Ankle Pain

Ankle Pain Foot Diagram ImageThe ankle is made up of 3 bones which are connected by muscles, ligaments and tendons. The tibia is the large bone located on the inside of the shin. The fibula is the thinner bone on the outside of the shin. The ends of the tibia and fibula are joined together by a strong ligament to form a socket called the ankle mortis. The talus is the highest placed bone of the foot. It has a dome which fits inside the ankle mortis (socket). Together these 3 bones form the ankle joint.

Articular cartilage is the smooth shiny material present anywhere that two bony surfaces come into contact with each other. In the ankle articular cartilage covers the end of the tibia, the dome of the talus and the bottom part of the fibula. Articular cartilage allows the ankle bones to move easily as the ankle bends up or down. The ligaments around the ankle joint are like strong ropes that help connect bones and provide stability to joint. In the ankle there are 3 ligaments on the outside of the ankle and one broad ligament on the inside aspect of the ankle. It is most common for people to injure the ligaments on the outside of the ankle.

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Different Types Of Ankle Pain

Ankle pain is a common foot complaint. Generally, there are two types of ankle pain: acute ankle pain and chronic ankle pain.

  • Acute ankle pain is usually a result of trauma or injury. One of the most common ankle injuries is a sprained ankle. It is an injury that is most often suffered while playing sports (e.g. football, basketball, tennis) or during running or athletics. It occurs because the ankle twists, causing damage to the ligaments and tissue surrounding the ankle. Although quite painful, an ankle sprain will usually heal itself within a matter of weeks by simply resting the foot.
  • Chronic ankle pain on the other hand is a long-term foot complaint. Pain is experienced either on the inside of the ankle (medial ankle pain) or on the outside (lateral ankle pain).


Medial ankle pain can be caused by stress on the tendons and nerves passing through the ankle region. Pain occurs on weight bearing and worsens with intense activity such as running and sports. Sometimes a sharp pain is felt, radiating into the arch of the foot. Typically medial ankle is caused by too much exercise (overuse injury) and/or over-pronation.

Lateral ankle pain occurs on the outside of the ankle and it is worse during walking, running and exercise. It is often caused by compression of the soft tissue (tendons and ligaments) that wrap around the outside of ankle and it occurs as a result of poor foot mechanics i.e. excessive pronation. To better understand this problem let's first have a look at the anatomy of the ankle.

Pronation And Supination

Pronation and supination are natural motions and play an important role in our gait. Pronation (rolling in) acts as a shock absorbing process and supination (rolling out) helps to propel our feet forward. Unfortunaly, most people suffer from over-pronation, or "excessive pronation".

Over-pronation occurs when we pronate too deep and for too long, not giving the foot a chance to 'recover' and supinate. As a result over-pronation hampers normal foot biomechanics puts excess forces and stress on the joints and ligaments in the foot and ankle.

Excessive pronation forces the talus bone to abnormally sit in the joint space. Over time this will cause a premature erosion of the articular cartilage, in the same manner that unbalanced tyres on a car will cause premature damage to the tread of the tyres. Futhermore, over-pronation causes compression of the ligaments around the ankle joint, causing pain and discomfort.

Treatment For Ankle Pain

Orthotics are shoe inserts designed to change the function and biomechanics of the foot and ankle. Orthotics can help relieve foot and ankle pain by improving the alignment of the lower limb. Orthotics provide stability and cushioning at the same time. Orthotics can be custom-made by a podiatrists, or in many cases, pre-made orthotics are used. Pre-made orthotics can be equally effective in the treatment of foot complaints, but are a fraction of the cost of custom-made orthotics. FootActive are pre-made orthotic insoles designed to prevent over-pronation and re-align the lower limb. By correcting abnormal foot biomechanics, FootActive orthotics reduce unnatural friction and pressure in the ankle joint, thereby preventing excessive erosion of the articulate cartilage as well as compression of the soft tissue around the ankle joint.

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