a person recovers.

Traditional Chinese Medicine (TCM) herbs can quicken healing and encourage blood circulation. Real Health Senior TCM Physician Brandon Yew recommends the following:

Mulberry twig (sang ji sheng, 桑寄生)
Achyranthes (niu xi, 牛膝)
Slender-style Acanthopanax bark (wu jia pi, 五加皮)

East-Asian tree fern rhizome (gou ji, 狗脊)
Copper (zi ran tong, 自然铜)
Drynaria fortune rhizome (gu sui bu, 骨碎补)
Eucommia bark (du zhong, 杜仲)
Himalayan teasel root (xu duan, 续断)

Acupressure massage too can be administered to hasten the recovery of a fracture. A few of the points that can be stimulated according to Physician Yew are:

.5 finger-breadths lateral to the lower border of the spinous process of the first thoracic vertebra (T1).

3 finger-breadths above the lateral malleolus, between the tibial anterior ridge and the anterior edge of the calf bone.

3D illustration of the tai xi acupressure point — Located on the tibial aspect of the leg, posterior to the medial border of the tibia, three finger widths inferior to the Yin Ling Quan acupoint.

An illustration of a left hand, showing he gu (LI4) acupressure point — He gu is located on the back of the hand, between the 1st and 2nd metacarpal bones. It helps dispel pathogens and restores and enhances qi and blood circulation within the meridians.

3D illustration of the Taichong (LV3) acupressure point — Located on top of the foot, in the depression closest to the first metatarsal space. It revitalises the Liver.

San Yin Jiao — Located 4 finger-breadths above the ankle.

An illustration of zusanli to maintain overall health — Zu san li is located on the front of the lower leg, 4 fingers-breadth below the knee joint.

Da zhu (BL11, 大杼)
Xuan zhong (GB39, 悬钟)
Tai xi (KI3, 太溪)
He gu (LI4, 合谷)

Tai chong (LR3, 太沖)
San yin jiao (SP6, 三阴交)
Zu san li (ST36, 足三里)

Sprains

Direct or indirect trauma is the reason behind ankle sprains. The trauma a person experiences can overstretch or tear the ligaments that support the ankle. They may endure symptoms like bruising, swelling or pain in the affected area. A person might hear a popping sound or find their ankle’s range of motion limited.

The extent of an injury can also be broken down into:

Grade 1 injuries – A minimal tearing of the muscles, tendons, or ligaments
Grade 2 injuries – A combination of completely or partially torn muscles, tendons, or ligaments
Grade 3 injuries – A complete tear or rupture of the muscles, tendons, or ligaments

Treating an ankle sprain

A person with a Grade 1 or 2 sprain may benefit from using NSAIDs and the RICE method. A medication called paracetamol can also relieve pain. A Grade 3 injury requires a traditional plaster or commercial air cast, and crutches may help them walk freely.

To relieve pain and support the development of new tissue, an ultrasound, electrical stimulation, and strengthening exercises can help.

Physician Yew usually prescribes these TCM herbal formulas and ingredients:

Blood vine slices (ji xue teng pian, 鸡血藤片)
Tao Hong Si Wu Tang (桃红四物汤)
Jin Gu Die Shang Pian (筋骨跌伤片)
Zheng Gu Zi Jin Dan (正骨紫金丹)
Xiao Zhong Huo Xue Pian (消肿活血片)

Shu Jin Huo Luo Pian (舒筋活络片)

Shin Splints

As a consequence of rigorous and repetitive movement, shin splints inflame the muscles, tendons, and thin layers of tissue covering the shins. The injury won’t directly harm the ankle but can still cause severe pain.

The pain starts in the lower leg above the ankle and can worsen when the ankle turns inward. Recovery begins when you stop activities that instigate pain.

Treating shin splints

A healthcare provider will propose a treatment plan consisting of medications, cold compresses, strengthening and stretching exercises, and running shoes with a stiff heel and arch support.

Whole ginger and sliced ginger arranged on a wooden platform — Ginger is a herb that can be consumed to help with shin splints.

To treat shin splints the TCM way, Physician Yew explains that the focus is placed on relaxing the muscles, removing Stasis, nourishing the Liver and promoting qi (vital life force) circulation. He explains that Tao Hong Si Wu soup (桃红四物汤) and Zheng Gu Zi Jin Dan (正骨紫金丹) are commonly used in the treatment of shin splints by removing Blood Stasis, relieving pain and promoting healing. Consuming natural ingredients like ginger (sheng jiang, 生姜), turmeric (jiang huang, 姜黄), Valerian root (xie cao, 缬草), and coconut oil will help too.

Minor ankle injuries respond well to a self-administered treatment option like RICE. Likewise, acupressure only offers mild symptomatic relief for a sprained ankle. If you’re considering herbal formulas and ingredients, you shouldn’t self-medicate. Speak to a TCM practitioner beforehand to enable a holistic and more effective treatment of an ankle injury based on your body constitution.