Physical Therapy for Painful and Injured Ankles


Your ankles play an important role in movement and stabilization of your entire body, and injury is not only painful but can be severely debilitating. Poor ankle function can limit your ability to walk, run and jump, and an unstable ankle can set you up for an injurious fall.

In addition to contributing to movement, your ankle joint, along with your foot, creates a foundation for a kinetic chain of joints and body segments that affect one another when standing or during movement. Because your ankle is at the base of the chain, dysfunction can move up the chain to affect your knee, hip and spine, throwing your posture out of alignment. Likewise, dysfunction higher up on the chain can affect your ankle function, leading to injury.

There are many approaches to treating ankle pain and injury, but they often only address the pain and zero in on the injury site itself. However, ankle pain and injury often result from broader issues that set you up for injury. If you only treat the site of your ankle pain without exploring the underlying cause that led to injury, you may be setting yourself for recurrent and more serious injuries later on.

Common Ankle Injuries

Your ankle movement and stability are governed by a complex system of muscles, bones and ligaments that allow the joint to not only carry your body weight, but to control and stabilize it in reaction to high force loads. Despite its complex structure, the ankle is a tough joint that can really take a beating. Nevertheless, injuries do occur.

Some common ankle injuries include:

  • Sprain: Damaging to the ligaments that protect the ankle and connect bones to one another, sprains are the most common type of ankle injury that can range from mild to severe. A lateral ankle sprain is most common, where the ankle rolls under the lower leg, usually during sports or when walking or running on uneven terrain. A sprain is marked by pain, swelling, bruising and instability.
  • Achilles tendonitis and rupture: A common sports injury, the Achilles tendon is the most commonly ruptured tendon in the human body. The Achilles tendon connects your calf muscle to your heel bone, and is subjected to high force loads when jumping.
  • Fracture: Less common than sprains or Achilles tears, fractures may occur at the tibia, fibula, talus or calcaneus, often as a result of powerful twisting, multi-directional forces. Pain onset is immediate and intense, and accompanied by bruising and inflammation.

Physical Therapy Treatment for Ankle Pain and Injury

An ankle injury should not be taken lightly. Once pain and inflammation are under control, a physical therapy regimen geared at strengthening and stretching the muscles that control the ankle should be undertaken. In rare cases, reparative surgery may be called for, after which physical therapy will be crucial to full recovery and function.

At NYDNRehab, we use state-of-the art technology to diagnose and treat your ankle injury. Diagnostic ultrasonography and sophisticated computer gait analysis help us determine the primary source of pain and injury. Lower kinetic chain strengthening exercises, acupuncture, and video gait retraining, along with ESWT (extracorporeal shock wave therapy), are just some of the advanced treatment strategies at our disposal to restore your ankle function.

The ankle pain specialists at NYDNRehab go beyond just treating your pain, striving to  identify and correct the underlying deficiencies that often lead to injury. Do not ignore your ankle pain. Contact NYDNRehab today for complete analysis, diagnosis and state-of-the-art treatment.



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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