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Pain Top of Foot Near Ankle

Getting Pain Top of Foot near Ankle?

As a Podiatrist, we see a lot of pain top of foot near ankle joints. Due to the fact your whole body moves over these ankle joints, it is imperative we get it sorted out so the patient does not have other joints affected and or become injuries themselves.

The anatomy of the ankle joint as seen to the right.

 As for the Cause of Pain top of foot near ankle, there are many possibilities:

  • Ligament damage, strain or sprain
  • Tendon dislocation or damage
  • Nerve entrapment
  • Metatarsal Fault
  • Sinus Tarsi Syndrome
  • Bone damage, such as stress fractures
  • Muscle fatigue or strains
  • Abnormal growths e.g. Ganglion Cyst
  • Superficial Phlebitis

Ligament Damage causing pain top of foot near ankle

Due to the ankle joint going through so much stress on a day to day basis, it is not surprising that the support network that holds the joints together can come under fire and cause pain across the top of the foot.

As the ligaments are made from very dense tissue, when they do get injured, they often cause pain and may take sometime to heel.

These  ligaments can include the lateral or medial ankle ligaments.

Lateral view of the ankle joint and associated ligaments often causing pain top of foot near ankle

Lateral ankle ligaments include;

  • the anterior talofibular ligament
  • the calcaneofibular ligament
  • and the posterior talofibular ligament
Medial ankle ligaments include;
  • the Deltoid ligament
  • talonavicular ligament
  • long plantar ligament
  • plantar calcaneonavicular ligament
Generally a lateral (outside) ankle sprain is more common, as the ligaments themselves are weaker and the foot has a tendency to move out to the shorter length metatarsals at toe off.
The higher ligaments can cause pain top of foot near ankle with even modest damage, as the superficial peroneal nerve stretches across these structures.
Fortunately however the ligaments can be somewhat de-activated by using a wedge type scenario under the foot to prevent the ankle from turning out.

Tendon Damage causing pain top of foot near ankle

There are various tendons associated with the top of the foot near your ankle joint.

Tendons that can cause Pain Top of Foot Near Ankle

These tendons include;

  • Tibialis anterior
  • Tibialis posterior
  • Peroneal brevis
  • Peroneal longus
  • Peroneus tertius
  • Extensor hallucis longus
  • Extensor digitorum longus
Each one of these can cause sharp or dull pain around the ankle joint and should be treated accordingly.
The tibialis muscles mentioned above attach just in front of the ankle and primarily hold the arch of the foot up.
Therefore, if the arch is under constant pressure to drop or stretch, these tendons commonly cause trouble.
Fortunately they are both easy enough to relieve by simply helping them out through some form of arch support.
This may come in the form of supportive footwear or orthotics.

Nerve Entrapment near the ankle

As the name suggests, it is more than possible to have a nerve in the area compressed and cause pain around the ankle.

Sometimes this can be due to anatomical anomalies i.e. the way you’re born.

Often however this can be due to biomechanical anomalies.

Most commonly, over pronation.

Although pronation is a normal motion and required for shock absorption, excessive movements may cause a compressible stress to the tissues around the ankle joint and result in a sharp pain across the top of the foot.

Understandably you would want to reduce this aggravating force by limiting the amount of pronation, generally speaking this can be a very successful and almost immediate resolution of symptoms.

Metatarsal Fault leading to pain top of foot near ankle

The metatarsals are the midfoot bones of your foot. From time to time these bones can be placed in a very vulnerable position, such as when rolling the ankle.

Unfortunately the joints may sprain and even break in places, leading to quite a nasty pain top of foot near ankle, usually occurring on the outside part of your foot.

Often the treatment for severe sprains and breaks is immobilisation and rest.

However in a lot of cases it is advised the foot is somewhat supported, such as wearing appropriate shoes and orthotics or arch supports.

This has the added benefit of distributing pressure more evenly across the whole of the foot and feeling more comfortable.

Sinus Tarsi Syndrome

Sinus tarsi syndrome can cause pain top of foot near ankle also. It tends to be noted slightly towards the outside of the ankle and often becomes a chronic condition.

The primary causes are thought to be excessive pronation and or sequel to an ankle sprain.

If this is thought to be the case it may be necessary to see a doctor in order to receive an injection into the space to lower inflammation and or pain to confirm the structure is indeed at fault.

Stress fractures around ankle

The bones in and around the ankle joint can also become fractured should they receive enough stress.

pain top of foot near ankle from stress fracture

Stress Fracture as noted by the red arrow

The stress may come in the form of a quick sharp force such as falling off a ladder, or a slow persistent fatigue type stress as often seen in distance runners.

Common muscle/tendon strains near ankle

As the various images on the site show, there are many muscles that may cause pain top of foot near ankle.

The most common are:

  • Tibialis Anterior Muscle/Tendon
  • Tibialis Posterior Muscle/Tendon
  • Extensor Hallucis Longus Muscle/Tendon
  • Extensor Digitorum Longus Muscle/Tendon
  • Peroneus Longus Muscle/Tendon

Abnormal Growths causing pain top of foot near ankle

There are numerous types of abnormal growths found around the ankle joint. These types of growths can be made from bone, ligaments, tendons, bursa (fat type sacks), muscle and skin.

If the growth is due to a know past trauma, such as a broken ligament or section of bone, it may be surgically removed or revised.

If the growth is physically affecting the ankle joint’s movement, it would be no surprise that your pain top of foot near ankle is present.

The pain is often only going to get worse if the growth continues to grow also.

The growth of biggest concern we as Podiatrists have is the skin type. This is because it may be cancerous.

A classic example of a skin cancer is the melanoma.

Without any word of a lie I once diagnosed one of these back in 2002 and the gentlemen sadly lost half of his foot!

Needless to say he was very relieved it was found, so it always pays to get these growths checked.

Superficial Phlebitis causing pain top of foot near ankle

This is basically your veins swelling up and causing a notable pain and discolouration in the area.

Obviously if you suspect this could be the case, a prompt visit to the Doctor is recommended as to not risk any long term damages to the blood vessels.

The image below is a great ankle brace often used to help pain on top of foot near ankle, with a number of conditions discussed above