What is happening in your ankle when new pain arrives and what to do first
Nicola Tik
New ankle pain can feel uncomfortable and, depending on how it came on, a little alarming. Most ankle pain that develops recently is the body responding to irritation or injury in the area rather than anything serious, and it tends to settle well with the right approach in the first few days. This article explains what is likely going on and what you can do straight away to help things ease.
The ankle is a hinge joint connecting the lower leg to the foot. It is held together by several ligaments, strong bands of tissue that connect bone to bone and give the joint its stability. Around the joint sit tendons, which connect the muscles of the lower leg to the foot and allow the ankle to move in different directions. A network of small bones in the foot sits just below, all of which work together to absorb load with every step.
One of the most common reasons for new ankle pain is a sprain. This happens when the ligaments around the joint are stretched beyond their comfortable range, usually when the foot rolls inward or outward further than the joint was ready for. A sprain does not mean the ligament is torn or permanently damaged. It means the tissue has been stretched and is now irritated and sensitive while it recovers. Sprains are among the most common musculoskeletal injuries, and the large majority settle well with straightforward management.
New ankle pain can also develop more gradually, without a specific moment of injury, from an increase in activity, a change in footwear, or prolonged time on hard surfaces. In these cases the tendons or the joint itself are most commonly involved.
In the early stage, the priority is reducing the load on the ankle while keeping it gently mobile. A few simple steps tend to make the most difference in the first day or two.
Reduce activities that place significant demand through the ankle, such as walking long distances, running, or anything that involves pushing off the foot forcefully. Short, gentle walks on flat surfaces are generally fine and more helpful than staying completely off the foot.
Elevating the ankle when resting, by propping the leg up on a cushion or footstool so the foot sits at roughly hip height, helps reduce swelling and eases the aching that often builds through the day. Even short periods of elevation, 15 to 20 minutes a few times across the day, can make a noticeable difference.
Applying something cool to the area, such as a cold pack wrapped in a cloth, for 10 to 15 minutes at a time helps ease swelling and discomfort in the early days. Avoid applying ice directly to the skin.
Supportive footwear with a firm sole and reasonable cushioning reduces the load going through the ankle with every step and tends to feel more comfortable than flat or unsupportive shoes while things are settling. Avoid walking barefoot on hard floors in the early days.
Early, gentle movement is one of the most helpful things you can do for new ankle pain, including after a sprain. Prolonged immobilisation tends to increase stiffness and slow recovery rather than support it. The aim is to keep the joint moving within a comfortable range rather than loading it heavily.
Sitting in a chair with your foot off the floor, slowly draw the alphabet with your big toe, moving only from the ankle. This gentle exercise keeps the joint moving through a range of directions without placing load through it. Doing this once or twice a day in the first few days is a good starting point.
If you would like a guided stretch to support you through this, VIDA has a short video you can follow at your own pace.
Over-the-counter pain relief taken as directed can help keep discomfort manageable in the first few days, particularly if pain is making it difficult to sleep or to keep gently moving. A pharmacist can advise on the most appropriate option for you.
Most new ankle pain begins to ease within a week or two. If you are unable to put any weight through the foot at all, or if there is significant swelling and bruising that came on quickly after a specific injury, it is worth speaking to your GP or a physiotherapist to rule out anything that needs further assessment.