PATIENT EDUCATION
Ankle Symptoms
Select the symptom that most closely describes what you are experiencing. The information below explains common causes, possible conditions, initial self-care and when medical assessment may be needed.
Select a symptom below to view more information.
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Pain With Weight-Bearing
What you'll notice or feel
- Pain when standing, walking or putting weight through the foot.
- Pain that eases with rest and returns when you get moving again.
- Discomfort at the front, sides or deep within the ankle joint.
- Reduced walking distance or a tendency to limp.
Common causes
- A previous ankle sprain that has not fully recovered.
- Wear of the ankle joint surface, often following an earlier fracture or repeated sprains.
- Irritation of the tendons running around the ankle.
- A stress-related bone injury after a sudden increase in activity.
What it could be
- Ongoing symptoms after a previous ankle sprain, including residual ligament laxity or scar tissue.
- Ankle osteoarthritis, which is often related to previous injury rather than age alone.
- Irritation of a tendon around the ankle, including the tendon supporting the arch behind the inner ankle bone.
- A stress fracture, especially after a recent increase in walking, running or standing.
- A cartilage injury within the ankle joint after a previous sprain.
Initial self-care
- Temporarily reduce weight-bearing activity and allow the ankle to settle.
- Apply ice if swelling is present.
- Use supportive, well-cushioned footwear rather than flat or unsupportive shoes.
- Use over-the-counter pain relief if appropriate, as per the label.
When to see a doctor urgently
- Inability to bear weight following an injury.
- Visible deformity or the ankle looking out of alignment.
- Severe pain and rapid swelling after an injury.
- Numbness, or a cold or pale foot.
When to see a doctor
- Pain persisting beyond 2–3 weeks despite rest.
- Pain limiting walking or work.
- Pain that keeps recurring.
Swelling
What you'll notice or feel
- Visible puffiness around the ankle, sometimes making the bony contours less distinct.
- Swelling that may be worse at the end of the day and better in the morning.
- Sock marks or shoes feeling tighter than usual.
- Swelling affecting one ankle or both ankles.
Common causes
- A recent sprain or injury.
- Ongoing irritation within the joint or surrounding tendons.
- Fluid accumulation related to prolonged standing, sitting or travel.
- Swelling in both ankles may point to a general medical cause rather than a local ankle problem.
What it could be
- Post-injury swelling following a sprain, which can persist for several weeks.
- Joint or tendon irritation causing localised swelling.
- Swelling in both ankles from a general medical cause such as heart, kidney, liver or venous circulation problems.
- An infection or inflammatory condition if the ankle is hot, red and painful.
Initial self-care
- Elevate the leg above heart level when resting.
- Apply ice for injury-related swelling.
- Use compression with a supportive bandage or sock if comfortable.
- Avoid prolonged standing or sitting without moving.
When to see a doctor urgently
- The ankle is hot, red and increasingly painful, or you have fever.
- Swelling in both ankles associated with breathlessness or chest discomfort.
- Sudden swelling with severe calf pain or tenderness.
- Swelling following a significant injury with inability to bear weight.
When to see a doctor
- Swelling persisting beyond 2 weeks after an injury.
- Swelling affecting both ankles without an obvious cause.
- Swelling that keeps recurring.
Recurrent Instability / Giving Way
What you'll notice or feel
- The ankle repeatedly turning over or giving way, especially on uneven ground.
- A lack of confidence when walking on slopes, kerbs or grass.
- Repeated sprains, each happening more easily than before.
- Ongoing mild pain or swelling between episodes in some cases.
Common causes
- Ligaments stretched or incompletely healed after a previous sprain.
- Reduced balance and position sense after injury.
- Weakness of the muscles that stabilise the ankle.
- Foot shape, particularly a high-arched foot, predisposing to repeated turning.
What it could be
- Chronic ankle instability following inadequately rehabilitated sprains.
- Ligament laxity from repeated injury.
- A cartilage injury within the joint from previous sprains.
- A tendon problem on the outer ankle contributing to instability.
Initial self-care
- Balance and proprioception training, such as controlled single-leg standing.
- Ankle strengthening, especially of the muscles running along the outer ankle.
- A supportive brace or high-top footwear during activity on uneven ground.
- Avoid returning to sport on uneven surfaces until stability has improved.
