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? What about foot and ankle pain after hiking? 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 tibiotalarjoint, 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:
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.
Common Conditions Associated to Pain in the Ankle After Walking
Heel pain is one of those issues that can affect most of what you do in a day and can be disabling. A common cause of heel pain is the Achilles tendon. What is the Achilles tendon? What is Achilles tendonitis? What are the different injuries? Is stem cell therapy for Achilles tendonitis a viable option?
Where & What Is the Achilles Tendon?
A tendon is a thick fibrous band of connective tissue that connects a muscle to bone. There are more than 30 million tendon and ligament injuries annually. The Achilles tendon, which is the thickest tendon in the body connects the calf muscles to the heel bone. It consists of the gastrocnemius and soleus muscles that unite to form a thick band that is immediately above the heel tab on your shoe. It enables the downward movement of the foot and bending of the knee.
Your ankle is located where the distal ends of the tibia and fibula bones (lower-leg bones) meet the talus bone at the foot. Between these bones are the ankle joints (e.g., tibiotalar, tibiofibular, subtalar, etc.). The ankle joint also consists of strong supporting tendons and ligaments. If you consistently experience ankle pain with walking or running or carrying a heavy load, this could be tendon inflammation, ligament instability, or arthritis in one of those joints.
The ankle is susceptible to injury. It is the most injured joint in sports and accounts for 10-30% of all sports injuries. A sprain (aka twisting the ankle) is when one or more of the ligaments is stretched or torn. Pain, swelling, and bruising are common. Sprains are classified into grades 1, 2, or 3 based upon the severity of the injury. Simple tasks like stepping off the curb or sports can lead to ankle sprains. Ligaments stabilize the ankle joint and when sprained can lead to ankle instability. When acute ankle sprains are not identified, treated, and allowed to heal chronic…
Have you been told you have an ankle tendon tear and need surgery? Do you really need this procedure or will less invasive injections do the trick? Let’s review ankle tendon surgery and who needs it and who doesn’t.
The ankle has many tendons that come from leg muscles. They help stabilize the ankle and move the foot up, down, left, and right.
The ankle tendons include:
FHL (Flexor Hallicus Longus)
FDL (Flexor Digitorum Longus)
These can be torn in trauma or due to wear and tear.
Ehlers-Danlos Syndrome (EDS) refers to a group of disorders that affect the body’s connective tissue including skin, tendons, and ligaments. It is a hereditary disorder which means you are born with it. EDS has many different signs and symptoms which can vary significantly from patient to patient. It most commonly affects the skin, joints, and blood vessels. The estimated prevalence for all EDS varies between 1/10,000 and 1/25,000. The three most common types of EDS are: Hypermobile, Classic, and Vascular. We have used these skills and knowledge to treat the loose ligaments commonly found in EDS in children. Treatment options include bone marrow concentrate (BMC) and PRP.
Disorders that affect and weaken the connective tissues such as tendons and ligaments. It is a hereditary disorder which means you are born with it. EDS has many different signs and symptoms which can vary significantly depending upon the type of EDS and its severity. It most commonly affects the skin, joints, and blood vessels. Joints are typically hypermobile with excessive joint range of motion because of a defect in collagen formation. In most cases Ehlers-Danlos syndrome is inherited. That is to say that you are born with it. The two main ways EDS is inherited are: autosomal dominant inheritance and autosomal recessive inheritance…
Your ankle is comprised of bones held together by a bunch of ligaments. These ligaments end up getting damaged when you sprain or roll your ankle.
Common causes are trauma or injury related, such as twisting your ankle.
Carpal tunnel syndrome is compression of the median nerve at the level of the wrist with resultant hand and wrist pain. Tarsal tunnel syndrome (TTS) is the equivalent in the ankle.
What is Tarsal Tunnel Syndrome (TTS)?
Also called tibial neuralgia, TTS is compression of the tibial nerve as it passes through the tarsal tunnel at the ankle. The tarsal tunnel is located behind the medial malleolus, the bump on the inside of the ankle.
Book an Appointment with a Interventional Orthopedics Doctor
Christopher J. Centeno, MD
Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…
My passion and specialization are in the evaluation and treatment of cervical disc, facet, ligament and nerve pain, including the non-surgical treatment of Craniocervical instability (CCI). I quit a successful career in anesthesia and traditional pain management to pursue and advance the use of PRP and bone marrow concentrate for common orthopedic conditions. I have been a patient with severe pain and know firsthand the limitations of traditional orthopedic surgery. I am a co-founder of the Centeno-Schultz Clinic which was established in 2005. Being active is a central part of my life as I enjoy time skiing, biking, hiking, sailing with my family and 9 grandchildren.
Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.
Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.
Doctor Hyzy is Board Certified in Physical Medicine and Rehabilitation (Physiatry) and fellowship-trained in Interventional Orthopedics and Spine. Dr. Hyzy is also clinical faculty at the University of Colorado School of Medicine in the Department of Physical Medicine and Rehabilitation; In addition, Dr. Hyzy is an Adjunct Clinical Assistant Professor at The Rocky Vista University College of Osteopathic Medicine. Dr. Hyzy also maintains an active hospital-based practice at Swedish Medical Center and Sky Ridge Medical Center. He is also recognized and qualified as an expert physician witness for medical-legal cases and Life Care Planning. He is published in the use of autologous solutions including…
Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…
Dr. Mairin Jerome is a physiatrist with subspecialty fellowship training in Interventional Orthopedics and Regenerative Medicine. This subspecialty serves to fill the gap for patients who are interested in therapeutic options that lie between conservative treatment and surgery. Dr. Jerome uses regenerative medicine techniques, including prolotherapy and orthobiologics, via X-ray or ultrasound guidance to precisely deliver injections to areas of musculoskeletal injury or degeneration. Orthobiologics refers to tissue harvested typically from a person’s own body, such as platelets (platelet-rich plasma, PRP) or bone marrow, for use in treating painful musculoskeletal conditions. The goal is to stimulate the body’s healing mechanisms to improve pain, function, and decrease inflammation.