Ankle Pain

Ankle injuries are treated by Dr. Kevin Mangum who is a family medicine and sports medicine physician who works in Salt Lake City Utah

Ankle Sprain

Ankle sprains are one of the most common reasons for people to see a doctor, with an overall incidence of 2.15 per 1,000 person-years. Teenagers and young adults have the highest rates of ankle sprains, with a peak incidence of 7.2 per 1,000 person-years for those 15 to 19 years of age. Nearly one-half of all ankle sprains occur during athletic activity, with basketball and dancing being the most common sports where ankle sprains occur. The greatest risk factor for ankle sprains are a previous ankle sprain. It is very important to properly treat every ankle sprain to prevent further ankle sprains.

How long does it take for a sprained ankle to heal?

Depending on the type and severity of the ankle sprain, most ankle sprains heal in 4 to 8 weeks.

Can you walk on a sprained ankle?

The most common type of ankle sprain is an inversion ankle sprain where the ligaments on the outside of the ankle are injured. With these types of ankle sprains, it is usually safe to walk. High ankle sprains or the ankle sprain on the inside of the ankle can be more severe and they may be difficult to walk on. If there is a fracture involved it is not safe to walk on a sprained and fractures ankle. It is best to be evaluated by a a highly trained physician to get proper education and recommendations for your ankle sprain.

How do you heal a sprained ankle quickly?

There are several modalities that may help recovery an ankle sprain. However, ankle sprains do take time to heal. The ligaments and damaged structures have to heal naturally and through biological mechanisms. There are some supplements and modalities that claim to help heal ankle sprains; however, medical data on those are lacking. The best way to heal a sprained ankle is an individualized treatment approach that usually involves bracing, rehabilitation and conservative therapy.

How do I know if I sprained my ankle?

Sprained ankles usually happen from some sort of accident or trauma. If you have tenderness, swelling or pain around your ankle after a fall, trip or trauma, you likely have an ankle sprain. It is best to seek a trained physician to help you diagnose this and get the proper treatment.

Here are some important rules in diagnosing and managing ankle sprains:

  • The Ottawa ankle rules should be used to rule out fractures and prevent unnecessary radiographs in patients with suspected ankle sprain.
  • Cryotherapy should be applied for the first three to seven days to reduce pain and improve recovery time in patients with ankle sprain.
  • An air stirrup brace combined with an elastic compression wrap, or a lace-up support alone, reduces pain and recovery time after an ankle sprain and allows early mobilization.
  • Early mobilization and focused range-of-motion exercises reduce pain and recovery time after an ankle sprain, and are preferred to prolonged rest.
  • Patients at risk of reinjury after an ankle sprain should participate in a neuromuscular training and rehabilitation program.
  • Air stirrup braces, lace-up supports, and athletic taping can reduce the risk of ankle sprains during sports.

Achilles Tendon Rupture

Achilles tendon ruptures are frequently seen in athletic patients, especially in males in their fourth decade of life. It usually occurs about 6 cm above where the Achilles tendon attaches to the heel bone. It is estimated that in order for the Achilles tendon to rupture, there needs to be some degeneration, usually about 50%.

When patients rupture their Achilles tendon, they usually are pushing off or cutting side to side during an athletic event. Patients usually hear a pop or they describe the sensation of getting hit in the back of the heel. The pain is usually localized to the back of the heel. After the rupture happens, patients usually describe a weakness walking or pushing off. Achilles tendon ruptures have been associated with fluoroquinolone antibiotics usage and steroid injections around and into the tendon.

Diagnostic ultrasound and MRIs are helpful in determining the extent, the type and how much separation occurred during the tearing or rupturing of the Achilles tendon.

