Pain in the ankle when flexing the foot is often discomforting. Flexing the foot involves two main movements: dorsiflexion (pulling toes upward) and plantarflexion (pointing toes downward). The ankle joint, with its bones, ligaments, and tendons, allows these movements. Pain during these actions signals an underlying issue.
Common Causes of Pain
Ankle sprains are a common cause of pain. These injuries occur when ligaments are stretched or torn, often due to an awkward landing or twisting motion. Pain from an ankle sprain can worsen with movements like dorsiflexion, as it strains the injured ligaments.
Tendinitis, or inflammation of a tendon, causes ankle pain during flexion. Specific tendons like the Achilles, tibialis anterior, or peroneal tendons become inflamed from overuse or repetitive stress. For example, Achilles tendinitis causes pain along the back of the ankle that worsens when flexing the foot upward, as this motion strains the tendon.
Ankle impingement occurs when soft tissues or bone structures get “pinched” within the ankle joint during extreme movements. Anterior ankle impingement, often called “footballer’s ankle,” causes pain in the front of the ankle, intensified by forced dorsiflexion. Conversely, posterior ankle impingement results from compression at the back of the ankle during terminal plantarflexion, common in activities like ballet or soccer.
Small cracks in bones, known as stress fractures, develop from repetitive stress, causing ankle pain when flexing. These subtle bone injuries may not be immediately obvious but can cause aching pain that gradually increases, particularly with activities that involve flexing the foot. Arthritis, characterized by joint cartilage degeneration, leads to stiffness and pain in the ankle during movement.
Nerve compression, though less common, manifests as tingling or burning pain when flexing the foot. Conditions like Tarsal Tunnel Syndrome involve tibial nerve compression in the ankle. This discomfort intensifies with specific movements like dorsiflexion, irritating the compressed nerve.
At-Home Relief Measures
At-home measures can manage ankle pain when flexing the foot. Rest is a primary measure, involving avoiding aggravating activities to allow healing. Continuing to put stress on an injured ankle worsens the condition and prolongs recovery.
Applying ice to the affected area reduces swelling and pain. Ice packs should be used for 15 to 20 minutes at a time, several times a day, with a thin towel placed between the ice and the skin. Compression with an elastic bandage also controls swelling and supports the ankle. The bandage should be firm but not so tight as to cut off circulation.
Elevating the ankle above the level of the heart further reduces swelling by assisting fluid drainage. This is especially helpful during periods of rest or sleep. Gentle stretching or movement, if pain allows, helps maintain flexibility, but it is important not to push into pain. Over-the-counter pain relievers, such as ibuprofen or naproxen, manage pain and reduce inflammation. These medications should be taken according to dosage instructions.
When to Seek Medical Attention
While many instances of ankle pain improve with home care, certain signs indicate professional medical evaluation. Severe pain that prevents bearing weight on the foot warrants immediate attention. Sudden swelling, significant bruising, or a visible deformity of the ankle or foot are serious indicators.
Numbness, tingling, or weakness in the foot suggests nerve involvement and requires professional assessment. If the pain worsens despite home treatment or does not improve within a few days, medical consultation is advised. Pain accompanied by signs of infection, such as redness, warmth, increased tenderness, or fever, requires prompt medical attention. Recurrent ankle pain, even if mild, signals an underlying issue requiring diagnosis and treatment.
Medical Diagnosis and Treatment
When seeking professional help for ankle pain, a medical provider typically begins with a physical examination. This involves assessing the ankle for swelling, tenderness, range of motion, and stability. The doctor also inquires about the onset and nature of the pain.
Imaging tests often provide a clearer picture of the ankle’s internal structures. X-rays identify bone issues like fractures or bone spurs. For more detailed information on soft tissues such as ligaments, tendons, and cartilage, an MRI (Magnetic Resonance Imaging) or ultrasound are ordered.
Treatment approaches vary based on the diagnosis. Physical therapy is common and effective, focusing on exercises to improve ankle strength, flexibility, balance, and overall function. A physical therapist guides individuals through specific movements to aid recovery and prevent future injuries.
Beyond over-the-counter options, prescription anti-inflammatory medications reduce pain and swelling. Bracing or taping provide external support and stability to the ankle during the healing process. In some cases, injections, such as corticosteroids, reduce inflammation and provide pain relief directly to the affected area. These injections offer temporary relief, particularly for conditions like tendinitis or impingement. Surgical intervention is a last resort for specific, severe, or chronic conditions that have not responded to conservative treatments, such as repairing torn ligaments, removing bone spurs, or addressing severe arthritis.