Orthopedics-Online

Outer ankle pain

introduction

Outer ankle pain is very common. The foot and ankle are a very heavily used structure and can quickly cause discomfort due to incorrect and excessive stress. Just wearing the wrong shoes or twisting your foot can lead to pain in the outer ankle area.

The pain is often short-lived, but in some cases a torn ligament or broken bone can be the cause of the pain, so that further treatment is necessary.

Causes of external ankle pain

The causes of pain in the area of the outer ankle are very diverse. Many sports, especially jogging or jumping, which result in long-term overstressing of the foot, can cause pain in the outer ankle.

The skin, muscles and bones are very sensitive, so even light blows or kicks can lead to pain. Wearing the wrong shoes or walking for long periods on restless ground can also lead to pain.

Accidents can also be a cause, for example if you twist your foot inward. If it comes to torn ligaments or broken bones, the pain can increase.

Read on below: Tendinitis on the ankle

Peroneal tendon syndrome

Peroneus tendon syndrome is inflammation of the tendons of the long and short fibula muscles (m. Peroneus longus and brevis). These muscles are located on the lateral lower leg and lead around the outer ankle and then attach to the metatarsal bone. On the one hand, they stabilize the arch of the foot and also have functions in the most varied of foot movements.

Incorrect or excessive strain can lead to inflammation of these tendons, which leads to pain in the outer ankle. These occur mainly when there is stress, especially when lifting the inside of the foot. In the case of a chronic syndrome, they also appear at rest and there is swelling and redness in the area of the outer ankle.

Peroneus syndrome is treated by relieving the tension on the tendon, which is usually done with the help of a splint or bandage. This immobilization allows the tendon to regenerate. Taking pain reliever and anti-inflammatory drugs can also help.

Ligament injury

An external ligament injury often occurs as a result of what is known as a distortion trauma. The foot kinks inwards so that the ligament on the outside of the ankle is overstretched. This can happen when simply twisting an ankle on the curb or when playing soccer.

You might also be interested in: Ankle twisted - what to do?

Strictly speaking, the outer band is not just a band, but a construct of several different bands with different starting points. These stabilize the ankle during movement. In most cases, only one or more ligaments are overstretched with no further consequences.

If it is stretched too much, the outer ligament can tear and lead to severe pain in the outer ankle. The stability in the ankle is lost and the patients are often no longer able to put their feet down.

Read on below: Outer ligaments of the foot

Bone splintering at the outer ankle

If the outer ligament ruptures as part of a twisting accident, part of the bone can also be torn off. This depends on the substance of the bone and ligaments as well as the dynamics of the accident.

The ligaments on the outside of the ankle attach to the metatarsal and fibula in different places. If overstretched, they can either tear in the middle or tear out at the attachment points on the bone. This is also the reason why an X-ray of the ankle is often requested to rule out bone chipping.

Learn more at: Outer malleolus fracture

Accompanying symptoms of pain in the outer ankle

If there is pain in the outer ankle as part of an accident, the following symptoms also often occur:

Swelling,
Bruise,
possibly abrasions.

A ligament injury can also cause the following symptoms:

Instability in the ankle,
Pain when stepping on,
Restricted mobility,
Changes in gait pattern,
Inclination of the foot.

Swelling and pain in the outer ankle

In most cases, as a result of the ankle twisting and a possible external ligament injury, there is also a bruise formation, which is noticeable as a significant swelling in the outer ankle. This is often accompanied by a bluish discoloration caused by bleeding.

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The swelling can be so pronounced that the patient no longer fits into the shoe. It is also typical that the swelling only appears after a short period of time after the accident, often at night.

Direct cooling of the area can prevent the swelling from progressing. The swelling usually lasts for a few days.

What does pain in the outer ankle without swelling indicate?

A swelling of the outer ankle is not always necessarily present if there is pain at this point.

If there is only pain in the outer ankle without swelling or without a previous accident, the cause of the pain may be in the bone or tendons. Tendonitis is usually accompanied by no swelling.

In most cases, osteoarthritis of the ankle is also associated with no swelling. If the pain persists for a long time or if it gets worse, further medical evaluation and diagnosis should be carried out.

In general, the tendency to swell often depends on the characteristics of the patient. Some people get massive swelling after just twisting their ankle, others don't get any swelling even with a torn outer ligament.

You can also find out more at: Ankle pain

Diagnosis of pain in the outer ankle

In the case of pain in the outer ankle, the first thing that is usually done is a detailed medical history and a physical examination by the doctor. He performs various tests on the foot, which allows him to test the stability of the ankle and the function of the muscles.

In most cases, an X-ray of the foot is then taken to detect or rule out possible fractures or torn bones.

In most cases this is already sufficient to diagnose a strain and to treat it. However, if symptoms persist, an MRI can be done later. The MRI can be used to examine the ligament structures of the foot and diagnose possible cracks.

Therapy for pain in the outer ankle

Treatment for external ankle pain depends on the underlying condition.

If the cause is a sprained ligament due to an ankle twisting of the foot, it is usually treated conservatively. Direct therapy should be by cooling the joint to counteract swelling.
Then an ankle orthosis is put on to stabilize the foot. This orthosis is kept on day and night for about 6 weeks. As far as possible, the foot should be loaded normally, but sport should be avoided for the time being. In the case of severe pain, taking pain reliever medication can also be helpful. Kinesio tapes can also help.

Learn more about this at: Orthosis - Application and Benefits

A tear in the outer ligament is treated in a similar way. Here, too, the treatment is initially conservative using an ankle orthosis and pain reliever medication. If the outer ligament ruptures, however, the foot should initially not be loaded. Therefore, the patients are treated with crutches and thrombosis injections. The foot should not be loaded for the next 6 weeks so that the crack can regenerate completely.

Then you can begin gradually with the exercise.
If the injury is more severe and has also torn bones or the like, an operation may be necessary. During the operation, the ends of the band are sewn back together and the bone fragments are reattached with screws. Then the foot is put on a plaster of paris and left for several weeks.

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Operate the lateral fracture of the ankle
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Taping for pain on the outer ankle

Using kinesiotape can help with recovery. Kinesio tapes are stuck to the skin in the direction of movement of the muscles and provide traction in the affected area. Due to this pulling force, the underlying tissue is better supplied with blood and therefore leads to better healing.

In the case of ligament injuries, it can also help to strengthen the stability of the ankle. Tapes can also relieve symptoms of chronic pain. The tape should be applied by an experienced expert, e.g. a physiotherapist or orthopedic surgeon.

Bandage / orthosis for pain in the outer ankle

An ankle bandage, also known as an orthosis, is often used for injuries to the ankle. It leads to relief and stabilization of the ankle. This is very important, especially if the ligament is torn. The mechanical compression also leads to pain relief and swelling.

The bandage is usually worn day and night. Movement is only slightly restricted by the orthosis, so that patients can also put full weight on their feet with the orthosis. There are different forms and often it is not necessary to buy new shoes.

There are also special orthoses that are worn during sports. This is particularly helpful for athletes who frequently twist their feet or have discomfort in their ankle.

How long does pain in the outer ankle last?

The time it takes to heal depends on the type of injury to the outside of the ankle.

If there is an external ligament strain, those affected are usually symptom-free again after 6 weeks. In the case of an outer ligament tear, the healing time can be somewhat longer, depending on how severe the tear is.

Healing takes a few months for broken bones. However, you can usually start to put weight on your foot after just 6 weeks.

In the case of tendinitis, patients are often pain-free again after a week with adequate cooling and rest.
If the cause of the pain is arthrosis of the ankle, the pain can persist for a long period of time from several months to years.