Your ankles are one of your body’s unsung heroes. They are strong and bear an impressive load — about five times the force of your body weight when you walk — and they allow you to shift your weight, walk, run, and do many other activities that you love. What’s more, healthy ankles are essential for your overall musculoskeletal health. “When your feet and ankles are strong, healthy, flexible, and mobile, it helps your knees and hips function better too,” says Mjio Cotic, PT, DPT, a physical therapist at Hinge Health. 

But many people don’t pay much attention to everything their ankles do — at least not until they have an ankle injury or pain. Ankle pain when walking can make just about any part of your daily routine more challenging. Here, learn more about what might be causing your ankles to hurt when you walk and get tips and exercises from our physical therapists to reduce your ankle pain and get you back to doing what you love.

Why Your Ankles Hurt When Walking

If you’re not recovering from an ankle sprain or fracture, you might be wondering why your ankle hurts when you walk. Here are some common causes of ankle pain:

• Tendinitis. The muscles or tendons (tissue that connects muscle to bone) around your ankle joint can be tight or stiff, says Dr. Cotic. They can also become irritated or inflamed and contribute to pain. Achilles tendinitis in particular can be a contributor to pain when walking. This causes pain and stiffness in your heel or lower leg due to inflammation of your Achilles tendon, which connects your heel bone to your calf muscle. 

• Posterior tibial tendon dysfunction (PTTD). This is an irritation of your posterior tibial tendon (PTT). Your PTT connects your calf muscle to bones inside your foot. Located under your Achilles tendon (deeper inside your ankle and foot), it helps support your arch and foot. PTTD can cause pain and swelling along the inside of your foot and ankle that worsens with activity. When symptoms are severe, it can be difficult to walk or even stand. 

• Shin splints. Also known as medial tibial stress syndrome, shin splints are characterized by a painful irritation of your tibia (shin bone) and surrounding tissues. Intense or repetitive activity that your body isn’t prepared for can inflame the muscles, tendons, and bones in your shins and cause pain, swelling, and tenderness. Shin splints often occur after a sudden increase or return to activity. Running is a common trigger, but an abrupt change in the intensity, frequency, or duration of any activity can cause an uptick in shin pain that affects your ankles. 

• Tarsal tunnel syndrome. This can occur when the tibial nerve that runs through a narrow space in your ankle is compressed or irritated. Symptoms can include pain, burning sensations, tingling, numbness, or weakness on the inside of your ankle, the bottom of your foot, and your toes.

• Heel bursitis. Retrocalcaneal (or heel) bursitis occurs when the bursa between your Achilles tendon and your heel bone becomes inflamed. A bursa is a small, fluid-filled compartment that acts like a cushion between your bones, tendons, muscles, and skin. This is common among runners and athletes who perform repetitive movements or increase their activity too quickly. Heel bursitis can cause pain, swelling, and redness in your heel and affect how your ankles feel during activity. 

• Arthritis. The most common type of ankle arthritis is osteoarthritis. This happens because of changes to the cartilage in the ankle joint. Everyone experiences changes in their cartilage over their lifetime. For some people, it wears down and reduces the amount of space between bones, which can lead to pain and stiffness.

No matter what might be aggravating your ankle, remember that there is a lot you can do to treat it and get your function back. 

Treatment for Ankle Pain When Walking

The first thing to remember when it comes to treating ankle pain when walking is this: Don’t stop walking. That may sound counterintuitive, but the best way to treat ankle pain while walking is to improve the mobility and strength of your ankle joint, says Dr. Cotic. “Walking and doing targeted ankle strengthening and stretching exercises are some of the best ways to do that.” 

You also want to just keep your ankle moving in general, even if you’re not walking. “By just moving your ankle, you can help avoid stiffness and accelerate the healing process because you’re increasing blood flow to that joint,” explains Dr. Cotic. 

