Ankle pain is a common complaint that affects people of all ages and activity levels. While some ankle discomfort resolves on its own, pain that persists for several months or longer may indicate a more serious underlying condition. Chronic ankle pain can make even simple tasks like walking or standing feel unbearable, greatly diminishing your quality of life.
At Marvel Foot & Ankle Centers, we understand the frustration and limitations that come with ongoing ankle issues. Our experienced podiatry team combines compassionate care with the latest diagnostic and treatment technology to help patients in the Phoenix area overcome complex ankle conditions. We're dedicated to getting to the root of your pain and developing practical solutions to get you back to the activities you enjoy.
Understanding Ankle Anatomy
The ankle is a complex hinge joint that connects the leg to the foot, allows for up-and-down motion, and bears the full weight of your body with each step. It's composed of several important structures that work together to provide stability and enable movement:
- Bones. The ankle joint is formed by the meeting of three bones: the tibia (shinbone), the fibula (the smaller bone of the lower leg), and the talus (a bone in the upper part of the foot). The bony protrusion on either side of the ankle, known as the malleolus, is the lower end of the tibia (medial malleolus) and fibula (lateral malleolus).
- Cartilage. The ends of the bones in the ankle joint are covered with a thin layer of cartilage, which acts as a shock absorber and allows for smooth, gliding motion between the bones.
- Ligaments. Strong bands of tissue called ligaments hold the ankle bones and joint in position. The ligaments protect the ankle joint from abnormal movements, especially twisting, turning, and rolling of the foot. The three major ligaments in the ankle are the anterior talofibular ligament (ATFL), the posterior talofibular ligament (PTFL), and the calcaneofibular ligament (CFL).
- Tendons. Tendons are soft tissues that connect muscles to bones. The largest tendon in the ankle is the Achilles tendon, which connects the calf muscles to the heel bone (calcaneus). Other vital tendons in the ankle are the posterior tibial tendon, which supports the arch of the foot, and the peroneal tendons, which provide lateral stability to the ankle.
- Muscles. Muscles in the lower leg, foot, and ankle work together to enable movement and provide stability. The main muscle groups in the ankle are the anterior muscles (tibialis anterior, extensor digitorum longus, extensor hallucis longus), the posterior muscles (gastrocnemius, soleus, tibialis posterior, flexor digitorum longus, flexor hallucis longus), and the peroneal muscles (peroneus longus and peroneus brevis).
Any of these structures can become damaged or deteriorate over time, leading to chronic ankle pain and dysfunction. Identifying which component is affected is key to effective treatment. Our podiatrists utilize advanced imaging to visualize your ankle anatomy in detail and pinpoint the source of your pain.
Common Causes of Chronic Ankle Pain
Ankle pain that persists for months can have numerous causes, such as:
- Ankle arthritis. Cartilage breakdown and inflammation in the ankle joint, often due to past trauma or wear and tear. Symptoms of arthritis include pain, stiffness, and grinding sensations.
- Posterior tibial tendonitis. Inflammation of the tendon that supports the arch of the foot. It can cause pain along the inner ankle and is sometimes associated with flat feet.
- Peroneal tendonitis. Irritation of the tendons that stabilize the outer ankle. Results in pain, swelling, and weakness when pushing off the foot.
- Sprains and strains. Stretching or tearing of the ligaments (sprains) or muscles and tendons (strains) in the ankle. While these acute injuries usually heal with proper care, they can lead to chronic pain and instability if left untreated or if they recur frequently.
- Ankle instability. Looseness in ankle ligaments, usually from repeated sprains. Causes the ankle to frequently "give out" or roll inward.
- Stress fractures. Tiny cracks in the bones of the ankle or foot, often due to overuse or repetitive impact. Pain is usually worse with activity and improves with rest.
- Nerve entrapment. Compression of the nerves that pass through the ankle, such as tarsal tunnel syndrome. It can cause burning, tingling, or shooting pain.
- Scar tissue. Buildup of fibrous tissue after an ankle injury or surgery. Scar tissue can restrict motion and cause pain with certain movements.
Our podiatrists conduct comprehensive exams to assess all potential pain generators and determine the best course of treatment. We take time to thoroughly discuss your symptoms, medical history, and lifestyle goals to create a care plan tailored to your unique needs.
Advanced Therapies for Lasting Relief
Once we identify the primary issue, we develop a customized care plan incorporating cutting-edge, minimally invasive solutions whenever possible. Available treatments include:
- Regenerative medicine. Platelet-rich plasma (PRP) and stem cell injections harness your body's natural healing properties to stimulate tissue repair and reduce inflammation in arthritic or tendon-related conditions. These innovative biologic treatments can help accelerate recovery and provide longer-lasting relief compared to traditional steroid injections.
- Ultrasound-guided procedures. Using live ultrasound imaging, we can deliver medication or regenerative treatments with precision to the exact site of damage. This targeted approach ensures optimal healing and reduces the risk of complications. Ultrasound also allows dynamic visualization of the ankle structures as they move.
- Ankle arthroscopy. This minimally invasive surgical technique allows us to thoroughly evaluate the ankle joint and perform procedures like smoothing damaged cartilage, removing scar tissue, or repairing ligaments—all through tiny incisions. Arthroscopy offers faster recovery times and less post-operative pain compared to open surgery.
- Custom orthotics. For instability or tendonitis related to structural issues, custom orthotics provide the specific support and correction your ankle needs to offload painful areas. Unlike generic inserts, custom devices are created from a precise mold of your foot to ensure an optimal fit and maximum comfort.
Our podiatrists combine these innovative solutions with time-tested treatments, such as physical therapy, bracing, and medication, to help you achieve the best possible outcome. Our collaborative approach involves close communication with your other healthcare providers and a dedicated focus on patient education. We make sure you understand each step of the treatment process and are empowered to make informed decisions about your care.
Whether you're dealing with persistent pain from an old ankle injury, suffering from the effects of arthritis, or experiencing instability that keeps you from your favorite activities, Marvel Foot & Ankle Centers is here to help. With our patient-centered care philosophy, collaborative approach, and commitment to excellence, you can trust that your ankles are in the best possible hands.