How can I improve my ankle pain in the morning?

The feet and ankles make up one of the most complex and hardest-working areas in the body. The amount of impact and pressure they withstand with excessive use can easily lead to injuries in the short term and conditions like tendinitis or osteoarthritis in the long term. 

If you’re experiencing ankle pain first thing in the morning, you’re not alone. Up to 15% of the population is likely dealing with ankle pain for various reasons, and any of them can be associated with worse pain in the morning. 

In this article, we’ll discuss several of the most common causes for morning ankle pain and what you can do to get relief.

Common causes of ankle pain in the morning

Understanding the cause of your ankle pain can help you determine the right course of action. For most of these conditions, there are simple exercises and treatments you can do at home to relieve the pain. If your pain is severe or doesn’t go away with some exercise, you’ll need to see a health care provider such as a physical therapist.

The following conditions are known to cause ankle pain in the morning:

• Ankle sprain — A sprain caused by overstretching or tearing of a ligament in the ankle.
• Ankle osteoarthritis — Arthritis caused when the protective cartilage in your joints wears away.
• Achilles tendinitis — Injury of the Achilles tendon caused by overuse.
• Flat feet — Fallen or underdeveloped arches.
• Plantar fasciitis — Inflammation of the band of tissue that connects your heel to your toes.
• Bone spur — A bony protruding growth that can develop on the edge of a bone.
• Poorly fitted shoes — Shoes that are too loose, too tight or don’t provide enough support.

Home remedies for ankle pain

Some of the first measures to take when you’re experiencing morning ankle pain are reducing inflammation and strengthening your ankle. Once your pain and swelling start to go away, strengthening your foot and ankle can help prevent the problem from coming back. Strengthening exercises are especially important for pain from potential overuse like sprains, tendinitis, plantar fasciitis and flat feet. 

Over-the-counter pain relievers can help with initial inflammation from an acute injury and with structural problems like osteoarthritis and bone spurs. You may benefit from different treatments depending on where your pain is: medial ankle pain (inside the joint) or lateral ankle pain (on the outside of the ankle). 

Try these strategies to relieve ankle pain in the morning:

• R.I.C.E. — Rest, ice, compression and elevation are great for relieving pain and swelling. Try this method for acute soft tissue injuries like sprains, strains and overuse. 
• Rolling massage — Place a rounded item under your foot and roll back and forth under your heel and the ball of your foot. You can use a variety of rounded objects including a tennis ball, a small- or medium-sized foam roller, and even a frozen water bottle. We recommend using a frozen water bottle to help with pain and swelling.
• Towel curls — Towel curls may be recommended by physical therapists as an effective ankle strengthening exercise. With a small towel under your foot, sit in a chair with your foot flat on the towel. Use your toes to grip the towel, pulling it toward you. Release your grip and repeat around 20 times. This exercise works out muscles throughout your ankle and foot. 
• Ankle circles — Start by sitting or lying down and extend one leg in front of you. Slowly rotate your ankle clockwise in a circular motion 10 or 15 times. Then, reverse direction so that your ankle rotates counterclockwise. Rotate the same number of times in each direction. You can switch ankles as you go.
• Change footwear — If your pain interferes with your ability to stand or walk, changing your footwear might provide some relief. Choose properly fitted shoes that have room in the toe area, and try orthopedic inserts for extra cushion if you have low arches or flat feet.
• Over-the-counter pain relievers — Medication can be used for temporary pain relief.

Looking for more exercises you can do at home? See more of our favorite ankle-strengthening techniques.

Physical therapy for morning ankle pain

If you’ve tried some of the above remedies and exercises and your pain persists, it’s time to see a physical therapist. A therapist can help you determine what’s causing the pain and provide more advanced treatments. They might do more exercises with you or perform different therapies and treatments.

Here are some techniques a physical therapists can use to reduce persistent ankle pain in the morning:

• Joint mobilization — Joint mobilization is a manual therapy technique that helps to restore function in joints that have tightened up due to an injury or pain. Your physical therapist will coax slow movements out of your joints to reduce stiffness and improve their mobility.
• High-velocity, low-amplitude thrusting — This technique helps increase flexibility in the joints by stretching them almost to their limit. With more range of motion in your ankle, you'll find it easier to move around without pain.
• Dry needling — This technique can increase blood flow and range of motion to relieve tension to affected areas. Dry needling can be effective for tendinitis and other joint problems.
• Instrument-assisted soft tissue mobilization (IASTM) — Therapists use ergonomic stainless steel tools to massage soft tissue and break up scar tissue in IASTM. This can be used for tendinitis, tendinopathy and scar tissue buildup.
• Graston Technique® — The Graston Technique is a specific type of IASTM where you start with cardiovascular activity to get your blood flowing. Physical therapists must undergo extensive training to obtain Graston certification.

Alliance PTP is ready to help you find top-notch PT for ankle pain in the morning

At Alliance Physical Therapy Partners, we’re proudly bringing together physical therapy practices across the country to help people get the high-quality PT they need. 

Want to see a physical therapist in person? We can put you in touch with an Alliance PTP partner that’s close to you and that can help you address ankle pain in the morning. 

Come find help for your injury or chronic condition today!