10 Reasons Why You Might Be Experiencing Chronic Ankle Pain

chronic ankle pain

Chronic pain of any kind can greatly reduce an individual’s quality of life and chronic ankle pain is no different. If you experience chronic ankle pain, you probably have difficulty walking, standing, or making the necessary movements you need to get through the day.

But what might be worse than chronic pain in the ankles is not understanding why you are experiencing such debilitating pain each and every day. Here are ten of the most common reasons an individual might experience chronic pain in the ankles:

1. Bone Fracture

There are dozens of tiny bones in your ankles and feet that you may not even recognize have been broken. If you land on your ankle incorrectly or twist your ankle into an unnatural position, you may have created a micro fracture in one of these tiny bones. Because they are so small and may go unnoticed, they often don’t get the treatment they need. It can take a while for them to heal on their own or they may not heal properly at all. This could lead to chronic pain in your ankles.

2. Nerve Injury

Nerve injury can occur when the nerves in your feet and toes have been pinched, twisted, torn, or stretched. While it may seem like this kind of damage is difficult to sustain, it can actually occur from a pretty common activity. When your nerves are damaged, it sends messages back to the brain to let you know something is wrong. These messages could be one of your chronic ankle pain causes.

3. Nerve Pressure

Unlike nerve injury, nerve pressure occurs due to a pinch of the nerves. In this situation, your nerve isn’t damaged, but there is something leaning against the nerve that is preventing it from working properly. Again, the nerves send signals back to your brain to let it know something needs to be fixed in the form of pain.

4. Sprains

Unlike a break of the bone, a sprain is characterized by damaged done to the ligaments, or the pieces of tissue that hold your bones together. The damage usually involves a stretching or tear of the ligaments but in most cases, the pain only lasts a minimal amount of time. Unfortunately, if the sprain is particularly bad or it has not been treated correctly, a sprain may heal incorrectly or it may not heal at all. This can be a source of chronic pain in the ankles.

5. Strains

Similar to a sprain, a strain is identified as damage to the tendons, which are the pieces of tissue that connect your muscles and your bones. If too much pressure is put onto your ankle, the tendons may become weak and become damaged. Strains are just one of the chronic ankle pain causes.

6. Osteoarthritis

Osteoarthritis occurs when the cushioning between your joints begins to break down due to incorrect use of your joint or from repetitive movements in the joint. When the cushion is gone, the bones of the joint are prone to rubbing together, which can cause things like swelling, inflammation, and pain. It can also make movement difficult, which can lead to chronic pain in the ankles.

7. Rheumatoid Arthritis

Unlike Osteoarthritis, rheumatoid arthritis is a condition that occurs in the autoimmune system. With rheumatoid arthritis, the cartilage between the bones begins to eliminate because it is attacked by the immune system, even though it is healthy. When the cartilage is gone, like osteoarthritis, it can cause pain in the joints, including chronic pain in the ankles.

8. Damaged Tendons

The pain of a damaged tendon is similar to that of a strain, but even the most minimal amounts of pressure or strain on a tendon can lead to chronic pain in the ankles, especially if it does not heal properly. A damaged tendon can cause your ankle to feel tense or stiff, which can make moving difficult.

9. Synovial Inflammation

Synovial fluid is created by the body to help lubricate joints. But when there is too much fluid in the body, it can actually cause the joints to swell and become inflamed. This can be a painful experience and can even cause chronic pain in the ankles.

10. Scar Tissue

If you have had an ankle injury in the past, the scar tissue created by the body after that injury could be causing you chronic ankle pain. Scar tissue is thicker than regular tissue, making movement difficult and cause your ankle to need to work in overtime to move the scar tissue. This can be painful.

Regardless of your reason for having chronic pain in your ankle, be sure to get it checked out and treated.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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