Ankle injuries are extremely common, with roughly half of the Australian population sustaining at least one ankle injury at some time in their lives. In a large percentage of cases the ankle injury becomes an ongoing issue with chronic pain and limited physical activity.

Perhaps because acute ankle injuries are one of the most common sports injuries, they are often thought of as solely sports related, but they can happen to anyone, at any age, of any weight, of any level of fitness, and of any occupation.

Indeed, one study of over three million ankle injuries found just over half occurred off the sports field. In the predisposed, something as simple as losing your balance or walking on an uneven surface can cause a painful, debilitating sprain or even a bone fracture. Recurrent injury is the biggest risk factor for developing ankle osteoarthritis.

During weight bearing your foot is part of a closed mechanical chain so that what happens at the hip joint largely determines how the ankle (and knee) behaves including the forces acting on it. In this way, assessment of hip and knee mechanics is an essential part of a comprehensive ankle evaluation.

Ankle pain may arise from any one of a number of anatomical structures in the ankle, including bones, joints, ligaments, muscles, tendons, nerves and blood vessels. When diagnosing ankle pain it is essential to examine the entire lower limb and the lower back because during weight bearing your foot is part of a closed mechanical chain - what happens at the ankle, including the forces acting it, is largely determined by the mechanics of the lower back, pelvis, hip and knee joints.

The most common ankle injury is a sprain of the ligament(s) on the outer side of the ankle. Other common injuries include strain of a muscle/tendon on the outer side of the lower leg and fracture of the lower outer prominence of the leg bone.    

As the symptoms of a ligament sprain, a muscle/tendon strain and a bone fracture can be very similar, fractures are sometimes mistaken for sprains or strains. So it's important to have an acute ankle injury professionally examined as soon as possible. In the medium to long run it is important to address any underlying factors to prevent ongoing problems.

There are a number of painful conditions that occur at the back of the heel. Although this area is not part of the ankle proper, these conditions are included on this page because it is generally thought of as being part of the ankle.

Left untreated, ankle pain may lead to:

• chronic pain in other parts of the same or opposite foot;
• chronic pain elsewhere in the body, such as the knee, hip and/or lower back, due to altered gait (e.g. limping) from ankle pain.

Osteopathic treatment may relieve acute and chronic ankle pain, stiffness and other symptoms and restore function by improving range of motion; reducing fibrosis and adhesions; remodeling tissue architecture; stimulating tissue regeneration; and by improving blood supply and nerve activity.

Long term resolution can be achieved by identifying and managing underlying causative and maintaining factors. 

Ankle conditions that may respond well to osteopathic treatment include:

• Ankle sprain -“twisted ankle”;
• Peroneal tendinopathy - outer leg, ankle and/or foot pain;
• Anterior Ankle Impingement - pain at the front of the ankle;
• Posterior Ankle Impingement - pain at the back of the ankle;
• Achilles heel - pain at the back of the ankle;
• Achilles tendon rupture - sudden severe pain at the back of the ankle;
• Ankle arthritis - chronic ankle pain and instability;