Chronic Ankle Pain After Injury — What’s Going On?
- Shawn Hegarty
- 4 days ago
- 3 min read
If your ankle still hurts months after an injury, it usually means something didn’t fully heal or your movement patterns changed. Common causes include:
Ligaments that were stretched or partially torn can heal too loosely, so your ankle feels wobbly and keeps giving way — especially on the outside of the ankle. 👉 This is one reason people feel pain and “rolling” sensations, even long after the initial sprain.
2. Cartilage Damage (Talar Dome Lesion)
Cartilage inside the ankle joint can be injured like a “pothole,” leading to pain deep inside the joint, clicking or grating with movement.
3. Ankle Impingement or Bone Spurs
Scar tissue or extra bone growth can get pinched at the front or back of your ankle when you flex it, causing sharp pain with motion.
4. Nerve Entrapment
A nerve around your ankle can be compressed by scar tissue or tight structures, giving burning or shooting pain along the inside or outside of the ankle.
5. Tiny Fractures or Complications
Some small fractures (like the anterior process of the calcaneus) can heal slowly or incompletely and keep causing deep aching pain.
6. Mechanical/Structural Issues
Flat feet (pes planovalgus) or very high arches can misalign your ankle mechanics, putting extra stress on tendons and ligaments.
What You Should Do
If pain lasts more than 3 months, it’s worth seeing an orthopedic specialist or a foot & ankle doctor. They can order an MRI to check for ligament tears, cartilage damage, or nerve issues.
An MRI shows soft tissues like ligaments, cartilage, and nerves — information X-rays can miss.
PT helps a lot — especially for strength, balance, and proprioception — but chronic symptoms often require adjustments or more advanced care alongside therapy.
These gentle movements and strengthening exercises help improve mobility, reduce stiffness, and support healing. Always stop if motion causes sharp pain, and check with your therapist or doctor first.
Stretching & Mobility
Ankle Circles & Alphabet
Sit or lie down and make circles with your foot — clockwise and counterclockwise.
Or “write” the alphabet with your big toe.
Why: Promotes blood flow and range of motion.
Towel Stretch
Sit with your leg extended. Loop a towel around your foot and gently pull your toes toward you.
Hold 20–30 sec.
Targets: Calf muscles (gastrocnemius & soleus) and Achilles.
Standing Calf Stretch
Face a wall, injured foot back, heel flat, lean forward slightly until you feel a stretch in your calf.
Hold for 30 sec, repeat 3 times.
Targets: Back of the lower leg.
Strength & Stability
These build support around the joint and improve balance — essential to prevent repeated sprains.
Calf Raises
Stand and lift your heels up and down slowly.
Build up gradually.
Works: Calf muscles and overall ankle stability.
Resistance Band Ankle Movements
Push foot up (dorsiflexion), down (plantar flexion), in (inversion), and out (eversion) against a band.
Works: Strength in multiple directions.
Single-Leg Balance
Stand on the injured foot for 30+ seconds. Progress to no support, soft surface, or eyes closed as tolerated.
Helps: Proprioception & balance.
Ankle Alphabet (again!)
This also helps strengthen muscles while improving range of motion.
Tips for Managing Pain Flare-Ups
Balance rest with gentle activity: Avoid long high-impact days early on.
Supportive shoes: Good arch support and cushioning help.
Low sodium & anti-inflammatory strategies: Diet and icing can reduce swelling.
When to Seek Immediate Care
You can’t bear weight at all on the ankle.
Severe swelling or redness that doesn’t improve — sometimes this points to other medical issues.
Bottom Line
Months of ankle pain usually mean the initial injury didn’t fully heal or changed how your ankle moves. Simple PT helps many people, but persistent symptoms often need professional evaluation and possibly imaging like an MRI to find exactly what’s going on and guide targeted treatment.
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