The ankle is a highly complex joint that plays an essential role in movement, balance, and weight-bearing. It must withstand constant force, adapt to uneven surfaces, and provide stability with every step. Because of these demanding responsibilities, the ankle is particularly prone to injury and degenerative change.
Whether caused by a sudden sports incident, repetitive strain, chronic instability, arthritis, or tendon dysfunction, ankle pain can significantly impact mobility, daily comfort, and confidence in movement.
At Foot Foundation, clinicians combine podiatry and physiotherapy expertise to provide comprehensive diagnosis and evidence-based treatment for all forms of ankle pain. Using advanced therapies, modern assessment techniques, and a personalised rehabilitation approach, our team supports patients through every stage of recovery.
Why Ankle Pain Occurs
The ankle is built to handle high levels of stress — often several times a person’s body weight during walking or running. When joint mechanics, footwear, muscle balance, or loading patterns are disrupted, the structures around the ankle can become irritated or injured.
Contributing factors may include:
Poor foot posture or biomechanical alignment
Previous ankle sprains that never fully recovered
Weakness in stabilising muscles
High-impact sport or occupational activity
Age-related changes in cartilage and tendons
Unsupportive or worn footwear
Identifying the underlying cause ensures targeted treatment and prevents long-term complications.
Common Causes of Ankle Pain
1. Ankle Sprains
Ankle sprains are among the most common lower-limb injuries. They occur when the ligaments are stretched or torn, usually due to rolling or twisting the ankle.
Symptoms may include:
Sharp pain immediately after injury
Swelling and bruising
Difficulty weight-bearing
A feeling that the ankle is unstable or “giving way”
Even mild sprains require proper rehabilitation to prevent chronic problems.
2. Chronic Ankle Instability
Chronic ankle instability develops when previous sprains are not fully rehabilitated, causing the ligaments to remain weak or stretched.
Common signs include:
Frequent ankle rolling
Ongoing discomfort around the joint
Reduced strength or balance
Difficulty trusting the ankle on uneven ground
Without intervention, instability can lead to tendon irritation, cartilage wear, and further ligament damage.
3. Ankle Arthritis
Arthritis occurs when the cartilage in the ankle joint wears down, often due to previous trauma or long-term biomechanical stress.
People with ankle arthritis may experience:
Deep, aching pain
Stiffness after periods of rest
Swelling or joint thickening
Reduced mobility, particularly on inclines or uneven surfaces
Early management helps maintain mobility and slow progression.
4. Osteochondral Lesions
Osteochondral lesions affect the cartilage and underlying bone in the ankle, most commonly following a sprain or impact injury.
Symptoms may include:
Deep ankle pain that worsens with activity
Clicking or catching in the joint
Persistent swelling
Reduced ankle confidence or stability
These lesions often require imaging to confirm diagnosis.
5. Posterior Tibial Tendon Dysfunction (PTTD)
The posterior tibial tendon supports the arch of the foot and stabilises the ankle. When the tendon weakens or becomes inflamed, the arch can collapse, leading to flatfoot and progressive pain.
Symptoms may include:
Pain along the inside of the ankle
Swelling around the tendon
Difficulty standing on tiptoes
Increasing flattening of the foot
Fatigue or instability during walking
PTTD is progressive, making early diagnosis essential to preventing long-term deformity.
When to Seek Assessment for Ankle Pain
Professional assessment is recommended if:
Pain lasts longer than one to two weeks
You experience recurrent ankle rolling
The ankle feels weak, stiff, or unstable
Swelling persists or worsens
Pain affects walking, sport, or daily tasks
You notice changes in foot posture or arch height
Accurate diagnosis is the first step toward effective rehabilitation.
How Foot Foundation Assesses Ankle Pain
Foot Foundation uses a comprehensive assessment approach to ensure the underlying cause is identified and treated appropriately.
Clinical and Biomechanical Assessment
This includes evaluating ankle alignment, muscle strength, joint mobility, and functional movement patterns.
Gait and Movement Analysis
Walking and running assessments help identify how the foot and ankle behave under load.
Functional Strength and Balance Testing
These tests identify weaknesses or imbalances that may contribute to pain or instability.
Imaging Referral (when required)
X-ray, ultrasound, or MRI may be recommended for complex or persistent conditions.
Evidence-Based Treatment at Foot Foundation
Treatment is tailored to the individual and may include:
Custom Orthotics
Orthotics help correct biomechanical issues, improve stability, and reduce strain on the ankle.
Shockwave Therapy
Effective for chronic tendon and ligament issues, shockwave therapy stimulates tissue healing and reduces pain.
Strengthening and Rehabilitation Programmes
Structured exercise plans aim to:
Improve ankle strength and stability
Enhance balance and mobility
Prevent future sprains
Support return-to-sport goals
Manual Therapy and Joint Mobilisation
Hands-on techniques may improve mobility and reduce stiffness.
Strapping and Bracing
These provide short-term support during recovery or return to activity.
Collaboration With Specialists
For severe arthritis, complex instability, or osteochondral lesions, Foot Foundation works closely with orthopaedic and sports medicine specialists to ensure the most appropriate care.
Treatment is offered at all Foot Foundation clinics: Pinehill, Takapuna, Remuera, Botany, Hamilton, and Tauranga.
Preventing Ankle Pain
Prevention strategies include:
Completing full rehabilitation after any ankle injury
Wearing supportive footwear
Strengthening the peroneals, calves, and intrinsic foot muscles
Avoiding sudden increases in training intensity
Improving balance and proprioception
Maintaining good ankle mobility
These measures help protect the joint and reduce the risk of reinjury.
