Pain in the ankle

Pain in the ankle can be caused by incorrect footing (pronation or supination), external violence, a sprain or inflammation.


Malposition of the ankle

Natural pronation

The outside of the heel is first placed on the ground when walking.
The foot turns slightly inwards, gets full contact with the ground and can carry the body weight without any problems.
By turning the foot, the acting forces are optimally distributed.
This movement is called “pronation” and is fundamental to ideal weight distribution.
The step is completed by pressing evenly the entire forefoot.


Supination of the ankle occurs when the foot is rolled over the outer edge while walking.
A slight supination during movement or walking is quite normal; however, if it is excessive, severe pain may occur and the tissue structures of the foot may be overstretched.
Typical supination symptoms are arch pain or heel pain.
Sometimes supination also causes back pain and knee pain. Due to the unnatural dynamics, the stability can be impaired, because the feet do not touch the ground as intended.

Supination of the ankle also favors the occurrence of plantar fasciitis (inflammation of the sole tendon plate).
On the underside of the foot stretches a strong ligament, the so-called plantar fascia or plantar aponeurosis.
This tendon plate originates from the heel and attaches to the front of the foot near the toes.
Supination often creates excessive pressure and overstretches this fibre strip, causing strain and/or micro-injury to the tissue; in this case, pain occurs on the heel.

Hyperpronation or pronated foot

Again, the outside of the heel is the part of the foot that is first placed on the ground when walking.
However, the foot is excessively turned inwards, this movement is called “hyperpronation”.
This means that the foot and ankle have problems stabilizing the body and the weight is not optimally distributed.
The step is terminated by pressing upwards through the front part of the foot (especially big and second toe).



Hyperpronation and runner injuries

The pronated foot becomes a problem if the deformity is too pronounced, because it can cause numerous injuries, especially in athletes who walk a lot; The following complaints may occur as a result of malpositions:

With a pronated ankle joint, the leg turns inwards, the knee and hip joint then experience an axis deviation, which can lead to a rotation of the back.
The position of the foot can be corrected with the help of an insole. It is inserted into the running shoe, controls the heel position and improves weight distribution.

Why can hyperpronation lead to injury?

Normally, the pronated foot leads to overload-related injuries, which occur especially in runners.
When a neutral foot pronates while walking or running, the lower part of the lower leg, knee joint and thigh turn inward (towards the middle of the body). If an athlete now runs with a hyperpronated foot, this rotational movement is much more pronounced.
Overloading the inside of the foot can cause injuries and pain in the foot and ankle. Due to the repeated rotational forces acting on the shinbone, knee joint, thigh and pelvis, the muscles, tendons and ligaments in the lower part of the leg are also more stressed.

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