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Understanding and Managing Chronic Lateral Ankle Pain

Chronic Lateral Ankle Pain


Pain in the lateral ankle can be debilitating and persistent, often disrupting daily activities and hindering mobility. Chronic lateral ankle pain is a condition that requires attention and proper management for long-term relief.

In this article, we will explore the intricacies of chronic lateral ankle pain, including its causes, symptoms, diagnosis, and various treatment options. Whether you’re experiencing this discomfort or seeking preventive measures, understanding the condition is crucial for informed decision-making.

What is Chronic Lateral Ankle Pain, and Why Does it Occur?

Chronic lateral ankle pain refers to persistent discomfort on the outer side of the ankle that lasts for more than six months. This condition typically stems from previous ankle injuries that may not have healed correctly or have been aggravated over time. The lateral aspect of the ankle involves complex ligaments and tendons, making it susceptible to chronic pain due to inadequate healing or repetitive stress.

Common Causes

Chronic lateral ankle pain can arise from a variety of factors, each playing a distinct role in the persistence and intensity of the discomfort. Understanding these causes is pivotal in tailoring effective treatment strategies.

Previous Ankle Sprain and Scar Tissue Formation

One of the primary triggers for chronic lateral ankle pain is a history of ankle sprains. An ankle sprain occurs when the ligaments supporting the joint are stretched or torn, often due to a sudden twist or turn. If not allowed sufficient time to heal or if not rehabilitated properly, the ligaments may not regain their full strength, leading to lingering pain.

Scar tissue formation, a natural part of the healing process, may also contribute to ongoing discomfort by altering the flexibility and function of the ligaments.

According to research, nearly two million ankle sprains are treated in emergency departments in the United States and the United Kingdom. Sprained ankles are known as the most common type of sports injury.

Repetitive Stress

The lateral ankle is particularly vulnerable to repetitive stress, commonly observed in activities that involve frequent side-to-side movements or constant impact on the joint. Sports such as basketball, soccer, or running on uneven surfaces can subject the ankle to repetitive microtrauma, gradually wearing down the supportive structures and contributing to chronic pain.

Ankle Instability

Lateral ankle pain can also stem from chronic ankle instability. This condition arises when the ligaments fail to provide adequate support to the joint, leading to a recurrent sense of giving way. This instability not only perpetuates pain but also increases the risk of further injuries.


Osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis can contribute to chronic ankle pain. These conditions involve the degeneration of joint lining, causing friction between bones and resulting in persistent discomfort.

Structural Abnormalities

Anatomical variations or structural abnormalities in the foot and ankle, such as high arches or flat feet, can predispose individuals to chronic lateral ankle pain. These variations may alter the distribution of forces during movement, putting additional stress on specific areas of the ankle.

Signs and Symptoms of Chronic Lateral Ankle Pain You Shouldn’t Ignore

Signs and Symptoms of Chronic Lateral Ankle Pain You Shouldn't Ignore

Recognizing the subtle yet persistent signals of chronic lateral ankle pain is pivotal for timely intervention and effective management. These symptoms often manifest gradually, and while they may seem minor initially, ignoring them can lead to exacerbated discomfort and potential complications.

Persistent Pain

The hallmark of chronic lateral ankle pain is enduring discomfort on the outer side of the ankle that persists for an extended period, typically more than six months. This pain may vary in intensity, ranging from a dull ache to sharp, stabbing sensations. It often becomes more pronounced during weight-bearing activities or specific movements.

Why it Matters: Persistent pain is a clear indication that there may be underlying issues with the ligaments, tendons, or joints in the lateral aspect of the ankle. Addressing this symptom promptly can prevent further damage and improve overall quality of life.


Swelling in the lateral ankle region is a common accompaniment to chronic pain. It may be subtle initially, appearing as mild puffiness, but over time, it can become more noticeable. Swelling is often a result of inflammation caused by ongoing stress or structural issues within the ankle.

Why it matters: Persistent swelling suggests an ongoing inflammatory response, indicative of underlying problems that may require attention. Identifying the cause is essential for developing an effective treatment plan.

Tenderness to Touch

Tenderness on palpation, particularly along the outer side of the ankle, is a key symptom of chronic lateral ankle pain. The affected area may feel sensitive to touch, and individuals may notice increased discomfort when pressure is applied.

Why it Matters: Tenderness indicates localized sensitivity, potentially pointing to specific structures like damaged ligaments or inflamed tendons. Understanding the source of tenderness is crucial for targeted treatment.


Chronic lateral ankle pain often coincides with a persistent feeling of instability. Individuals may experience a sense of the ankle “giving way” during weight-bearing activities or even while at rest. Chronic instability can significantly impact mobility and increase the risk of falls.

