Ankle Pain

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Achilles tendonitis (also known as Achilles tendinopathy or Achilles tendinosis) is an overuse injury causing pain, inflammation and or degeneration of the achilles tendon at the back of the ankle. If not caught early this can be a difficult injury to cure but with the right treatment and particularly eccentric strengthening exercises a full recovery can usually be achieved.


The main cause, particularly in older athletes is degeneration or wear and tear of the tendon.

A number of factors make the athlete more likely to sustain an overuse Achilles tendon injury:

  • Foot biomechanics
  • Incorrect footwear
  • High heels
  • Training
  • Uphill / treadmill running

Signs & Symptoms


  • Onset of Pain at the back of the Ankle, just above the heel bone
  • Achilles Tendon stiffness and pain in the morning or at the start of exercise
  • Lump/nodule in the Tendon
  • Painful to the Touch


  • Constant pain during exercise
  • Pain when walking uphill / upstairs
  • Affects Performance



A sprained ankle is one of the most common sports injuries and is also the most frequently re-injured. In the majority of cases the ankle rolls inwards (inversion) under the weight of the rest of the body, resulting in damage to the ligaments on the outside of the ankle.


Ankle sprains usually occur as a result of either a sudden twisting or rolling action of the ankle during either contact (tackles) or non-contact situations. The most commonly injured structures are the lateral ligaments, however other tendons, muscles, nerves and bones can also be injured depending on how bad the injury is. There are a number of causes of ankle sprains and these include poor proprioception, previous injury history and inappropriate footwear.

Signs & Symptoms

Grade 1:

  • The injured person can still walk, although with some degree of difficulty.
  • There may be some swelling, stiffness, and pain.
  • There is only minor tearing of the ligaments. A common analogy is comparing a ligament to a piece of tissue paper. In a Grade 1 injury there are only minor tears in the tissue.
  • The ankle joint remains quite stable. This stability will be evident with stress testing (Anterior Drawer Test, and Anterior Tilt Test).

Grade 2:

  • The injured person may experience considerable difficulty when walking and could be in severe pain. There may be swelling and some degree of bruising.
  • There is a moderate amount of tearing of the ligaments. To use the tissue analogy, there will be a significant amount of tears in the tissue.
  • The ankle will become somewhat unstable. This instability is evident on stress testing (with increased anterior motion showing on the Anterior Drawer Test and indicating an ATFL tear).

Grade 3:

A Grade 3 Sprain is a complete tearing of the ligament. To use the tissue analogy, the tissue is now torn into two pieces. This type of sprain may require surgical intervention to reattach the ligament. In most cases a conservative period of therapy will be tried for about six weeks before surgery is considered.