Arthritis Today

Prevent Ankle Pain

Learn to love your ankles. Take steps to keep ankles pain- and sprain-free.


Are you rankled by arthritis ankle pain or frustrated by recurring ankle sprains? While ankles are one of the most commonly injured joint, the good news is there are simple steps that you can take to prevent arthritis ankle pain and injury, and keep you on your feet.

Skip the stilettos. “If you walk on a spiked heel, you have much less stability,” says James A. Nunley, MD, chief of orthopaedic surgery at Duke University Medical Center in Durham, N.C. For ankles weakened by osteoarthritis, he recommends shoes with a wide, low, flared heel or lateral post shoes, like running sneakers.

“You are less likely to roll your ankle because your shoe is wider and it takes much more to roll it over,” says Dr. Nunley.          

Scrap the flats. Sandals and flip-flops fall flat on safety too. “When you go to that flatter shoe, you lose some of the support for the arch,” says Ronald D. Jensen, a podiatrist and president of the American Podiatric Medical Association. “A lot of people who get arthritis in their ankles begin to get a deformity in their ankle called pronation and this consists of an inward rolling toward the arch of both the foot and the ankle. If you’re in a flat shoe, there’s nothing to resist this painful movement.”

Sandals also lack heel protection, so the heel can wobble twisting your ankle. For the most support and stability, choose everyday footwear choose an enclosed, laced-up shoe with a heel no higher than 1-½ inches.

Get a lift. Shoe inserts and insoles not only provide shock absorption, they also keep your ankle from rolling. “Modifications to the shoe to try to tip the foot in can take the stresses off those lateral ligaments,” says Dr. Nunley, who heads Duke’s Orthopaedic Research Laboratory.

He recommends over-the-counter one-quarter-inch lateral heel inserts for those whose ankles have a tendency to roll. In shoes without proper internal support, a three-quarter-inch insole provides arch support and reduces ankle pressure.

Brace yourself. Elastic ankle braces, such as sports bandages or compression socks, reduce ankle swelling and associated arthritis joint stiffness and pain. While they offer little support, elastic braces affect proprioception – our ability to sense where our limbs are in space.

“Many people when they get swollen also get numbness in the foot,” says Jensen. “By using a compression sock and reducing the swelling, they have better feeling and it makes it safer for them to walk because they can feel the ground better.”

For extra support and to control painful movement, particularly in those with tendonitis of the ankle, Jensen recommends a lace-up or stirrup brace. Hiking boots or hi-top sneakers made of firm leather or other thick material also serve as effective braces.

Avoid uneven ground. Cobblestone pathways, bumpy hillsides and shifting sand can wreak havoc on ankles affected by arthritis that have a limited range of motion. Stepping on uneven ground is a common cause of ankle sprain. If all else fails – for example, while on vacation in an historic town with hilly terrain – follow the footwear rules above.

Sit smart. Avoid sitting with your feet crossed behind you and pointed down. This puts pressure on your toes that can lead to ankle stiffness and soreness.

“The best way to sit at a desk is to have your feet flat. If your heels don’t touch the ground, consider a foot rest,” says Suzanne Hawson, a physical therapist with University Foot and Ankle Institute in Valencia, Calif.

Condition your ankles. Strengthening your peroneal muscles – the muscles in your shin that support your ankles – through resistance band exercises will keep your ankles stable and injury free. Towel crunches with your feet also can help build strength and stability, says Hawson. Place a towel under your foot and scrunch the towel under your toes.

“Many of the muscles that cross the ankle joint have insertions in the foot. Stronger foot muscles help to support the ankle joint,” she says.

To increase flexibility and range of motion, Hawson suggests simple calf stretches against a wall, or, in a seated position, moving your ankle to write out the letters of the alphabet using your big toe as the tip of the “pen,” and doing 10 repetitions of ankle circles in both directions.

Switch sports. To preserve ankle health, avoid high-impact sports, such as running, or sports that require cutting from side to side, such as basketball, tennis and soccer. Beware the seemingly benign golf. (Most golf courses aren’t flat).

“If you hit a sand trap, you have to climb in and out and that’s when you are most likely to twist your ankle,” says Dr. Nunley, who advises golfers to wear a stirrup brace for added support.

Choose low-impact sports, such as biking, swimming or other aquatic exercises. “The buoyancy of the water helps to de-weight the ankle and allows the muscles to get strong without stressing the ankle joint,” says Hawson, whose specialty is sports rehabilitation. Whatever sport, stretch your ankles properly before and after.

Watch your weight. Extra weight puts added pressure on ankle joints. “Even people who are moderately overweight can suffer the consequences of a more rapid progression of their arthritis,” says Jensen. Above all, stay active to maintain a healthy weight and to keep your ankles strong and flexible.