Ankle pain is a common problem that can arise from a wide range of injuries and conditions affecting the bones, ligaments, tendons, cartilage, or joint lining. It may develop suddenly after an acute injury, or more gradually as a result of repetitive strain and micro-trauma over time.
Because the ankle is a complex joint that absorbs significant load during walking, running, and jumping, even relatively small changes in its structure or function can lead to pain and reduced performance. Common causes include ligament sprains, tendon irritation, joint impingement, cartilage injuries, and early degenerative change.
Importantly, nearly half of patients who sustain an ankle injury may not make a full recovery if the underlying issue is not accurately identified and managed. For this reason, obtaining the correct diagnosis early is essential before starting treatment.
A thorough clinical assessment is the first and most important step. This includes a detailed history of the injury, symptom behaviour, and a physical examination of the ankle and foot to assess movement, stability, tenderness, and loading patterns.
In many cases, further imaging is helpful to confirm the diagnosis and guide treatment planning.
This may include:
Accurate diagnosis allows for a targeted treatment plan, which may include physiotherapy, activity modification, injections, or, in some cases, surgical intervention. With the correct approach, most patients can achieve a full recovery and return to their normal level of activity.
In case of persistent ankle pain which does not improve despite good physiotherapy further imaging will be needed. When a structural problem inside the ankle like excessive scar tissue, inflammation, a so-called “meniscoid lesion” or a cartilage defect is responsible for the pain, an arthroscopy will be very helpful. Through one small portal a camera and through a separate portal the instruments are inserted into the ankle joint. Any inflammation, scar tissue or bony prominences which cause the pain can be removed. For a cartilage defect, a “microfracturning” procedure is normally the choice of treatment. Arthroscopic procedures mean minimal invasive surgery and promote speedy recovery, less scarring and fewer complications.
