What is ankle pain?
The Achilles tendon is the combined tendon of the two calf muscles, the gastrocnemius and soleus.
Despite being the strongest tendon in the body, it can sometimes be overloaded, which causes discomfort and even pain.
Two common conditions affecting the ankle are achilles pain and an ankle sprain.
Dealing with Achillies Pain
The Achilles is painful and swollen because it has been overloaded, i.e. it is too weak to cope with the load it is placed under. Rest is only going to make matters worse as the Achilles will get even weaker if rested.
So, the treatment of Achilles tendinopathy is very simple: the Achilles strengthening exercise, which in most cases will resolve the problem
This exercise may be painful to start with, but must be done once every other day and should be viewed as a three months treatment. Increase repetitions e.g. 3 sets of 11, 12, 13.. as able.’
Adjusting your daily activities and reducing or even stopping the activity that has caused your problem will also help. For example, runners should stop running for the first six weeks of the Achilles strengthening exercise, then gradually re-introduce running.
Avoiding Achilles Pain
You can avoid developing Achilles pain by performing strengthening exercises regularly. Footwear also plays a big part in the prevention of Achilles pain, so you should make sure that the shoes you have are supportive and appropriate for the activities you use them for, and also fit properly.
What is an ankle sprain?
An ankle sprain refers to tearing of the ligaments of the ankle. The most common ankle sprain occurs on the outside part of the ankle. This is an extremely common injury which affects many people during a wide variety of activities.
What are the symptoms of an ankle sprain?
Patients report pain after having twisted an ankle. This usually occurs due to an inversion injury, which means the foot rolls underneath the ankle or leg. It commonly occurs during sports. Patients will complain of pain on the outside of their ankle and various degrees of swelling and bleeding under the skin (i.e. bruising). Depending on the severity of the sprain, a person may or may not be able to put weight on the foot. If you are unable to put weight through the foot you may need to seek medical attention.
If the injury is minor, you can look after yourself by using "PRICE therapy" this is described below.
PRICE stands for:
Protection – protect the affected area from further injury by using a support or, in the case of an ankle injury, wearing shoes that enclose and support your feet, such as lace-ups.
Rest – stop the activity that caused the injury and rest the affected joint or muscle. Avoid activity for the first 48 to 72 hours after injuring yourself. Your GP may recommend you use crutches.
Ice – for the first 48 to 72 hours after the injury; apply ice wrapped in a damp towel to the injured area for 15 to 20 minutes every two to three hours during the day. Don't leave the ice on while you're asleep, and don't allow the ice to touch your skin directly because it could cause a cold burn.
Compression – compress or bandage the injured area to limit any swelling and movement that could damage it further. You can use a simple elastic bandage or an elasticated tubular bandage available from a pharmacy. It should be wrapped snuggly around the affected area, but not so tightly that it restricts blood flow. Remove the bandage before you go to sleep.
Elevation – keep the injured area raised and supported on a pillow to help reduce swelling. If your leg is injured, avoid long periods of time where your leg isn't raised.
Self refer into our service
It is important that you apply the advice and guidance provided above for around 8 weeks by which time we would expect you to notice improvement and in some cases complete recovery. If not, we have a team of trained physios who can help.
Think you need more urgent or emergency treatment? Follow the below guidance to see if you need to see someone quicker.
Physiotherapy Triage Red flag re-direction of patients to A&E/GP consultation
IMPORTANT 'Cauda Equina Syndrome’ although rare, can cause a permanent change to your bladder and/or bowel function, or foot strength.
IF you are suffering with low back pain and if you have any changes regarding the following since your pain started;
- Bladder or bowel function (i.e., Increasing difficulty when you try to urinate, increasing difficulty when you try to stop or control your flow of urine, loss of sensation when you pass urine, leaking urine or recent need to use pads, inabilityof knowing when your bladder is either full or empty, inability to stop bowel movement or leaking, loss of sensation when you pass a bowel motion)
- Loss of sensation/tingling around genitals, back passage, buttocks or inner thighs • Erectile or ejaculation problems or loss of sensation in genitals during sexual intercourse
- Loss of sensation/ tingling or numbness in both legs
- Weakness in foot (i.e. floppy foot or inability to lift front of foot when walking)
If YES call NHS 111 or go to A&E IMMEDIATELY
If you are suffering with low back pain and if you have any of the following;
- History of cancer
- Unexplained weight loss
- Feeling generally unwell/fever/lack of appetite
Please contact with your GP as soon as possible to discuss if other investigations are required rather than self-referring to physiotherapy.
You can also visit your GP for more information and advice on;
- Women's and men's health including pelvic floor and incontinence
- If you have had a series of falls and want to learn more to help avoid them
- If you have reduced mobility and require a stick or frame
- If you require neurological support for example if you have had a stroke or Parkinson's
- If you are housebound
- If you are under 16 years old