The experience of aching knees and ankles is common. These joints are frequently affected due to their significant roles in supporting body weight and facilitating movement. While occasional discomfort might be temporary, persistent pain warrants attention to identify and address its underlying causes.
The Mechanics of Knee and Ankle Joints
The knee, the body’s largest joint, connects the thigh bone (femur) to the shin bone (tibia) and includes the kneecap (patella). This complex hinge joint allows for bending, straightening, and some twisting movements, crucial for activities like walking, squatting, and jumping.
Articular cartilage, a smooth, slippery tissue, covers the ends of these bones, reducing friction and absorbing shock during movement. Within the knee, two C-shaped pieces of cartilage, the menisci, act as additional shock absorbers and help distribute weight evenly across the joint.
Ligaments, strong bands of fibrous tissue, connect bones and provide stability to the knee, preventing excessive or incorrect motion. The knee has collateral ligaments on its sides (medial and lateral) that control sideways movement, and cruciate ligaments (anterior and posterior) that manage front-to-back motion. Tendons connect muscles to bones, enabling movement, such as the quadriceps tendon connecting thigh muscles to the patella.
The ankle joint comprises two main joints: the true ankle joint and the subtalar joint. The true ankle joint involves the tibia, fibula, and talus bones, allowing for up-and-down foot movement. The subtalar joint, located below the ankle joint between the talus and calcaneus, enables side-to-side foot motion. These structures collectively facilitate mobility and bear the entire body’s weight during daily activities.
Common Mechanical and Overuse Causes
Pain in the knees and ankles frequently stems from mechanical issues or overuse, which can lead to various conditions.
Osteoarthritis, a common form of arthritis, occurs when the protective cartilage cushioning the ends of bones gradually wears away over time. This degeneration can cause pain, stiffness, tenderness, and a grating sensation in affected joints like the knees and ankles, especially during or after movement. If the cartilage fully erodes, bone may rub directly against bone, leading to increased pain and reduced mobility.
Sprains involve the stretching or tearing of ligaments. Ankle sprains are common, often resulting from a sudden twist or roll of the foot. Knee sprains can occur when ligaments are forced to stretch too far. Strains refer to the stretching or tearing of muscles or tendons. Both injuries often present with pain, tenderness, swelling, and difficulty using the affected area.
Tendinitis is tendon inflammation, often caused by repetitive movements, leading to pain and tenderness near the affected joint. Bursitis involves inflammation of bursae, fluid-filled sacs that cushion joints, making activities painful.
Meniscus tears are common knee injuries to the C-shaped cartilage. These tears often result from twisting movements of the knee and can cause pain, swelling, stiffness, or a sensation of the knee locking or giving way.
Inflammatory and Systemic Conditions
Beyond mechanical issues, certain inflammatory and systemic conditions can also cause aches in the knees and ankles, often affecting multiple joints simultaneously.
Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system mistakenly attacks the lining of the joints, known as the synovium. This attack leads to inflammation, causing pain, swelling, stiffness, and warmth in the affected joints. RA can affect various joints, including those in the feet and ankles, and symptoms often appear symmetrically, meaning the same joint on both sides of the body.
Gout is a type of inflammatory arthritis resulting from the buildup of uric acid crystals in a joint. While it most commonly affects the big toe, gout can also cause sudden, severe pain, swelling, redness, and tenderness in other joints, including the ankles and knees. Psoriatic arthritis (PsA) is another chronic autoimmune condition that can cause joint inflammation, often occurring in individuals with the skin condition psoriasis. PsA symptoms can include pain, swelling, and stiffness in various joints, such as the knees and ankles, sometimes affecting fingers and toes with “sausage-like” swelling known as dactylitis. This condition can also involve inflammation where tendons or ligaments attach to bone, known as enthesitis, which is common around the ankle.
Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and tenderness. While not an inflammatory joint condition, it can cause persistent aching and stiffness throughout the body, including in the knees and ankles. These systemic conditions require a different approach to diagnosis and management compared to mechanical injuries, as they involve broader bodily processes that affect joint health.
When to Seek Professional Medical Advice
While some knee and ankle aches can be managed with self-care, certain symptoms indicate the need for professional medical evaluation. A healthcare provider can conduct a physical examination, and recommend imaging tests like X-rays or MRI, or blood tests to determine the cause of the pain and guide appropriate treatment.
You should seek medical attention if you experience:
- Severe pain, especially after injury, or if pain worsens or doesn’t improve with home treatment.
- Sudden or significant swelling, redness, or warmth around the joint.
- Inability to bear weight, difficulty moving the joint, or a noticeable deformity.
- Numbness or tingling in the limb, or joint instability.
- Joint pain accompanied by fever or general unwellness.
Strategies for Managing Aches and Supporting Joint Health
Managing mild aches and promoting overall joint health involves several practical strategies.
The RICE method—Rest, Ice, Compression, and Elevation—is a widely used approach for acute injuries like sprains and strains. Resting the injured area helps prevent further damage, while applying ice reduces swelling and pain. Compression with an elastic bandage can help limit swelling, and elevating the limb above heart level promotes fluid drainage.
Engaging in gentle stretching and strengthening exercises, when appropriate and not exacerbating pain, can improve joint flexibility and support. Maintaining a healthy weight significantly reduces stress on weight-bearing joints like the knees and ankles. Every kilogram of excess weight can add approximately four kilograms of extra stress on the knee joints, and even modest weight loss can substantially reduce pain and slow joint degeneration.
Wearing supportive footwear with adequate cushioning and arch support can help distribute weight evenly and absorb shock, reducing strain on the knees and ankles. Avoiding activities that consistently trigger or worsen pain can prevent further irritation to the joints.