Reviewed by Simon Shen, D.C., Physician Brandon Yew and Dr Andre Budihardjo, MM on April 5, 2023

5 Reasons Why You Have Ankle Pain And How To Heal Fast

Published May 19, 2023| 7 min read

Identifying the cause of your ankle pain can help you find the right treatment. Here are 5 common ankle injuries and treatments.

Ankle pain can really slow you down if you’re trying to be more active this Spring. It can also be hard to treat as there may be several causes.

Some ankle pain may be due to an injury. However, you can also experience problems if you are overweight, use inappropriate footwear, or are female.

Read on to learn about the most common types of ankle pain and injuries, how they occur, and tips for treating them.

What’s Causing Your Ankle Pain?

A male runner experiencing ankle pain — Not warming up properly before exercise can sometimes lead to ankle pain.

Ankle injuries can happen to anyone, irrespective of age or level of physical activity. However, certain factors can make you vulnerable to ankle pain. 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

Types Of Ankle Pain And Treatments

Here are 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.

Treatment

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 immobilizing 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.

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.

Treatment

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

A woman with a stress fracture wearing a brace on her leg — A stress fracture is most likely to occur right above the ankle in the distal fibula bone.

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.”

Dr. Simon Shen, Real Health Medical’s Doctor of Chiropractic.

Treatment

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 specialized 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 speed up healing and encourage blood circulation. Real Health Senior TCM Physician Brandon Yew recommends the following:

Mulberry twig (sang ji sheng)
Achyranthes (niu xi)
Slender-style Acanthopanax bark (wu jia pi)
East-Asian tree fern rhizome (gou ji)
Copper (zi ran tong)
Drynaria fortune rhizome (gu sui bu)
Eucommia bark (du zhong)
Himalayan teasel root (xu duan)

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:

On the upper back, 1.5 finger widths lateral to the lower border of the spinous process of the first thoracic vertebra.

Located 3 finger widths above the lateral malleolus, between the tibial anterior ridge and the anterior edge of the fibula.

In depression midway between the tip of the medial malleolus and the attachment of the Achilles tendon, level with the tip of the medial malleolus.

On the dorsum of the hand, between the 1st and 2nd metacarpal bones.

On the dorsum of the foot, in the depression proximal to the 1st metatarsal space.

On the inner lower leg, 4-fingers-breadth above the tip of the inner ankle bone, just behind the shin bone.

On the anterior aspect of the lower leg, 4 fingers-breadth below the outer depression of the knee joint, one finger-breadth (middle finger) from the anterior crest of the tibia.

Da zhu (BL11)
Xuan zhong (GB39)
Tai xi (KI3)
He gu (LI4)

Tai chong (LR3)
San yin jiao (SP6)
Zu san li (ST36)

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

Treatment for ankle pain due to a sprain

A person with a Grade 1 or 2 sprain may benefit from using pain relievers such as NSAIDs or paracetamol. 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)
Tao Hong Si Wu Tang
Jin Gu Die Shang Pian
Zheng Gu Zi Jin Dan
Xiao Zhong Huo Xue Pian
Shu Jin Huo Luo Pian

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.

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 and Zheng Gu Zi Jin Dan 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), turmeric (jiang huang), Valerian root (xie cao), Tian Qi, and coconut oil will help, too. Meanwhile, many medicinal mushrooms, such as Cordyceps and Lingzhi, contain pain-relieving properties.

Try Different Treatments For Ankle Pain

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.