Here are some other things you can do to treat ankle pain when walking: 

• Adjust your activities. If your ankle pain is making it hard to do your usual activities, it can help to temporarily stop or cut back on things that might hurt your ankle more (e.g., jogging, tennis) and focus on activities that put a little less stress on your ankle (e.g., swimming, cycling, walking). Once your pain improves, you can gradually work your way back to your normal activities and routines. 

• Do physical therapy. A physical therapist can provide exercises to help increase your ankle’s range of motion and flexibility and strengthen your foot and ankle muscles. “The goal is to develop an individualized exercise program that will get you back to your regular activities again,” says Dr. Cotic. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Use ice or heat. Using heat, like a warm towel or hot water bottle, periodically throughout the day can relax tight muscles and tendons, says Dr. Cotic. Some people find that ice — or even a combination of ice and heat — helps, too. Do whatever works best for you. 

• Consider an ankle brace for certain situations. Some ankle braces may help relieve pain and support your ankle as you build up your tolerance to be able to handle more intense, vigorous activity. They can be particularly helpful if you’ll be walking for a long stretch (say, at a theme park) or doing a high-intensity activity. But wearing an ankle brace too often may get in the way of your recovery. Ask your PT or doctor for guidance.

• Try shoe inserts (orthotics), which also help to minimize pressure on your ankle and decrease pain. A 2022 study published in the journal Gait & Posture found that they helped to reduce pain while walking among people with arthritis.

• Use over-the-counter medication as needed. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for ankle pain when walking. It’s important to make sure that you are safely able to take these medications, based on your medical history.

How to Prevent Ankle Pain When Walking

The best way to avoid ankle pain when walking is to keep your ankles strong. Try to do the exercises below several times each week. Other ways to prevent ankle pain include:

• Stretch before activity. If you plan on doing a lower body workout, even if it’s just walking, do a few dynamic stretches beforehand, suggests Dr. Cotic. You can do any of the ankle exercises below or simply start your walk at a slower pace and work up to a faster speed. 

• Take care on tough terrain. If you’re a walker or runner, you may find it helpful to vary your regular routes, but be careful on rocky terrain or hills with loose gravel. There’s no need to be fearful of or avoid these spaces, but watch where you’re walking and avoid distractions (say, texting and hiking). If your ankle pain is particularly bad, you may do better walking on a flatter, less hilly terrain to start and build up to walking on hills or uneven terrain as your ankles get stronger. 

• Modify walking distance or time. If you experience ankle pain when walking, try decreasing your walking distance or time and gradually build back up to where you want to be. Your muscles and tendons get stronger as you walk more, but sometimes doing too much too soon puts too much strain on those structures. 

• Replace old shoes. Replacing worn out shoes can reduce strain on your ankles and keep them feeling strong and stable. As a general rule of thumb, try to replace your shoes every 350-450 miles, or every six months if you’re moderately active.

These exercises suggested by Hinge Health physical therapists can strengthen and stretch your ankles, providing pain relief and helping to prevent future pain flares. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Pick Supportive Footwear 

Flip flops or strappy sandals are okay occasionally, but if you are on your feet all day or walk a lot, you’ll want more supportive shoes to help your ankles. Look for a shoe with a supportive sole and low heel. If you have a high arch, you’ll likely have more success with a "neutral" athletic shoe. If you have flat feet or lower arches, however, you may have more success with a "stable" or rigid shoe type.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.  

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Brockett, C. L., & Chapman, G. J. (2016). Biomechanics of the ankle. Orthopaedics and Trauma, 30(3), 232–238. doi:10.1016/j.mporth.2016.04.015

2. Weatherford, B. M. (2017, September). Rheumatoid Arthritis of the Foot and Ankle. American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/rheumatoid-arthritis-of-the-foot-and-ankle

3. Simonsen, M. B., Næsborg-Andersen, K., Leutscher, P. D. C., Hørslev-Petersen, K., Woodburn, J., Andersen, M. S., & Hirata, R. P. (2022). The effect of foot orthoses on gait biomechanics and pain among people with rheumatoid arthritis: a quasi-experimental study. Gait & Posture, 95. doi:10.1016/j.gaitpost.2022.04.016