Understanding sharp ankle pain. 
Find out what it is, treat it and make sure it doesn't come back.

A sharp ankle pain does is not always as bad as it may initially seem. Depending on the location of the pain and how it happened, the chances are it is probably one of the following diagnosis conditions.

Tendinopathy

If the pain came on slowly or you did not notice an exact cause of you sharp ankle pain, the chances are you have a tendinopathy. This is especially likely if you have recently increased your workload or activity levels. A tendinopathy in the ankle occurs when the tendon (connecting a muscle to bone) becomes overloaded and experience micro trauma. This micro trauma causes inflammation which is the body's attempt to heal the tissue. As the overloaded tendon becomes inflamed sometimes the inflammation causes more damage to the tendon resulting in an ongoing cycle of inflammation and pain.

Ankle sprain

If you have got a sharp pain on the outside of your ankle and you know exactly the moment it happened then the chance are you have sprained your ankle. This usually occurs on the lateral (or outside) aspect of the foot and may involve significant swelling, discolouration and pain depending on how severe the sprain was. If you have pain from a sprain on the inside of your foot, then follow this page for information about inside ankle pain.

If the ankle sprain is big enough this it is possible to completely tear the ligaments on the outside of your foot and in extreme cases can lead to fracture, although this is unlikely. If you are concerned then you have fractured your ankle then visit a medical expert immediately. Extremely sharp ankle pain, swelling above the outside ankle bone (lateral malleolus) and a complete inability to bear weight immediately after the injury could possibly sign of a fracture. 

A simple ankle sprain requires immediate treatment as well as long term rehabilitation and treatment to maintain strength, provide support and prevent further injury.

Plantar Fasciitis 

Sharp ankle pain especially first thing in the morning could be a sign of plantar fasciitis, a painful condition which affects the bottom of the foot predominately at the heel. The thick band of fascia which supports the bottom of your foot becomes thickened and inflamed, an inflammation which can make the first few steps of the day extremely painful. 

Tension through the foot, ankle and calf musculature as well as abnormal weight bearing through each leg can all contribute to the onset and progression of plantar fasciitis. Follow the videos and advice for learning how to diagnose and treat plantar fasciitis as well as learn what an osteopath or other manual therapist might do to help.

Stress fracture

If you have recently taken up a new high impact sport such as running or anything that involves jumping, or perhaps you had a particularly hard impact as you stepped of the curb one day, you might be suffering from an stress  fracture.

This injury can cause an acutely sharp ankle pain. To diagnose this it is recommended to visit you doctor who will decide if you require an x-ray or not. In most case however the best advice is to immediately cease what you were doing. Harsh it may sound, but the bone (usually the calcaneus) needs time to heel. In time, a gentle return to exercise is usually possible with no adverse affects.

Ankle osteoarthritis 

While not always associated with sharp ankle pain, ankle arthritis can in some cases be acute enough to feel like you have a knife jammed into the top of your ankle. 

Usually ankle osteoarthritis is caused by wear and tear inside the joint and present with pain at the top of your foot or front of your ankle. Symptoms are typically worse when the ankle is used a lot and will feel very stiff and sore especially in the mornings and towards the end of the day.

Wear and tear can in joint is extremely common and a natural part of life, and it does not always need to be painful. Sharp ankle pain caused by osteoarthritis is a symptom that manual therapists treat all the time. By assessing gait (how you walk) as well as imbalances through your pelvis, lower back and legs, the increased forces that have led to the arthritis can often be removed resulting minimal change to the wear and tear already done, but a massive reduction in the pain, stiffness and immobility that arthritis is so well known for.

Other types of sharp ankle pain

While nearly always associated with pain and dysfunction, the other diagnosis which can cause this sharp pain are also worth considering especially if you've got other symptoms and issues:

  • Rheumatoid, arthirits
  • Psoriatic arthirits
  • Gout
  • Bone spurs
  • Serious fracture

If you suspect that you may be experiencing any of the above in the ankle then it is strongly advised that you seek a medical expert. In most other cases however, strengthening and stretching the muscles which surround the ankle and foot as well as working on ankle balance and mobility exercises, can go a long way to healing sharp pains in ankles. 

How to treat sharp ankle pain

Once a diagnosis has been made, ankle conditions can quite often be treated at home so long as the offending stimulus or cause has been resolved. This usually means taking a break from running, changing your shoes or resolving your primary complaint i.e knee, hip, back or neck pain for example.

Treating an ankle tendinopathy

If you have got a tendinopathy then typically this type of issue can be resolved through ice to the area, soft tissue work and massage to the connected muscle, rest and plenty of stretching. If the condition persists then metabolic disturbances to your physiology such as diabetes or pregnancy might need to be addressed as long with alterations to your lower back, pelvis, hip and lower leg bio-mechanics.

Follow the guides for more information on how to treat foot ankle tendinopathies or visit a manual therapist for example an osteopath or sports therapist.

Treating an ankle sprain

We all know the acronym RICE for treating ankle sprains. Additions include PRICE and PRICED.

  • Protection
  • Rest
  • Ice
  • Compression
  • Elevation
  • Drugs (always consult your doctor before taking any painkillers)

After this initial phase the ankle needs to be reconditioned, which involes working on the four main tenets of ankle injury recovery

  • Strength
  • Stretch
  • Balance 
  • Mobilise

These component to ankle sprain treatment and rehabilitation are covered in more detail on the ankle injury and ankle exercises pages.

Treating Plantar fasciitis

Plantar fasciitis can be a stubborn condition at times but with some persistent home treatment and occasional external treatment from a trained professional, it can effectively be treated. 

Like a tendinopathy, plantar fasciitis is essentially where a thick band of fascia on the bottom of your foot becomes inflamed usually because it can't handle the forces that have been imposed on it. Quite often footwear, weight, other secondary issues such as hip, knee or back pain can throw increased force through the sole of the foot leading to continued micro trauma to the fascia. This causes inflammation leading got pain and increased damage.

Removed the inflammation is therefore key. Continued icing over several weeks using a plastic bottle containing ice is the recommended method here at the osteo fitness collective. Place the bottle on the floor and roll it back on forth with the affect foot placing a fair amount of pressure so that cold penetrates the bottom of the foot and he fascia gets a good stretch and massage. This process may need to be repeated for several weeks before it is resolved. 

Due to the attachment of the Achilles tendon to the plantar fascia, stretching the gastrocnemius and soleus muscle (calf muscles) at the back of the leg is also required as well as stretching to the plantar fascia itself.

As recovery progresses more dynamic mobility exercises are required including picking up yowls/clothes with you toes and writing the alphabet with you big toe.

Follow the link for a complete guide to plantar fasciiitis and how to treat this type of sharp ankle pain.

More information

If you're looking for more information about how you doctor or other medical expert might deal with your sharp ankle pain then follow this page to see the NICE guidelines for musculosketal conditions.


We hope you found this guide to sharp ankle pain interesting and useful.

For more information follow the link below to return to the main Ankle injury page or for more information on how to rehabilitate and treat your ankle go to ankle exercises. 

Otherwise just return to the Osteo Fitness Collective homepage.