Treatment options for an Achilles tendon ruptures are both surgical and nonsurgical options. Nonsurgical treatment options usually involve immobilization with the foot pointing downward to some degree or in some position of plantar flexion with progressive dorsiflexion the ankle as healing progresses. Early functional rehabilitation has produced excellent results with re-rupture rates similar to those with surgical treatment options. Surgical treatment options consists of repairing the ruptured ends of the tendons using sutures. Re-rupture rates after Achilles tendon surgical repair are very low. Disadvantages of surgical management can include wound healing problems, infections and nerve damage how are these rates are very low also.

If you think you have ruptured your Achilles tendon it is best to seek medical help from a trained sports medicine or orthopedic physician for proper evaluation and management of your rupture.

How long does it take to recover from an Achilles tendon rupture?

Achilles tendon rupture, depending on the treatment approach, usually takes 6 to 8 weeks to heal.

Can you walk with a ruptured Achilles tendon?

It might be difficult to walk with a ruptured Achilles tendon however after proper treatment you will be able to walk. Initially your physician might put you in a non-weight-bearing status which means you cannot walk on it however with increasing time you will graduate through rehabilitation and onto walking status.

How do I know if I ruptured my Achilles tendon?

You usually know if you ruptured your Achilles tendon if you cannot push your foot down, do calf raises, cannot walk, or you have significant swelling and bruising on the backside of your ankle.

Is a ruptured Achilles tendon an emergency?

A ruptured Achilles tendon is usually not an emergency, however patients need to see a trained sports medicine or orthopedic physician within one to two days of the injury for proper treatment.

Achilles Tendinopathy

Achilles tendinopathy or Achilles tendinosis is a degenerative condition that occurs within the tendon substance with mucoid degeneration, chondroid metaplasia, and fatty degeneration. Achilles tendinopathy occurs over time with chronic inflammation in the Achilles tendon.

MRI and diagnostic ultrasound are 2 imaging modalities that are very helpful in diagnosing and quantifying the extent of the Achilles tendinopathy.

How do you treat Achilles tendinopathy?

Treatment for Achilles tendinopathy usually includes a stretching or rehabilitation program, night splints, nonsteroidal anti-inflammatory drugs (NSAIDs), ice, rest, and even immobilization for a period of 2–4 weeks can be helpful. Surgical treatment involves debridement of inflammatory and degenerative tissue. Platelet rich plasma (PRP) injections have also been found to be helpful for Achilles tendinopathy. Contact Dr. Kevin Mangum’s office today to schedule your consultation or PRP injection.

How long does Achilles tendinopathy last?

Achilles tendinopathy usually is a chronic condition and lasts longer than Achilles tendinitis. With a good rehabilitation and treatment plan from your sports medicine or orthopedic physician, you will have the best chance for healing.

What is the difference between Achilles tendonitis and Achilles tendinopathy?

Achilles tendinitis is usually in acute inflammation process of the Achilles tendon that resolves within a few weeks. Achilles tendinopathy usually refers to a chronic degenerative condition of the Achilles tendon that is more difficult to treat.

Can I walk with Achilles tendinopathy?

Yes, it is usually safe to walk with Achilles tendinopathy.

What happens if tendinopathy goes untreated?

If tendinopathy goes untreated, it will usually progress or worsen. Worsening Achilles tendinopathy can lead to a decline in function and worsening pain.

Is tendinopathy permanent?

Tendinopathy is a slow difficult process to heal. Sports medicine and orthopedic physicians have great success working with patients with tendinopathy to promote healing and rehabilitation.

Achilles Tendonitis

Achilles Tendinitis is a thickening and inflammation of the Achilles tendon and the tissues that are around the Achilles tendon. This most commonly happens from overuse of the Achilles tendon. It is usually associated with significant pain and inflammation.

What is the fastest way to heal Achilles tendonitis?

The fastest way to heal Achilles tendinitis is to rest. If you don’t have any contraindications, you can take ibuprofen or naproxen. Ice is always helpful for this condition. You can also wear heel cups and a heel lift to help take pressure off of the Achilles tendon. Stretching has also been very helpful along with eccentric exercises to help the Achilles tendon become stronger.

What are 2 signs of Achilles tendonitis?

