Chronic Ankle Pain and What to Do About It

Chronic Ankle Pain

Chronic ankle pain is any long-term soreness or tenderness in the ankle or in the adjacent areas of the foot or lower leg. Associated symptoms can include:

  • Inflammation
  • Limited range of motion in the foot and ankle.
  • Lack of mobility in the foot.
  • Low tolerance to standing or bearing weight on the foot and ankle.
  • Bruises or other signs of injury.

The most common cause of ankle pain is a sprained ankle, which is a ligament tear that is usually brought on by sports injuries or by the ankle getting twisted while walking on unlevel surfaces. There can be other triggers like a fracture, infected tissue, arthritic condition or other trauma. Pain can be felt in one or both ankles.

Fortunately, when your ankle sustains one of these painful injuries, it can recover rapidly with the right combination of rest and therapy. On the other hand, if you’re still struggling with chronic ankle pain from an injury even after it should be fully healed, you might be dealing with one of the following problems:

Nerve Damage

Nerve damage after sustaining ankle fractures is extremely common and frequently misdiagnosed. A lot of patients are told by their treating physicians that if the injury has healed properly, there shouldn’t be any pain. But there is always a cause for ankle pain, and the trouble most likely is due to a nerve injury in the area near the ankle.

It’s vitally important to seek advice for your chronic ankle discomfort from a specialist with adequate education on the diagnosis and treatment of a nerve injury.


Arthritis involves pain due to irritation of the joint lining or the articular cartilage. This inflammation and rigidity of the joints can show up several years following an ankle injury. Post-traumatic arthritis strongly parallels osteoarthritis and can create pain along with a reduced range of motion in the joint.


Any time an ankle fractures so that the bone is visible poking out of the skin, the risk of it becoming infected raises dramatically. This is why doctors typically prescribe antibiotics online whenever this kind of break occurs. Surgery complications may also cause it to become infected, and treatment might require another operation to remove any metal implants from your ankle. With regard to closed fractures, on the other hand, the chance of infection is under 2%.

Two of the most common causes of ankle injuries becoming infected are cellulitis in the transdermal tissue and osteomyelitis in the bones. Other causes include a tear in the skin due to an animal bite or ulceration. People with diabetes or who have a compromised immune system due to HIV/AIDS or immunosuppressive drugs carry an increased chance of getting infections.

Compartment Syndrome

This happens when an ankle is subjected to stress or tension after the muscles have already been injured. This pressure damages the nerves and capillaries due to the high amount of pressure in the area. Compartment syndrome is most commonly a result of major injuries like those sustained in car crashes.

Get Help From a Qualified Physician

If you’re suffering from chronic ankle pain associated with any of these potential causes after your injury, please schedule a visit with Dr. Lev Kalika at his New York practice by phone at 1-866-330-6445.


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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