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Treating the Cause of Burning Ankle Pain

RIS - Winter 2004

by Julie Donnelly

Ankle pain is common for skaters, and for good reason. The muscles of the lower leg originate at the knee joint and merge into tendons where the leg slims down, and the tendons go under ligaments that surround the ankle. The tendons then insert into various points of the foot and give the foot the ability to turn in or out, point or flex.

Two muscles, the peroneal and the tibialis anterior, are key to ankle pain.

The peroneal muscle causes pain on the outside of the ankle, under the anklebone, along the outer edge of the foot and into the arch. If you look at an anatomy book and realize that insertions always move toward the origination point, you will understand why this muscle causes you to put your weight onto the inside border of your foot and lifts the foot out into the graceful position that is common for ice skaters.

If you flatten your hand on the outside of your lower leg, starting just below your knee joint, while at the same time bringing the outer edge of your foot up off the floor, you will feel the muscle contracting. Follow the muscle all the way down and under your lateral ankle bone, and you will feel the tendon as it tightens. This is the longest of the three muscles of the peroneal muscle group. Since the muscles contract every time you pick up your foot from the ice while you skate, every step you take contracts the muscle.

The second muscle, the tibialis anterior, will cause pain at the front of your ankle because the tendons go under a band that runs across the bend at the ankle. The tendon inserts into the arch and may also cause arch pain.

As you skate for long periods of time, you are keeping the muscle held short and a phenomenon called "muscle memory" sets in. The brain actually causes the muscle to adjust to the new shortened length, however, the shortened muscle is still attached to your foot, so you feel tension at the insertion point. It will take a focused effort to release the tension in this muscle. If you even try to stand up straight, and the now-shortened muscle is too tight to allow this bit of a stretch on the fibers, the muscle pulls on the tendon and you feel pain at the outside and front of your ankle, along the outside of your foot and in your arch.

Fortunately, it is easy to flush out this muscle and lengthen the fibers back to their normal length. To treat this muscle, you will need a 24-inch length of dowel that is about 1 1/2 inch thick.

Sit on the floor with your leg bent and your foot turned in toward midline. Put the dowel just below the outside of your knee joint (don't put any pressure on the bone) and push so the dowel slides down the outside of your lower leg. Stop before you get to your ankle bone. Again, you don't ever want to push onto a bone and potentially cause a bone bruise.
If you turn your foot out a bit and put the dowel along the outside of your shinbone, avoiding your shinbone, you will be treating the tibialis anterior.

As you go down the muscles, you will find points that are exceptionally tender. These are spasms, which are knots in the muscle fibers. Hold the pressure on them for 30-60 seconds before continuing to slide down your leg. You must flush out the spasms, lengthen the contracted fibers, bring fresh blood into the area and stretch!

Another way to stretch the muscles is by bending your knees and sitting on your lower leg while your toes are pointed in toward midline.

Without strong, but flexible, muscles you cannot skate. If you have been practicing for hours, you need to care for your muscles at the end of each session. It will only take a few minutes, and the rewards are well worth the time and effort.

Julie Donnelly, a licensed massage therapist in New York, is the co-author of several books, including The Pain-Free Triathlete. She teaches workshops nationwide and works with athletes in her office. Visit her Web site at julstro.com.