The ankle joint is a “hinged joint” and moves primarily in two directions: towards the body and away from it. There’s very little side-to-side movement. Your ankle is moved by muscles and tendons, but it’s also surrounded by ligaments. The ligaments connect the lower leg bones to the ankle bone, in the process providing support and stabilization.
Because of how your ankle is constructed, there are two standard types of ankle injuries: sprains and fractures. If your ligaments are damaged, that’s a sprain. If the bones are broken, that’s a fracture. (Injuries to the tendons in your ankle are called tendonitis, as well.) All these ankle injuries can take weeks to months to heal, and they predominantly occur because of sport activity or awkward manipulation of the foot area.
As noted above, ankle sprains reflect ligament damage. They usually occur from sports (basketball is fairly common) or stepping onto uneven surfaces. Since sprains are essentially tears in the ligaments around the ankle, there are gradients for the severity of the tear: I, II, and III. III is the most severe and usually if you have a Level III tear, ankle surgery is recommended if you want to continue to participate in sports in the future.
There are three main tendons in the ankle: the Achilles tendon, the peroneal tendon, and the posterior tibial tendon. Inflammation of any of these tendons leads to tendonitis, which is usually accompanied by swelling, tenderness, and ankle pain. The best treatments are typically rest, ice, elevation, compression, and anti-inflammatory drugs.
Ankle pain can also be caused by different types of arthritis, which is inflammation of the associated joint. Reactive arthritis, gouty arthritis, rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis are the main types of arthritis associated with ankle pain and inflammation of the ankle joint. Arthritis is not caused by a single incident or injury to the ankle joint, but develops slowly over time. The symptoms of these types of arthritis cause ankle pain including swelling, stiffness, warmth in the area, and redness.
Ankle pain can also be caused by tarsal tunnel syndrome, which is the compression of nerves in the ankle joint.