Ankle pain behind the lateral malleolus

harrast

Increasingly I've been getting a pain in my right ankle that begins behind that outside ankle bone called the malleolus.  The pain extends from behind the malleolus down under my foot and radiates through the arch.  The right ankle also seems less stable than the left ankle.  After a race the ankle/arch is VERY uncomfortable--no I should say it just plain hurts.  I have to wear loose fitting Tevas or my foot barks at me loudly.  It can take a couple of days to calm down so that I don't have to favor it.  I have looked at ankle braces and wonder if I should start wearing one?  Any brand/type suggestions?  I am also wondering if anyone has had success with rest or strengthening exercises?  Thanks peeps.  

cgres123

Sounds like plantar fasciitis/tendinitis all about over use Steven. When I have that issue flaring up I will go as far to use a night splint; socks that support the area when training. I also rub the bottom of my foot with a golf ball to stimulate the area this gets more blood flow to the tendons and may increase the healing. Don't let it go to far as it can bust you up for a long time.

Satish Punna

Might be peroneal tendonitis or tenosynovitis (inflammation of the tendon sheath).. Where you are describing the symptoms is where the peroneal tendons live. If it is tendonitis, rest and ice until completely pain free is important to avoid turning this into a chronic problem, then you can do exercises. Cross friction massage can also be helpful to break down scar tissue and adhesions.

Here is a site with some exercises and info:

http://www.summitmedicalgroup.com/library/adult_health/sma_peroneal_tendon_strain_exercises/

Does the pain occur with running or biking or both? Was there an ankle injury that started the problem, or a change in running shoes/ habits or bike fit?

harrast

Thanks, Satish. I believe you are correct--peroneal tendonitis seems to be the correct diagnosis. The pain is most acute during/after running, less during cycling. I did a trail HM last Saturday, and I had quite a limp after. Can peroneal tendonitis radiate under the foot into the arch, or is that another issue? After my last race, my foot hurt so much that I had to remove my running shoe from my right foot because the pressure hurt a lot. I've had a number of issues with this foot including Morton's Neuroma. I am currently wearing orthodics. BTW, I need to get one of those stability balls they show in the exercise link.

harrast

Oh, I should have mentioned that I can't think of a particular injury that triggered this, but this ankle seems much weaker than the other and often will "roll" on a piece of uneven sidewalk or on a root. In my trail race last weekend, it rolled slightly once on some trail debris. It barked for a minute, then just went back to feeling weak and sore:-D. I am 5'8' about 160#.

Satish Punna

The peroneus longus tendon goes under arch of the foot. You should also look at "cuboid syndrome";  its possible this may also be a factor.  At the end of the day everything in the sole of the foot is in close proximity so in my personal experience once a problem has gone on long enough there may be several structures involved and all may require some attention that will only become evident as the more severely injured areas heal (sort of like layers of an onion).  Seeking help from a PT or sports doc may be indicated to get you on track to recovery with an appropriate exercise regime aimed at the foot/ankle and core, as well as taping etc to get you through any races you might still have. 

I would probably avoid anything that causes extreme pain afterwards though, as that will only make things worse.  Tendonitis commonly feels better with activity initially but then will come back sooner and sooner afterwards, until finally it is bad during activity as well.