Ankle Pain: When to Stretch and Strengthen Safely

Ankle pain!!

I would like to ask you: I heard a "pop" sound while performing a calf stretch (pushing against a wall).
Initially, I did not feel any pain and was able to walk normally.
However, after putting on shoes, I started to experience pain, primarily located above and around the inner and outer ankle joints.
There is no visible swelling, but as soon as I wear shoes and extend my leg forward while sitting, it becomes very painful.
I then wore sandals to work for a month, and after a month, I tried wearing shoes again, but the pain persists when I extend my leg forward while seated.
Given this situation, is it appropriate for me to continue doing calf stretches and strength training for the posterior calf?

A Dong, 30~39 year old female. Ask Date: 2003/12/30

Dr. Yang Zhengfan reply Orthopedics

Dear A-Dong,
Although you have made an effort to describe your symptoms, to be honest, it's still not very clear how pushing against the wall is related to pulling on the Achilles tendon.
If the pain you are describing is at the junction of the calf soleus muscle and the heel, this is actually a common symptom that many people experience after stretching.
There is no need to worry too much; with some time for adaptation, it should gradually improve.
You can continue with strength training and stretching exercises.
However, if there are no signs of improvement, I recommend that you seek further evaluation from an orthopedic physician.

Reply Date: 2003/12/30

More Info

When it comes to understanding ankle pain, particularly after an incident like the one you described, it's crucial to approach the situation with caution. The "popping" sound you heard during the calf stretch could indicate a potential injury to the Achilles tendon or surrounding structures. Although you initially felt no pain, the delayed onset of discomfort, especially when wearing shoes, suggests that there may be underlying issues that need to be addressed.

Understanding Your Symptoms
The pain you are experiencing, particularly around the inner and outer sides of the ankle joint, could be due to several factors, including tendonitis, ligament strain, or even a minor tear in the muscles or tendons. The fact that you do not see swelling is a positive sign, but it does not rule out the possibility of an injury. Pain when extending your leg while seated, especially when wearing shoes, indicates that certain movements are exacerbating your condition.

When to Stretch and Strengthen
1. Initial Rest and Recovery: After an injury, it's essential to allow your body some time to heal. Rest is crucial, especially in the first few days following the injury. Avoid activities that cause pain, particularly those that involve pushing off or putting weight on the affected ankle.

2. Gentle Stretching: Once the acute pain subsides, gentle stretching can be beneficial. However, it’s important to listen to your body. If stretching causes pain, it’s best to stop. You can start with non-weight-bearing stretches, such as seated calf stretches, where you gently pull your toes towards you without putting pressure on the ankle.

3. Strengthening Exercises: Strengthening exercises should only be introduced once you can perform stretches without pain. Begin with isometric exercises, where you contract the muscles without moving the joint. For example, you can press your foot against a wall or a stable surface without moving your ankle. Gradually, as your strength improves and you experience less pain, you can progress to more dynamic exercises.

4. Consulting a Professional: Given your symptoms and the mechanism of injury, it would be wise to consult a healthcare professional, such as a physical therapist or an orthopedic specialist. They can provide a thorough assessment and tailor a rehabilitation program specific to your needs. They may also use diagnostic imaging, such as an ultrasound or MRI, to rule out any significant injuries.

5. Using Proper Footwear: Since you mentioned that wearing shoes exacerbates your pain, consider using supportive footwear that provides adequate cushioning and stability. Avoid high heels or shoes that place excessive strain on your ankle.

Conclusion
In summary, while gentle stretching and strengthening can be beneficial for ankle pain, it is essential to proceed with caution. Pay attention to your body’s signals, and do not hesitate to seek professional guidance. Recovery from ankle injuries can vary significantly from person to person, and a tailored approach will help ensure that you regain strength and flexibility safely. Remember, the goal is to return to your activities without pain, so prioritize your recovery and listen to your body throughout the process.

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