The ankle is swollen and sore –what to do?

Problems with ankles are common which leads people to come to my physiotherapy office. Swelling and pain in the ankle can begin after a trauma, such as falling but it can also begin little by little, without any visible reason.

In the beginning of the physiotherapy session I always ask some questions from the client, with which I try to narrow down the problem and the cause for pain and swelling. My list of questions includes questions about the client’s job, free time, hobbies, diseases, shoes and previous traumas. This way I might already get some information about the location of the problem as well as the reason of the pain.

Traumas

If you just hurt your ankle or lower limb in the last day or two, your ankle may be swollen and painful indeed. The swelling adds up the most to the sides of the ankle were the ligaments of the ankle are located. In many cases of ankle pain there’s been a strain or a small tear in some of the ligaments, usually in the lateral side of the ankle. In this case the swelling is also on its worst at the lateral side of the ankle, but it spreads to other parts of the ankle and foot as well.

The acute phase of the trauma takes about 1-3 days, durig which you can use the ICE-principle: ice, compression and elevation. So you should use an ice pack on the ankle for about 20 minutes in every hour/few hours and for decreasing the swelling keep the leg elevated and compressed.

Do not let the ankle rest for more than a few days, you should begin to load the lower limb pretty soon after the trauma. If you cannot bear weight on your ankle at all, you should definitely go to see a doctor! The entire heel should be able to place on a floor and load some of your bodyweight on it a week after the trauma.

Pain that began little by little

Pain that began little by little can be associated with problems of the alignment of the lower limb, such as positions of the ankle, knee and hip. On the other hand, the pain and swelling can be caused from buying new shoes and suddenly using them a lot, or from stressing your ankle too much in a certain sport.

If the pain and swelling began insidiously little by little, I recommend you to think if anything changed in your life lately. Did you start a new hobby? Have you increased the amount of exercise? Have you bought a new pair of shoes? When did the pain really began?

As an example, I can tell you a story about my client, who began group exercising at the gym just before the Christmas. About two months later the client came to my clinic because of ankle pain, she told me that the pain began little by little, without any trauma. The client couldn’t believe that exercising had anything to do with the pain. When running the tests with the client, I noticed that the alignment of the lower limb failed when the client did some of the most typical group exercising-movements such as squats, lunges and jumps. This way it’s very likely that the failing of the alignment stressed the lower limb little by little, which finally led to pain and swelling on the ankle a few months after the beginning of exercising.

If you’re able to find some connection between the pain and some change in your life, you can easily test if that’s the real reason for the pain. Just try to eliminate the change from your life for a while, for example, use your old shoes or decrease the amount of exercise. Does the pain decrease? It could be true that you went little too far with the new hobby or with the new shoes and that’s why you got pain and swelling on your ankle.

Let a professional take a look at it!

In my previous example, the pain of the client wasn’t just a cause of exercising too much, it was also about the alignment of the lower limb during the exercise. In that case my client didn’t only need to reduce the amount of exercising, but needed also help of a physiotherapist to work on that alignment. If the client just decreased the amount of exercising the pain would have decreased for a while as well, but it would’ve gotten back after increasing the amount of exercising.

If the pain and swelling last even though you’ve used ice packs and reduced the amount of exercising, you should contact the professionals. I recommend you to go and check out the reason for the pain and swelling at a doctor’s or a physiotherapist’s office, so that the matter will be fixed!