Why it Matters: An unstable ankle increases the likelihood of further injuries and can impede daily activities. Addressing this symptom is essential for restoring stability and preventing recurrent issues.

Difficulty Bearing Weight

Difficulty bearing weight on the affected ankle is a significant red flag. Individuals may find it challenging to put full pressure on the lateral side of the foot, leading to altered gait patterns and compensatory movements.

Why it Matters: Difficulty bearing weight indicates functional impairment and suggests a substantial impact on daily activities. Seeking prompt medical attention can help identify the root cause and implement appropriate interventions.

How to Diagnose it

Diagnosing chronic lateral ankle pain involves a thorough physical examination by a healthcare professional. The medical history, including any previous ankle injuries, will be considered alongside physical tests to assess range of motion, stability, and pain levels. Imaging studies such as X-rays, MRIs, or CT scans may be ordered to provide an accurate diagnosis.

Treatment Options: Non-Surgical to Surgical Interventions

Treatment Options: Non-Surgical to Surgical Interventions


Physical Therapy: Physical therapists can target range of motion exercises that can help improve strength, stability, and flexibility in the ankle, promoting proper healing and reducing pain.

A study found that combining physical therapy treatment with therapeutic exercise improves clinical outcomes when compared to therapeutic exercise alone. As a result, healthcare providers should employ both treatments in patients with pain in the lateral ankle, as advised by recent clinical practice guidelines, to minimize swelling and pain, enhance foot and ankle mobility, and normalize walking metrics.

Bracing and Supportive Devices: The use of ankle braces or supportive devices may provide additional stability to the ankle, especially during physical activities.

Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and reduce inflammation.

Surgical Treatment

Ligament Repair or Reconstruction: In cases where ligaments are severely damaged, surgical repair may be necessary to repair or reconstruct them for improved stability.

Arthroscopy: This minimally invasive procedure allows surgeons to assess and address issues within the joint surface, such as removing loose fragments or damaged tissue.

Tips to Prevent Chronic Lateral Ankle Pain

Tips to Prevent Chronic Lateral Ankle Pain

Proper Warm-Up: Always warm up before engaging in physical activities to prepare your muscles and ligaments.

Strengthening Exercises: Incorporate ankle-strengthening exercises into your routine to enhance stability and prevent injuries.

Footwear: Choose supportive footwear, especially during sports or activities that involve repetitive lateral movements. Properly fitted shoes with adequate arch support and cushioning can help distribute forces evenly, reducing stress on the soft tissues of the lateral ankle.

Balance Training: Improve balance through specific exercises to enhance proprioception and reduce the risk of ankle injuries.


Consider Consulting with Kendall Performance PT

Consider Consulting with Kendall Performance PT

If you experience persistent lateral ankle pain, swelling, or chronic ankle instability, it is crucial to seek medical attention promptly. Delaying treatment can lead to further complications and may exacerbate the condition.

At Kendall Performance PT, we specialize in comprehensive care for chronic lateral ankle pain. Our team of experienced physical therapists can tailor an initial treatment plan to address your specific needs and guide you through the recovery process. From personalized exercises to hands-on techniques, we are committed to helping you regain optimal function and reduce pain.


Chronic lateral ankle pain is a challenging condition that requires a multifaceted approach to management. From understanding its causes and symptoms to exploring various treatment options, taking proactive measures is essential for long-term relief. Whether through non-surgical interventions, surgical procedures, or preventive strategies, addressing chronic lateral ankle pain head-on can significantly improve your quality of life and return to your best activity level.


Why does the lateral side of my ankle hurt?

Lateral ankle pain is often caused by factors such as previous ankle sprains, repetitive stress, ankle instability, or structural abnormalities. Seeking professional help, such as a physical therapist, can help determine the specific cause and appropriate lateral ankle pain treatment.

How do you fix lateral ankle pain?

Treatment for lateral ankle pain depends on the underlying cause. Non-surgical options include physical therapy, bracing, and medications. In more severe cases, surgical interventions like ligament repair or reconstruction may be recommended.

What causes chronic lateral ankle pain?

Chronic lateral ankle pain is commonly caused by inadequate healing of previous ankle injuries, repetitive stress, ankle instability, arthritis, or structural abnormalities. Accurate diagnosis and conservative treatments are essential for managing this condition effectively.

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Dr. Christopher Kendall PT

Kendall Performance PT

We help athletes and active adults move better, live pain-free, and get stronger to improve the health of our community and provide each client the knowledge to remain healthy and independent the rest of their lives.