When to see a doctor urgently
- Giving way after a fresh injury with severe pain, swelling or inability to bear weight.
- Visible deformity after an episode.
When to see a doctor
- Repeated episodes of the ankle giving way.
- Instability limiting activity or confidence.
- Instability persisting despite several weeks of balance and strengthening work.
Stiffness
What you'll notice or feel
- Difficulty pointing the foot upward toward you or downward away from you.
- Trouble walking up slopes or stairs, which requires good upward ankle movement.
- Stiffness that is worse in the morning or after periods of rest.
- A sense that the ankle does not move as freely as the other side.
Common causes
- Wear of the ankle joint surface, usually following a previous injury.
- Stiffness following a fracture, prolonged immobilisation or surgery.
- Tightness of the calf muscles restricting upward ankle movement.
- Bony outgrowths at the front of the ankle limiting movement.
What it could be
- Ankle osteoarthritis, most often related to previous trauma.
- Stiffness following a period in a cast or boot.
- Calf muscle tightness limiting upward ankle movement.
- Bony spurs at the front of the ankle blocking full upward movement.
Initial self-care
- Calf stretching held steadily rather than bounced.
- Gentle ankle range-of-motion exercises through the comfortable range.
- Heat before stretching to ease tightness.
- Avoid prolonged immobility where possible.
When to see a doctor urgently
- Sudden loss of ankle movement, especially with severe pain.
- Stiffness with fever, redness and warmth.
- Stiffness following a recent injury with significant swelling.
When to see a doctor
- Stiffness persisting beyond a few weeks and limiting walking.
- Difficulty with slopes, stairs or uneven ground because of restricted movement.
- Progressive loss of ankle movement over time.
Bruising After Injury
What you'll notice or feel
- Discolouration around the ankle, sometimes tracking into the foot or toes.
- Bruising that may appear a day or two after the injury rather than immediately.
- Associated swelling and tenderness.
- Bruising that changes colour over the following days as it resolves.
Common causes
- Bleeding into the tissues from a ligament sprain.
- A fracture, often associated with more extensive bruising and difficulty bearing weight.
- A muscle or tendon injury around the ankle.
- Blood tracking downward with gravity, which is why bruising may appear in the foot even when the injury is at the ankle.
What it could be
- A ligament sprain with bleeding into the soft tissues.
- An ankle fracture, particularly with marked bony tenderness and difficulty bearing weight.
- A tendon injury around the ankle.
- More extensive bruising in someone taking blood-thinning medication.
Initial self-care
- Rest, ice, compression and elevation during the first few days after injury.
- Begin gentle movement within a comfortable range once the acute phase settles.
- Use over-the-counter pain relief if appropriate, as per the label.
- Gradually return to weight-bearing as comfort allows.
When to see a doctor urgently
- Inability to bear weight for more than a few steps after the injury.
- Marked tenderness directly over the ankle bones.
- Visible deformity or the ankle appearing out of shape.
- Numbness, tingling, or a cold or pale foot.
When to see a doctor
- Bruising and swelling not improving after 1–2 weeks.
- Ongoing pain when weight-bearing beyond the first couple of weeks.
- Any concern that a fracture may have been missed at the time of injury.
YOUR CONSULTATION
What to Expect at Your Visit
- The doctor will ask how the injury happened, particularly the direction the ankle turned, whether you could walk immediately afterward and how the symptoms have changed.
- You'll be examined for ankle movement, swelling, tenderness over specific bony points and ligaments, together with stability tests and assessment of your walking pattern and balance.
- Your calf muscles, foot shape and footwear may also be assessed because these can contribute to ankle symptoms.
- Imaging depends on the clinical picture. An X-ray may be used when a fracture is suspected, while MRI may be considered for ligament, tendon or cartilage injuries or when symptoms are not settling.
- Management may include bracing, physiotherapy, balance retraining and activity modification, with injections or surgical opinion considered for selected structural injuries or persistent instability.
* IMPORTANT: A Note Before You Go
Ankle symptoms may arise from bones, ligaments, tendons, cartilage, joint wear or sometimes from medical conditions causing swelling.
This page covers some of the more common ankle symptoms and is not a substitute for an individual medical assessment. Persistent pain, recurrent instability, inability to bear weight, significant swelling or deformity should be properly assessed.