What Is That Ankle Pain??

     Developed a new pain in your ankle?  Maybe it has been there for a while, but has gotten worse or just hasn't gone away like you were hoping?  

    Ignoring pain or wishing it away probably won't work, but it can be hard to know what the problem is or if it needs attention.  Sometimes a little rest and ice will be all that's needed to alleviate symptoms, but that still doesn't get at the real root cause of the problem in the first place.  Having a basic idea of what the cause of your pain might be can be a helpful first step in managing your symptoms and deciding if they need further evaluation by a professional.

    Here are 5 common causes of ankle pain and a few tips on how to recognize them:

1. Posterior Impingement:   The soft tissues at the back of the ankle (the FHL, the posterior joint capsule, or even the ligaments) can get pinched between the ankle bones and cause swelling and pain. Pain is deep in the back of the ankle, usually when fully pointing the foot, at the top of elevé, and at the end of the day.  It may be ok while walking, in plié, during jumps, and in the morning.  It may respond well to over the counter anti-inflammatories.
2. Os Trigonum:  This is an extra bony prominence some people are born with that can get in the way and cause pain when pointing the foot.  Pain is also deep in the back of the ankle, with full point, in elevé, and at the end of the day.  There may be pain even in the air when the foot is fully pointed.  This also may be ok with walking, plié, and in the mornings.  Because this is caused by a bony restriction, it probably won't respond to over the counter medications for inflammation.  
3. Tendonitis of the Flexor Hallicus Longus (FHL) or Posterior Tibialis:  Overuse or excessive stretching of either of these tendons can cause soreness on the inside of the ankle, behind or under the large round ankle bone.  This may hurt while walking, during relevés, pliés, or jumps, and at the end of the day.  It may be stiff in the mornings but get a bit better after warming up.  There should be little pain during a tendú, and it may feel better with anti-inflammatories.   
4. Achilles Tendonitis:  Long-term overuse, lack of strength, or tightness can cause inflammation of the calf muscles and tendon.  Pain can be anywhere along the calf or down into the back of the ankle and heel.  It will usually hurt with walking, relevé, stretching/plié, jumping, in the morning, and at the end of the day.  It shouldn't be bad with tendús or pointing when there is no weight on the leg.  Ice and ant-inflammatory medication may help the symptoms if it isn't too chronic.
5. Sprain or Strain:  Obviously, if you twist your ankle or have a sudden pain from landing funny or something, pain will start suddenly and may decrease over time with rest and taking measures to reduce swelling.  A new injury like this may need more immediate attention from a doctor.