Pain on the outside of your ankle can be caused by a number of problems: arthritis, sports injuries, fractures, sprains, repeat ankle sprains, or tendonitis. Most ankle injuries are the result of trauma, a sports collision, or a sudden forceful twisting, but can also be the result of overuse. Contributing factors are improper or insufficient athletic conditioning, obesity, repeat injury, aging, arthritis, and unsupportive footwear.
To help describe your foot pain, see our ankle diagram here.
Lateral Ligament Strain
The three lateral ligaments on the outside of the ankle are most often injured while playing sports. A tear, rupture or strain occurs when the athlete makes a sudden change of direction, especially on an uneven surface like sand. It also might happen when one player lands on the foot of another. This can cause the ankle to roll inwards and backwards, overstretching the ligaments. Sharp pain, swelling, and bruising accompany the strain, and an inability to bear weight.
This one is pretty obvious. It usually occurs when you roll your ankle playing sports. But it can also be not so obvious, like when you roll your ankle stepping off a curb and you don’t feel the pain until hours later. No matter how minor the ankle sprain, it must be treated correctly to heal correctly. Untreated ankle sprains create weak tendons and ligaments which lead to… more ankle sprains. You may experience pain, bruising, tenderness, swelling, or a decreased range of motion.
Dr Teichman from PA Foot And Ankle Associates describes why you need to have every ankle sprain treated by a physician, no matter how minor.
A fracture usually creates pain with every step, and may be accompanied by swelling, bruising, and tenderness. A fracture can be caused by sports injury, trauma, aging, or from overuse.
The ankle joint becomes dislocated (separates) due to trauma from a sports injury or a high fall. Symptoms are severe pain, swelling, loss of function, or an obvious deformity if one or more fractures accompany the dislocation.
The Peroneal tendons run down the outside of the ankle joint and attach to the bones in the foot and ankle. These tendons can become inflamed if you’re performing an activity in which the ankle consistently rolls outward (like when you’re running in past-their-prime, unsupportive running shoes). The outside of the ankle will slowly become painful, and there may be a burning feeling. The area above the tendon may become swollen and tender.
Peroneal Tendon Rupture
Pain comes quickly when this tendon is ruptured, along with significant weakness in the ankle and a loss of function. When the tendon snaps or tears, it may actually be audible, and swelling, bruising, and tenderness may accompany it.
Peroneal Tendon Subluxation
Caused by the tendon moving out of its normal position, creating discomfort, pain, and an ache over the ankle bone. Swelling, bruising, and tenderness may accompany the injury.
Sinus Tarsi Syndrome
Quite common in those with flat feet. The Sinus Tarsi is a small bony structure on the outside of the ankle joint, and inside the canal is a small ligament which helps to hold the ankle together. It’s this ligament which is the source of the pain, which can be hard to pinpoint, as it may be felt from the outside of the ankle to the front.
Anterolateral Impingement Syndrome
This is a result of repeated sprains of the ankle. Pain may be felt over the bone which protrudes from the ankle, and the ankle will click or feel like it’s catching. Pain will increase with weight bearing.
Any ankle pain, even if minor, needs to be diagnosed by a podiatrist or podiatric surgeon if it occurs repeatedly, or if it can’t be relieved with ice, rest, and over the counter anti inflammatory pain medicine such as ibuprofen (advil). If you continue to walk, run, or otherwise put weight on an already injured ankle, the injury may become much worse, or become a chronic condition.
Until you see a podiatrist, employ the RICE treatment: Rest, Ice, Compression, Elevation. Rest the ankle as much as possible, preferably in an elevated position. If swelling occurs, ice for 20 minutes at a time, with a wet towel or cloth between the ice and your skin. Use an elastic bandage around the ankle for support when necessary.