Ankle Bursitis Pain: What It Is and How to Treat It

When your ankle hurts, it can throw your whole body off, affecting your gait, your hips, your knees, and even your back. “You need strong ankles for mobility and balance,” says Julianne Payton, PT, DPT, a physical therapist at Hinge Health. If your pain stems from ankle bursitis — a condition that results from inflammation of the fluid-filled sacs near the joint — it can make so many everyday activities more challenging. 

“Ankle bursitis usually causes pain that worsens when you walk uphill, squat, or run,” Dr. Payton explains. The good news: Ankle bursitis usually resolves on its own with simple, at-home interventions, including exercise. 

Read on to learn more about ankle bursitis: what it is, what it feels like, what causes it, and how to treat it, especially with exercises recommended by Hinge Health physical therapists.

What Is Bursitis of the Ankle?

Ankle bursitis occurs as the result of inflammation of your ankle bursae, the small, fluid-filled sacs that act as a gliding surface to cushion the area near your ankle joint where bones sit closely to muscles and tendons. “The bursae help to cut down on friction during movement,” explains Dr. Payton.

If you’ve heard of bursitis before, it may be because there are many forms of it. There are hundreds of bursae all over the body, including around your heels, shoulders, knees, hips, and elbows. Anywhere there’s bursae, there’s always the potential for bursitis. 

There are three different places where ankle bursitis commonly occurs, says Dr. Payton. These include:

• On the bottom of your heel bone

• Between your Achilles tendon and heel bone (this form of ankle bursitis is often referred to as Achilles bursitis)

• On the inside bone of your ankle

While ankle bursitis can happen in any of these spots, the treatment for all three is similar, says Dr. Payton.

Symptoms of Ankle Bursitis

The most common symptom of ankle bursitis is pain, says Dr. Payton. But the following may help to clue you in that bursitis is the cause of your discomfort.

• Swelling right where the bursa is. “In most cases, your whole ankle won’t hurt when you have ankle bursitis — you’ll feel it in one small, very specific area,” says Dr. Payton.

• A feeling of stiffness or achiness at the affected ankle joint.

• Ankle pain which gets worse with movement or pressure.

• Limited range of motion in your ankle.

Ankle Bursitis Causes 

Here are some common reasons you may experience ankle bursitis:

• An accident or injury. The most common cause of ankle bursitis, says Dr. Payton, is some sort of direct blow — you hit your ankle or fall right on top of it. This can damage the bursa and cause sudden swelling. 

• Doing more activity than your ankle is ready for. “We often see ankle bursitis when people start to do a lot more uphill walking or running than they are used to,” she explains. In this case, the bursitis will come on more gradually. However, the message here is not to avoid doing activities like this. Rather, it’s to back off the aggravating activity in the short term and add ankle and leg stretches and strengthening moves to your routine. This trains your ankles (and all the structures that support it) to adapt and handle these activities in the future with less pain.

• Weak or tight ankles. Both can strain your ankle muscles and tendons, which, in turn, can put added stress on the bursa.

• Poor-fitting shoes. If your footwear is too tight, it can put pressure on your ankle bursa and cause irritation and inflammation.

• Arthritis. Both ankle osteoarthritis — the normal cartilage changes that occur with age — and inflammatory arthritis, such as rheumatoid arthritis, are associated with bursitis. “If you have arthritis in your ankle joint, it affects how you move your ankle, which can irritate your bursa,” explains Dr. Payton.

These exercises can relieve ankle bursitis pain and may help prevent future flare-ups. Don’t be surprised that they target your calf muscles and Achilles tendon too. When these areas are strong, flexible, and healthy, your ankle and bursa are more protected from irritation. They’re great movement snacks to break up long periods of sitting by getting blood flowing, promoting healing, and improving mobility. The above exercises for ankle bursitis, recommended by Hinge Health physical therapists, are a great place to start.  

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Ankle Bursitis Treatment Options 

Ankle bursitis usually improves after a few weeks of at-home treatment and some activity modifications. Here is what Hinge Health physical therapists recommend for ankle bursitis treatment:

• Gentle leg and ankle exercises. At-home exercises (like the ones above) can add strength and flexibility in your legs, heels, and ankles to help keep your ankles healthy and relieve pressure on the bursa, says Dr. Payton. 

• Physical therapy. A physical therapist (PT) will focus on stretching your ankle tendons and strengthening the surrounding area to take pressure off your ankle bursa. Not only will it help heal your ankle, it can also play a role in preventing the bursitis from coming back. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit. 

• Ice and elevation. Ice can help relieve inflammation, and elevation may help fluid to move out of your bursa and reduce swelling, says Dr. Payton. You can rub your sore ankle with an ice cup several times a day for five-minute intervals.  

• Adjustments to everyday activity. Initially, you may need to scale back on activities that irritate your ankle bursa. While you can still do them, listen to your body — a little discomfort is fine, but sharp, intense pain is not, says Dr. Payton. Still, it’s important to continue to move. “If you sit around for two weeks, the lack of movement can make things worse,” she says. “Your ankle muscles and tendons will weaken and tighten up, which can delay recovery.” Switch to low-impact activities if you can, like a walk or bike ride instead of running.

• Consider over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for ankle bursitis pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Roomier shoes. There’s no perfect shoe that works for everyone, but if your shoes are too tight, they can worsen ankle bursitis. Over-the-counter orthotics may also help cushion and stabilize your feet, taking excess pressure off your ankles in the process.

While most of the time ankle bursitis can be treated at home, see a doctor right away if the area becomes red and/or feels hot to the touch. These can both indicate infection of the fluid in the bursa, which requires antibiotics.

Ankle Bursitis Prevention Tips

If you’ve had ankle bursitis in the past, there are some things you can do to help prevent it from coming back, including:

• Wear comfy shoes. Look for a shoe that has an “Achilles notch,” which is a groove in the back collar of your shoe which supports your Achilles tendon, says Dr. Payton. This can help take pressure off the bursa that can lead to Achilles bursitis. You also want to avoid shoes that are too tight or have stiff heels. 

• Increase workout intensity gradually. If you start a new exercise or change your existing intensity, do it slowly, advises Dr. Payton. This is especially true if you do an activity that puts a lot of stress on your ankles, like hiking or uphill walking.

• Do ankle strengthening exercises. These will help keep your ankle muscle joints strong and flexible, which will reduce strain on the bursa, explains Dr. Payton.

PT Tip: Use a Corn Cushion

These are doughnut-shaped pads you can buy over the counter and place near your ankle bursa, says Dr. Payton. “They help take pressure off the spot, especially if you find your bursitis gets more irritated by your shoes,” she explains.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Bursitis: Overview. (2018, July 26). National Institutes of Health; Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK525773/ 

2. Johnson, M. D., & Alvarez, R. G. (2012). Nonoperative Management of Retrocalcaneal Pain with AFO and Stretching Regimen. Foot & Ankle International, 33(7), 571–581. doi:10.3113/fai.2012.0571

3. Williams, C. H., & Sternard, B. T. (2019, February 14). Bursitis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513340/ 

4. Aaron, D. L., Patel, A., Kayiaros, S., & Calfee, R. (2011). Four Common Types of Bursitis: Diagnosis and Management. American Academy of Orthopaedic Surgeon, 19(6), 359–367. doi:10.5435/00124635-201106000-00006