More than any other joint, our ankles bear the burden of all of our body weight. The ankles aren’t large weight-bearing joints, like our hips or knees; comparatively speaking, the ankles are rather small for the tasks they are assigned to do. If the ankles are normal and healthy and there isn’t a weight issue placing excess stress on the ankles, the ankles can typically bear the forces of walking, running, hiking, and so on quite well. However, when the ankles are weak or carrying too much weight, any additional forces placed upon them—even something as simple as walking—can create problems.
Do your ankles get sore after walking, hiking, or any other activities? If so, it’s a good idea to proactively address it now, before it gets worse, rather than resigning yourself to it and decreasing or stopping the activities you enjoy.
We’ll explain more in a moment, but first let’s take a closer look at the structure of the ankle.
A Close-Up on the Ankle
The ankle isn’t just one joint, but three (the tibiotalar joint, subtalar joint, and tibiofibular joint). These joints live between the ankle bones, which include the distal ends of the tibia and fibula bones of the leg and the talus bone in the foot. The main joint of the three is the tibiotalar joint, a hinge joint connecting the tibia and fibula bones to the talus bone. In addition, the ankle joints consist of cartilage to provide smooth surfaces between bones and supporting tendons and ligaments.
The ankle ligaments form a complex system that provides structure and firm support for the ankle, enabling precise movements with just enough flexibility but not too much. These include the posterior talofibular, the anterior talofibular, the calcaneofibular, and the deltoid ligaments.
Why Do Ankles Get Sore After Walking?
If your ankles get sore after walking, or with other activities, several different things may be at cause. Injuries, such as a twist or sprain or even a sports-related injury, are common in the ankle. The problem is that we often tend to ignore a seemingly benign ankle twist or sprain and simply wait out the initial pain; however, this can create problems in the ankle weeks, months, or even many years later. When an ankle is twisted or sprained, for example, this overstretches and damages the ligaments, and ankle sprains, when left untreated can create an unstable ankle and eventually lead to arthritis as well as lesions, bone spurs, and so on. These injuries can also cause inflammation and pain in the ankle tendons.
This ankle instability is, by far, the most common cause of ankle soreness after walking. So let’s explore this more.
What Is Ankle Instability?
How many of us haven’t experience a twisted or turned ankle at some point in our lives? Think all the way back to childhood when you had that bad sprain jumping out of that big oak tree, or an ankle sprain took you out of the soccer game. Maybe you’ve sprained it a few times since then, most recently missing a step while heading downstairs for your morning coffee. The ankle may have stopped hurting and seemed fine for years, but now you’re fortysomething, and you can’t walk, run, or hike very far without your ankles being sore for days after. Or maybe they get sore when you have to carry something heavy, thereby forcing your weakened ankles to bear a heavier-than-normal load. Maybe you’ve even resorted to regular ankle brace use to relieve some stress. The problem, most likely, is that those initially injured ligaments have gradually become unstable.
The ankle ligaments should be tight, like a rubber band, in order to properly protect the joints. When these ligaments become stretched or lax, this creates ankle instability as the ligaments can’t effectively control movement and protect the joint. While certainly an old injury can be the catalyst for ankle instability, it can also occur with wear and tear as we age. If there isn’t an obvious injury, such as a snapped ligament, most orthopedic or family doctors won’t have a clue there is ligament instability. But the signs mentioned above should be a clue, and a visit to your interventional orthopedic physician can provide confirmation if there is ankle instability. To learn more, watch Dr. Centeno’s ankle video below:
Treat Ankle Instability Early, or It Will Only Get Worse
If ankle instability is left untreated, as already mentioned, this can lead to arthritis, lesions, bone spurs, tears, or other problems. Be proactive and treat ankle instability early, before it has a chance to get worse.
If there is an obvious severe ankle sprain or an accompanying ligament tear, surgery (most of which involve cutting out the ligament and replacing it with one of your harvested tendons) is often the recommendation by orthopedic surgeons. Unfortunately, ankle surgery comes with big risks, including arthritis, abnormal motion after surgery, painful and lengthy recovery and rehab, overtightened ligaments, and pain that doesn’t subside.
Your interventional orthopedic physician, on the other hand, can treat ankle instability nonsurgically in most cases. Ankle ligaments can be tightened using precise image-guided injections of your own orthobiologics (e.g., platelet-rich plasma, stem cells, etc.).
So if your ankles get sore after walking, running, or other activities, it’s a good idea to see your interventional orthopedic physician to have your ankles checked for ankle instability. In most cases, surgery can be avoided, but it’s important to note, the sooner the better! Don’t tolerate ankle soreness for weeks, months, or years, or in addition to limiting your activities, you may be slowing frying the joint. Tackle it before more serious problems take over.