Osteoarthritis in your ankle

What is ankle osteoarthritis?

Ankle osteoarthritis is a form of joint degeneration in which the cartilage within the ankle joint gradually becomes thinner. The ankle joint consists of the tibia (shinbone), fibula (calf bone) and talus. The cartilage between these bones allows smooth movement. In ankle osteoarthritis, the quality of this cartilage decreases, fluid buildup may occur and bony growths (osteophytes) can develop. This can lead to pain, stiffness and a reduced range of motion.

Common symptoms

• Pain in the ankle when standing, walking or climbing stairs
• Morning stiffness that improves once you start moving
• Stiffness after sitting or standing still for long periods
• Swelling around the ankle joint
• A grinding or cracking sensation during movement
• Reduced ankle mobility
• An unstable or insecure feeling when walking on uneven surfaces

Do you recognise these symptoms? Have your ankle assessed early. The sooner you start treatment, the more influence you have on the progression of the condition.

Causes and risk factors

Ankle osteoarthritis often develops due to a combination of factors. A previous ankle injury, such as a severe sprain, ankle fracture or repeated inversion injuries, significantly increases the risk. Overuse from work or sports, excess body weight and chronic ankle instability can also contribute. Some people have a genetic predisposition to joint degeneration. Reduced strength in the calf and foot muscles, as well as an altered walking pattern, can increase stress on the ankle joint.

Primary or post-traumatic osteoarthritis

Post-traumatic osteoarthritis develops after a previous ankle injury, such as a fracture or severe ligament damage. This is the most common type of ankle osteoarthritis. Primary osteoarthritis develops without a clear cause and usually progresses more gradually. The type of osteoarthritis you have partly determines the treatment approach and rehabilitation timeline.

What you can do yourself

• Stay active without heavily loading the ankle
• Start the day with gentle ankle circles and mobility exercises
• Use heat for morning stiffness and cold therapy for swelling
• Wear supportive shoes with adequate cushioning
• Alternate between sitting and standing and avoid prolonged standing
• Strengthen your calf and foot muscles with light exercises
• Maintain a healthy body weight to reduce joint stress

If your symptoms worsen or keep returning, consider scheduling an assessment.

Assessment and treatment plan at De Fysio Man

We listen to your story, your activity levels and your goals. We assess ankle joint mobility, calf and foot strength, walking mechanics and balance. We also evaluate the hip, knee and foot, as these influence the load placed on the ankle. Based on our findings, we create a personalised treatment plan with measurable goals and clear home exercises.

• Joint mobilisations to improve ankle movement and flexibility
• Exercise therapy focused on calf strength, foot muscles and stability
• Balance and proprioception training for improved control
• Gait analysis and advice regarding footwear or orthotics
• Ankle taping for additional support during demanding activities
• Guidance on load management, sports participation and daily activities

Rehabilitation phases

Phase 1: Reducing pain and stiffness

We reduce irritation within the joint and help you manage daily activities more comfortably. Gentle mobilisations, pain-free exercises and short activation sessions throughout the day form the foundation.

Phase 2: Improving mobility and strength

We work on restoring ankle range of motion while building strength in the calf, foot and hip muscles. This allows the joint to tolerate more load without symptom flare-ups.

Phase 3: Increasing activity levels

Walking, stair climbing and daily activities are gradually expanded. Balance exercises on different surfaces help improve confidence and stability.

Phase 4: Returning to sports and higher-level activities

Sport-specific and functional movement patterns are introduced based on your goals. You learn how to manage your load effectively so you can continue exercising consistently and confidently.

When is surgery necessary?

In most cases, physiotherapy and lifestyle adjustments can effectively manage ankle osteoarthritis. In cases of severe osteoarthritis where conservative treatment is no longer sufficient, an orthopaedic surgeon may consider surgery. Possible procedures include arthroscopy, ankle replacement surgery or ankle arthrodesis (joint fusion). We also provide rehabilitation following ankle surgery to support a safe and effective recovery.

Prevention and avoiding recurrence

Keep your ankle strong, mobile and stable. Vary your physical activities and gradually build up new forms of exercise. Maintain a healthy body weight and wear footwear appropriate for your activities. Pay attention to early warning signs and adjust your activity levels accordingly.

Your next step

Do not continue living with pain and stiffness. With a clear diagnosis and a personalised treatment plan, you can regain control of your ankle and your daily activities. Schedule an appointment with De Fysio Man today.