The two main signs of Achilles tendinitis is pain along the Achilles tendon or the back of the ankle and pain with activity. There can also be swelling and a fullness felt along the Achilles tendon

How long does Achilles tendinitis last?

Achilles tendinitis if properly treated should only last a few weeks. However this could continue to be a problem and Achilles tendinitis can develop into Achilles tendinosis.

Is it OK to walk with Achilles tendonitis?

Yes, it is okay to walk when you have Achilles tendinitis. It is recommended to avoid high-impact activities with inflamed tendons. Gentle walking and exercising can be helpful to stimulate healing in your Achilles tendon.

How do I get my Achilles to stop hurting?

The best way to stop your Achilles tendon from hurting is to rest it. Ice can also be helpful. Both topical and oral NSAIDs, like ibuprofen and naproxen, can also be helpful.

How do I know if I have a strained Achilles?

If you strained your Achilles tendon, you likely will have pain and may have some swelling on the backside of your ankle just above the heel bone. It’ll also be painful to walk and exercise.

Why is my Achilles tendon hurting?

Achilles tendons can hurt for a variety of reasons. The most common being Achilles tendinitis and Achilles tendinopathy.


Dowling S, Spooner CH, Liang Y, et al. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and midfoot in children: a meta-analysis. Acad Emerg Med. 2009;16(4):277–287.

Bachmann LM, Kolb E, Koller MT, Steurer J, ter Riet G. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003;326(7386):41

Hubbard TJ, Denegar CR. Does cryotherapy improve outcomes with soft tissue injury? J Athl Train. 2004;39(3):278–279.

Hubbard TJ, Aronson SL, Denegar CR. Does cryotherapy hasten return to participation? A systematic review. J Athl Train. 2004;39(1):88–94.

Bleakley CM, McDonough SM, MacAuley DC, Bjordal J. Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols. Br J Sports Med. 2006;40(8):700–705.

Boyce SH, Quigley MA, Campbell S. Management of ankle sprains: a randomised controlled trial of the treatment of inversion injuries using an elastic support bandage or an Aircast ankle brace. Br J Sports Med. 2005;39(2):91–96.

Beynnon BD, Renström PA, Haugh L, Uh BS, Barker H. A prospective, randomized clinical investigation of the treatment of first-time ankle sprains. Am J Sports Med. 2006;34(9):1401–1412.

Lamb SE, Marsh JL, Hutton JL, Nakash R, Cooke MW; Collaborative Ankle Support Trial (CAST Group). Mechanical supports for acute, severe ankle sprain: a pragmatic, multicentre, randomised controlled trial. Lancet. 2009;373(9663):575–581.

Kerkhoffs GM, Rowe BH, Assendelft WJ, Kelly K, Struijs PA, van Dijk CN. Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults. Cochrane Database Syst Rev. 2002(3):CD003762.

van Rijn RM, van Ochten J, Luijsterburg PA, van Middelkoop M, Koes BW, Bierma-Zeinstra SM. Effectiveness of additional supervised exercises compared with conventional treatment alone in patients with acute lateral ankle sprains: systematic review. BMJ. 2010;341:c5688

Hübscher M, Zech A, Pfeifer K, Hänsel F, Vogt L, Banzer W. Neuromuscular training for sports injury prevention: a systematic review. Med Sci Sports Exerc. 2010;42(3):413–421.

Emery CA, Meeuwisse WH. The effectiveness of a neuromuscular prevention strategy to reduce injuries in youth soccer: a cluster-randomised controlled trial. Br J Sports Med. 2010;44(8):555–562.

Handoll HH, Rowe BH, Quinn KM, de Bie R. Interventions for preventing ankle ligament injuries. Cochrane Database Syst Rev. 2001(3):CD000018.

Dizon JM, Reyes JJ. A systematic review on the effectiveness of external ankle supports in the prevention of inversion ankle sprains among elite and recreational players. J Sci Med Sport. 2010;13(3):309–317.