There are many reasons why the ankle can get sore. Here are some common reasons
Outer (Lateral) Ankle Pain
Peroneal tendonitis
The inflammation of the outer shin tendons (Peroneal tendonitis) which run behind the bony bit on the outside of the ankle (lateral malleolus). The term tendinopathy is probably more accurate than tendonitis in most cases because it is often degeneration of the tendon rather than acute inflammation. Symptoms include pain and swelling on the outside of the ankle, which get worse with exercises and improves with rest.
Sinus Tarsi
The sinus tarsi is a bony canal on the outside of the ankle – when the tendons running through it get irritated, the pain may be difficult to pinpoint, but it is mostly felt while turning or running around a corner. When the pain is in the outer side, an ankle impingement occurs when the tendons of the ankle get pinched between the ankle bones.
Stress fractures
Stress fractures can happen on the talus bone (the bone the ankle hinges on) or the fibula bone (the outer ankle bone). Symptoms include gradual onset of pain on the outside of the ankle, which gets worse with exercise, particularly running, and eases with rest.
Inner (Medial) Ankle Pain
Tibialis posterior tendinopathy
Is a degenerative condition of the inner shin muscle that helps turn and point the foot (Tibialis posterior tendinopathy). Pain can also radiate under the foot arch.
Flexor hallucis/digitorum longus tendinopathy
Is inflammation or degeneration of the muscles that flex the foot up (Flexor hallucis/digitorum longus tendinopathy). The symptoms experienced are pain on the inner side of the ankle and pain when flexing the foot or toes.
Tarsal tunnel and medial calcaneal nerve entrapment
Occurs when either the ankle nerve or foot nerve becomes impinged or pinched on the inside of the ankle (Tarsal tunnel and medial calcaneal nerve entrapment). This causes burning, tingling or shooting pain, that radiates into the arch of the foot, heel and sometimes toes. Some people get pins and needles or numbness in the sole of the foot. Pain may increase with activity or long periods of standing.
Front (Anterior) Ankle Pain
Posterior/anterior ankle impingement
Ankle impingement can happen either if poor healing after injury causing fibrosis (scarring) and bony fragments or when the soft-tissue gets trapped and irritated in the ankle joint capsule, or the joint’s ligaments or cartilage- this can thicken and accumulates over time from repetitive activities such as running and jumping. The soft-tissue or bony abnormality creates painful limitations of the ankle range of motion.
Referred pain
Pain on the inside of the ankle may be referred from injuries or conditions elsewhere in the body. For example, sciatic pain from the lower back can radiate down into the leg. Trapped nerves in the foot may also cause medial ankle pain .
WHAT CAN I DO ABOUT IT?
Treatment involves a variety of methods based on your activity, biomechanics, whether it came on quickly or gradually and what the root cause is. Here are some treatment modalities that are used to treat ankle problems. Although many are often misdiagnosed and all are treated very differently, its important to make sure the diagnosis is right.
