What Causes Inner Ankle Pain?

Inner ankle pain can be triggered by a variety of injuries and conditions. Commonly, such pain may relate to a sprained or ruptured deltoid ligament, though it may also be caused by an inflamed tendon of the tibialis anterior muscle in the shin, a hairline bone fracture, arthritis of the ankle joint, or, less commonly, tarsal tunnel syndrome. Pain in the inner ankle may range from mild to severe, with the individual experiencing such pain able to retain almost normal function or unable to place weight on the joint at all. Overuse injuries from such activities as running are common causes of inner ankle pain.

A sprain to the ligaments of the inner ankle is one condition that causes inner ankle pain. Resulting from such abrupt trauma as a rolled ankle, inner ankle sprains are much less common than outer ankle sprains, which account for 85 percent of all ankle sprains, but do occur when the sole of the foot rolls outward. In an inner ankle sprain, the ligaments connecting the tibia bone in the shin to the talus bone in the foot are stretched beyond their normal range, sometimes to the point of tearing. These ligaments are collectively known as the deltoid ligament for their triangular shape and include the anterior tibiotalar ligament, the tibiocalcaneal ligament, the posterior tibiotalar ligament, and the tibionavicular ligament. Pain resulting from damage to these ligaments ranges from mild to severe and is typically accompanied by tenderness and swelling at the injury site.

Another type of injury resulting in ankle pain is damage to the tendon of the tibialis anterior muscle. This muscle’s tendon crosses the ankle joint just anterior to the medial malleolus of the tibia, the prominent bony protrusion at the lower end of the bone visible along the inner ankle, and attaches to several tarsal and metatarsal bones on the medial aspect of the foot. Types of damage to this tendon include a strain, in which the tendon is stretched beyond its normal range; a rupture, in which the tendon is partially or completely torn away from the bone; and tendinitis, in which the tendon becomes inflamed and irritated over time as a result of a repetitive activity like jogging. Depending on the severity of the injury, pain may be experienced as mild or extreme and may also be accompanied by tenderness and swelling.

Arthritis is a relatively common form of inner ankle pain, distinguished by a chronic and recurring inflammation of the joint, even in the absence of activity. Characterized by a degeneration of joint structures, as in the case of osteoarthritis, or inflammation of the synovial membrane lining the joint, as in the case of rheumatoid arthritis, arthritis is a painful condition that presents with stiffness, warmness, and swelling about the joint. Arthritis pain is typically managed with a combination of anti-inflammatory medication or injections, ice, and exercise.

Less commonly occurring causes of inner ankle pain include bone fractures and tarsal tunnel syndrome. As the tibia and talus, the bones of the medial ankle joint, are weight-bearing bones, hairline fractures can develop over time from repetitive weight-bearing activity and cause only minor pain. Fractures resulting from an abrupt trauma would be accompanied by severe pain, swelling, and an inability to move or place weight upon the joint. Tarsal tunnel syndrome can sometimes result in inner ankle pain as well. This is a condition in which the tibial nerve, which passes behind the medial malleolus of the tibia, becomes entrapped and inflamed, usually resulting in pain and tingling in the foot, although severe impingement of the nerve can be felt as medial ankle pain.