What’s Wrong With My Ankle?

When it comes to the ankle, typically we are dealing with either a hypermobile (moves too much) or hypomobile (moves too little) structure.  With the case of the former, you may be dealing with recurrent ankle sprains, and with the latter you may be dealing with pinching pain or your ankle/foot just “gets stuck” sometimes.  Either scenario is not fun, and needs to be addressed to prevent long-term issues.  Let’s dig in.

First and foremost, we want to make sure you don’t have a fracture after an acute ankle injury.  To rule this out, we use the Ottawa Ankle Rules, which state there should be no bony tenderness along the lower portion of the inner and outer ankle bones, and you should be able to weight bear immediately after injury as well as be able to walk 4 steps during your evaluation (ideally a few days later so that the inflammation has decreased).  If any of these are positive, this warrants an ankle X-ray to rule out a fracture.

When we are certain there is no fracture, then we are looking at the numerous bones of the ankle/foot as well as ligaments, nerves, and muscles.  Regardless of if there is muscle, nerve, or ligament involvement, we will need to first address pain and mobility.  To do that, here are a couple of joint-mobilization and stretching techniques to try:

Dorsiflexion Joint Mobilization: Place a heavy resistance band at the ankle joint, then proceed to lean forward (within pain free range) while keeping your heel on the ground.  Perform gentle oscillations for 3-5 seconds at your end range, and complete 10 repetitions.

Gastrocnemius Stretch: Deemed “the calf stretch,” this one can be really effective if done properly.  The key is to keep your heel on the ground while not allowing your foot to cave inward.  This is prevented by keeping your knee in-line with your second toe throughout the stretch.  Stay within pain-free range, and perform 3x30 seconds.

Soleus Stretch: This one has the same positioning as the above stretch, though we will be bending the knee (while still keeping the heel on the ground and the knee in-line with your second toe).  This will give you a stretch in the lower leg and ankle.  Perform 3x30 seconds within pain-free range.

Remember to always ease into activity so as not to irritate the injured site.  These are general exercises and not meant for your specific condition.  Feel free to reach out to get help with your specific condition!

Best Regards,

Dr. James