Sudden ankle pain without injury: causes, treatment, and exercises

Have you ever been out for a walk when, all of a sudden, your ankle starts to hurt out of nowhere? Sudden ankle pain without a known injury is common but rarely worrisome, says Courtney Fitzpatrick, PT, DPT, a physical therapist at Hinge Health. “Your ankles help keep you balanced, so pain can make everyday activities more challenging and may change the way you move.” As a result, you may also feel discomfort in other areas of your body, as they pick up the slack.

Most cases of sudden ankle pain (without an injury) can be managed with conservative strategies like gentle movement and modified activity, Dr. Fitzpatrick says. Read on to learn why you might experience ankle pain, plus how to find relief with exercises recommended by Hinge Health physical therapists. 

Why does my ankle hurt without injury?

“I’d estimate that about 20% of the ankle pain I see shows up without a clear injury,” says Dr. Fitzpatrick. There are many reasons you might notice sudden ankle discomfort, even if there’s no tenderness or swelling. These include:

• Inactivity. If you haven’t been moving much lately, you may notice some ankle pain. “When your ankle isn’t moving regularly, it can become stiff, which leads to discomfort,” says Dr. Fitzpatrick. Taking movement snacks throughout the day to go for a walk or do gentle exercises near your desk can help the soft tissues (muscles, tendons, ligaments) near your ankle stay mobile and comfortable.

• Osteoarthritis. Osteoarthritis is the most common type of arthritis, affecting the cushioning (cartilage) around your ankle joint. Ankle arthritis often doesn’t cause symptoms, but some people experience flare-ups of joint stiffness, especially after a period of inactivity. “If you notice discomfort in the morning when you first get out of bed, or after sitting for a long time, osteoarthritis may be the reason,” says Dr. Fitzpatrick.

• Gout. Gout is a type of inflammatory arthritis that often affects the big toes, feet, knees, and ankles. Gout in the ankle can lead to swelling and severe pain. It occurs when uric acid — a substance your body normally gets rid of — builds up and crystallizes in the joints. Gout is fairly common, especially in men over 30 and women after age 55.

• Tarsal tunnel syndrome. The tibial nerve passes through a small space on the inside of your ankle and, at times, can become compressed or irritated. This may cause sensations like sharp pain, numbness, or tingling. “We sometimes see this with overuse,” says Dr. Fitzpatrick. If it’s not addressed, surrounding muscles can tighten, which can add to ankle discomfort.

• Tendonitis. Tendonitis can develop gradually and may not be linked to a specific injury. “Your ankle, like all joints in the body, has a threshold of how much stress it can handle,” says Dr. Fitzpatrick. “If your ankle takes on more stress than it’s ready for, especially when doing activities that involve a lot of repetitive, quick movements, your ankle tendons can become irritated or inflamed.” A common example is Achilles tendonitis, which often contributes to ankle pain.

• Plantar fasciitis. Plantar fasciitis is the irritation or inflammation of the plantar fascia, a strong band of tissue along the bottom of your foot that helps support your arch. While the overuse injury most commonly causes heel pain, it can sometimes lead to ankle discomfort as well.

Symptoms of sudden ankle pain

Most of the time, sudden ankle pain without injury tends to be a dull ache that intensifies with movement, especially if you twist your ankle from side to side, says Dr. Fitzpatrick. You may also notice:

• Swelling

• Stiffness

• Warmth

• Redness

These exercises help strengthen and stretch key muscles and tendons in and around your ankle. If you notice sudden ankle pain without injury, try these moves to see if your comfort improves. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for sudden ankle pain without injury

It might sound counterintuitive, but in most cases of sudden ankle pain without injury, movement is important for recovery. “Improving your ankle mobility through low-impact activities, like swimming, cycling, or walking, as well as doing specific strengthening exercises, can make a big difference,” says Dr. Fitzpatrick. Here are some additional ways to support your ankle and find relief:

• Try physical therapy and targeted exercises. Targeted exercises can help stretch and strengthen the soft tissues in and around your ankle. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Take over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for sudden ankle pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Relax in an Epsom salt bath. Soaking your ankle in a warm Epsom salt bath can help soothe discomfort and ease muscle tension, says Dr. Fitzpatrick. You can also apply moist heat — such as a warm towel or hot water bottle — to your ankle throughout the day for extra relief.

• Use athletic tape. Using elastic athletic tape (like kinesiology tape) on your ankle can provide support and help you feel more stable as you move through your targeted exercises. It also gives helpful feedback to your body about your ankle’s position, which can support your balance as you work on building strength, says Dr. Fitzpatrick.

• Swap your footwear. Worn-out shoes may not provide the cushioning your ankles need to feel their best. Replace your workout shoes often so your ankle, and surrounding muscles, stay supported. 

• Get a foam roller. Studies show foam rolling can help reduce ankle pain and increase its range of motion. A self-massage around your ankle joint can provide similar support, says Dr. Fitzpatrick. 

• Try TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle electrical impulses to interact with your nervous system and help reduce pain associated with ankle pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

• Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for ankle pain relief, such as massage, acupuncture, or chiropractic care.

When to see a doctor

Ankle pain without an injury often improves on its own with conservative treatments. But if your ankle pain is severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if your ankle:

• Hurts so much you can’t put weight on your foot

• Has worsening swelling or redness that doesn’t go away after a few days

• Causes fear and anxiety that limits your ability to work, socialize, or exercise

• Comes with unusual symptoms like loss of sensation or strength 

PT tip: Stick with your ankle exercises

“Ankle pain without injury can take weeks or even months to improve,” says Dr. Fitzpatrick. “Doing ankle-specific exercises and stretches regularly doesn't need to take a lot of time — you can reduce pain and improve stiffness and mobility in just 10-15 minutes a day.”

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Ranbhor, A. R., Prabhakar, A. J., & Eapen, C. (2020). Immediate effect of foam roller on pain and ankle range of motion in patients with plantar fasciitis: A randomized controlled trial. Hong Kong Physiotherapy Journal, 41(1), 1–9. doi: 10.1142/s1013702521500025

2. Al Adal, S., Pourkazemi, F., Mackey, M., & Hiller, C. E. (2019). The Prevalence of Pain in People With Chronic Ankle Instability: A Systematic Review. Journal of Athletic Training, 54(6), 662–670. doi: 10.4085/1062-6050-531-17

3. Wang, L., Yu, G., Zhang, X., Wang, Y., & Chen, Y. (2023). Relationship between ankle pain, range of motion, strength and balance in individuals with functional ankle instability: a cross-sectional study. BMC Musculoskeletal Disorders, 24(1). doi: 10.1186/s12891-023-07079-1