What is Causing My Ankle Pain?

Q: When I wake up in the morning, the back of my ankle is sometimes sore and red. What could be going on?

A: Ankle injuries are common and don’t just happen to people who play sports. While there are several types of injuries, including sprains and fractures, your injury sounds like it could be a tendinopathy.

Tendons connect muscles to bones and help stabilize and protect the ankle. When they become persistently swollen and painful without any injury, we are often dealing with a process called tendinopathy. Over the past several years the term tendinitis has fallen out of favor because we have learned that the underlying pathologic process is usually degenerative in nature and not inflammatory.  The two most commonly involved tendons in the ankle are the peroneal and posterior tibialis tendons.  Chronic overuse and/or misuse of these tendons leads to degeneration and dysfunction, causing you to have pain or limitations in activity levels.

Initial treatments for this type of tendon injury are resting, applying ice and taking a nonsteroidial anti-inflammatory drug (NSAIDs), such as aspirin or ibuprofen. Once the ankle starts to feel better, you can slowly increase back to your normal activities. If it starts hurting again, you may want to see your family physician or a sports medicine physician to see if you’re doing something incorrectly, whether it’s the way you’re walking or using the elliptical trainer.  Furthermore, evaluation can rule out other diagnoses that may seem a tendon problem.  Furthermore, a doctor or physical therapist may recommend specific exercises in order to treat these types of problems.

By Douglas Connor, MD, sports medicine physician, ThedaCare Ortphopedics Plus in Appleton.