Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.

Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains. 

An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.

Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.

Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.

Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.

Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.

Foot and ankle pain can be a nuisance in a person’s life, especially if it happens frequently. The best way to prevent this type of pain, is to exercise often. Regular exercise of the foot includes stretching and strength exercises. Stretching exercises can help prevent injuries such as a sprained ankle, while strength exercises can prevent ailments such as plantar fasciitis.

Stretching exercises can help improve flexibility and the foot and ankle’s range of motion. These exercises can certainly help with those who participate in high-energy activities such as sports. Many athletes routinely perform foot and ankle exercises to prevent injuries like sprained ankles, which are common injuries where the tendons in the ankle are over stretched. Strength exercises help develop foot muscles for better support and protection.

Most exercises are simple and can be done at home, either standing or sitting. One chair exercise is called “limber up”. In this exercise, a person would start by sitting down with their feet flat on the floor. Then lift one leg up so the feet are not touching the floor, then rotate your foot clockwise 15-20 times, and 15-20 times counterclockwise. Repeat the same process with the opposite leg. Another sitting exercise helps stretch the back of your heel and requires an exercise band. It begins by looping the band around a heavy piece of furniture, or something stable that will not be moved when the band is tugged or pulled. Then sit directly in front of it, and slide one foot into the loop, so that the band curves around the forefoot. Start by pulling the forefoot back and holding it for 5-10 seconds. Doing this 10-15 times on each foot, will stretch the back of your heel, increasing your flexibility.

Foot exercises that require standing are also just as easy and simple. Referred as the “Achilles Stretch”, this exercise stretches the Achilles tendon, making it more flexible, helping prevent foot, ankle, and leg pain. It begins by first standing and facing the wall, with the arms outstretched and the palms on the wall. Then place one foot behind another keeping the back leg straight, and the forward leg bending at the knee. Make sure both heels are flat on the floor and adjust your stance accordingly. With your hips, lean forward to feel the stretch, you can also adjust the distance from your feet to feel the stretch in various parts of the calf. Make sure to hold the stretch for about 30 seconds and repeat the same process 3 times with each leg. An even easier foot exercise is simply walking on sand. Walking barefoot on sand both strengthens and stretches your feet.

Doing these exercises regularly can help prevent many foot and ankle problems. Other foot exercises can even relieve pain. For example, those affected with plantar fasciitis can simply sit down on a chair, and then place a tennis ball below their affected foot. By rolling the ball under the foot, and increasing or decreasing pressure, pain will be relieved. With any exercise, it is always important to do a small warmup such as walking a few laps around the house to get the blood flowing. If after doing an exercise to relieve pain such as the tennis ball exercise, or are unsure that your execution is correct, be sure to contact a podiatrist for further instruction.

A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.

Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.

A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.

Cracked heels may make you want to think twice about showing off your feet in warmer weather. However, cracked heels may be harmful to more than just the appearance of your feet. If deep fissures and cracks develop in your heels, they may make walking and standing painful for you. Additionally, these openings make way for germs to enter through your skin and cause infection.

There are several different causes of cracked heels. One of the most common reasons for this ailment is dry skin. This problem may make your keeps feel rough tight and itchy. Dry skin may be caused by cold air, extremely hot water, harsh soaps, and aging. Skin disorders such as eczema and psoriasis may eventually lead to dry skin. In some cases, complications may arise from cracked heels. Some of these complications are a loss of feeling in the heel, cellulitis, or a diabetic foot ulcer.

There are ways you can try to prevent getting cracked heels. One of the best ways to do so is to avoid wearing flip flops and sandals because these shoes increase your risk of drying out your feet. You should also avoid wearing shoes with a tall skinny heel, because these shoes cause your heel to expand sideways. At night, you should slather on a thick moisturizing cream on your feet and then cover them in socks to keep your feet moisturized overnight. Drinking water to stay hydrated is also a good way to ensure that your skin doesn’t become dry.

If you suffer from a severe case of cracked feet, you should make an appointment with your podiatrist to see what treatment methods are best for you.

A plantar fibroma is a knot in the arch of the foot. It can cause pain when repeated pressure is applied by walking barefoot or wearing tight shoes. While plantar fibromas can appear in anyone, men who are middle-aged or older are said to be more susceptible. The main symptom of a plantar fibroma is a firm lump on the arch of the foot. If there is pain, it can be intensified by putting pressure on the nodule. The lump can stay one size or grow larger. You may have one or more fibromas in the feet and there tends to be a high incidence of recurring plantar fibromas.  Generally, a plantar fibroma can be treated without surgery. Treatment might include steroid injections to help shrink the lump, orthotics to help redistribute weight away from the nodule, plantar fascia stretching, or physical therapy to help use anti-inflammatory medication on the lump. If a lump grows larger or more painful, a podiatrist can be consulted to confirm the diagnosis. The doctor will palpate the lump and this may cause pain that can be felt all the way to the toes. An X-ray, MRI, or biopsy might be done if further evaluation is necessary. A lump in the arch of the foot might be something other than a plantar fibroma, such as cysts, nerve or fatty tumors, swollen tendons, or an infection in the foot. It is important to see a podiatrist for proper diagnosis and treatment of plantar fibromas.