What Causes Pain to the Back of Your Ankle & Heel When You Walk?

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Close-up of feet walking along the beach. (Image: Jupiterimages/Stockbyte/Getty Images)

Pain at the back of your ankle and heel during walking may indicate muscle tightness, tendinitis or ankle impingement syndrome. Your pain may be described as achy, sharp or stabbing and can be accompanied with swelling and joint stiffness. Treatment includes rest, ice, compression and elevation, commonly given the acronym RICE. For persistent or worsening pain, consult your physician.

Tendinopathies

Your Achilles tendon attaches your calf muscles to the back, or posterior, aspect of your ankle and heel. Other tendons around your ankle include your peroneal, posterior tibial and flexor hallucis longus tendons. Tendinopathies is a general term for tendon injuries or inflammation; these may also be called tendinitis and tendinosis. Your age, muscle tightness and previous injuries increase your risk of developing tendon injuries. The most common symptom is pain on the back of your heel and ankle, which can increase with activities like walking. Additional symptoms include swelling, stiffness and thickening of your tendon. Chronic inflammation of your tendon may also increase your risk of a tendon strain or tear.

Posterior Impingement Syndrome

Posterior impingement syndrome is when soft tissue, like tendons, is compressed on the back of your ankle between your heel bone and tibia, or shin bone. According to research published in 2006 in the journal "Foot and Ankle Clinics of North America," runners and dancers are at a higher risk of developing posterior impingement syndrome. Impingement can lead to pain, swelling and numbness or tingling. Walking, running and dancing can further aggravate your symptoms.

Ankle Sprain

An ankle sprain is when you twist your ankle, causing damage to your ligaments such as your posterior tibiofibular ligament. An ankle sprain can be a minor over-stretching, a partial tear or a complete rupture of one or more ankle ligaments. Symptoms include swelling, pain and bruising around your ankle and heel. A severe ankle sprain also causes joint instability, which can make walking and other activities painful and difficult.

Osteoarthritis

Osteoarthritis is the wearing-away or deterioration of the cartilage in your ankle. High-impact activities like jumping, a previous ankle injury such as an ankle sprain and chronic inflammation may increase your risk of developing osteoarthritis. Symptoms include grinding or catching, swelling, stiffness, joint instability and pain around your ankle and heel. Advanced osteoarthritis may lead to bony projections or bone spurs, which can cause further pain.

Treatment and Prevention

Rest the affected area, ice it, wear a compression wrap and elevate your ankle above your heart to reduce swelling and pain. Take nonsteroidal anti-inflammatory drugs such as ibuprofen to further reduce pain and swelling. Your physician may also recommend using crutches during walking, corticosteroid injections, physical therapy and surgery. To prevent further pain and injury of your ankle and heel, stretch before and after exercise, increase the intensity and duration of exercise slowly and maintain a healthy weight. Exercises such as single-leg balancing and calf raises may also help maintain ankle strength and stability and prevent reinjury.

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