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Dealing with a sore ankle is hard. These small joints bear your entire body weight over and over as you lift one foot off the ground to take the next step. Our busy lives mean that when ankle pain develops, you can’t just avoid using the ankle until it feels better. It’s often not just pain that you’re battling but feelings of weakness and instability that can leave you feeling unsteady and unsure of your footing, too. So what could be causing your ankle pain if you haven’t had something obvious like an ankle sprain recently? 

Today our Podiatrists have shared five common causes for ankle pain that comes on during walking.

1. Chronic Ankle Instability

Chronic ankle instability develops when you’ve had multiple sprains or other injuries to your ankles. As a result of the injuries, the ligaments surrounding the ankle joint, whose job is to keep your ankle stable and supported, are weakened. Over time, this can lead to aching and pain when you’re walking, given this is the time that these ligaments must be engaged to help stop your ankle from rolling. 

If you have unstable ankles, you may notice that the pain is worse when you’re walking over uneven ground. Ankle instability can progressively worsen if left unmanaged, making you vulnerable to recurrent ankle sprains and falls. Treating ankle instability involves providing immediate stability back to the ankle to improve your comfort and ease your pain now and working to strengthen the ankle to help you regain stability and control in the long term.

2. Arthritis

Arthritis in the ankle joint also causes ankle pain. We see this in three forms:


This ‘wear and tear’ type of arthritis affects the cartilage that covers the bone ends in a joint. Over time, the breakdown of your cartilage means it can no longer cushion and protect the bones, leaving the bones to painfully rub against one another. The result is ankle joint pain and stiffness, as the shape and integrity of the joint change.

Rheumatoid arthritis

Rheumatoid arthritis (RA) occurs when the body attacks its own cells, and when this affects the ankles, the joint degrades and becomes painful. The symptoms of RA often occurs in both ankles and tend to affect multiple joints, like the toes or knees.


When you have excess uric acid in your body, it converts to painful, sharp crystals in the joints under certain circumstances. While gout’s typical first port of call is the big toe joint, it can also affect the ankles, leading to ‘flares’ of severe pain, redness and swelling.

3. Sinus Tarsi Syndrome

Don’t be put off by the name – the sinus tarsi is simply the term for a tunnel between two of your bones just below your ankle, towards the outer side of the foot. Sinus tarsi syndrome describes a situation where damage to the tunnel, or the ligaments, blood vessels or nerves in or around the tunnel, results in symptoms like pain, burning, tingling or weakness at the ankle.

Treating sinus tarsi syndrome involves helping keep the foot supported in an optimal position for the damaged structures to heal. Using custom foot orthotics to achieve this enables our patients to keep walking, often with reduced or minimal pain. Your podiatrist will always advise you of the best treatment, given your unique circumstances and symptoms.

4. Flat Feet – Posterior Tibial Tendon Dysfunction

When you have a flat foot type, you’re naturally more vulnerable to a painful condition called posterior tibial tendon dysfunction (PTTD). Your posterior tibial tendon is a tendon that runs down the inside of your lower leg, crossing the inside of the ankle. It plays a large and important role in keeping you moving. When the tendon is damaged, often from overuse relating to flat, unsupported feet, the pain is usually felt on the inside of the ankle.

Treating PTTD involves helping heal the damaged tendon to alleviate the ankle pain and keeping the flat foot supported so that the flat foot posture does not cause damage to the posterior tibial tendon again in the future.

5. Stress Fracture

Stress fractures differ from regular fractures in that they develop gradually over time, starting as a small crack and progressively worsening as the bones continue to be loaded and used. At the ankle, they most often affect the bottom of the fibula at the outer ‘bump’ of the ankle, and at the talus bone within the ankle joint. Ankle stress fractures feel painful and tender, worsening when weight is placed on the ankle, like when walking. There may also be some swelling or bruising.

Effectively treating stress fractures means helping the bone heal abd understanding what factors have caused the stress fracture, to prevent it from simply recurring again after it has healed.

Are Your Ankles Holding You Back?

If painful or unstable ankles are holding you back from work, time with your family, or doing the things you love, our experienced podiatry team can help.  Book your appointment online or call us on 1800 366 837.