In the last three years I've started to have ankle pain when walking. The doctor thinks it's from a motorcycle accident I had 10 years ago. I broke my ankle then and it took a long time to mend. What is it that causes the pain exactly?

There can be several sources of ankle joint pain and stiffness associated with osteoarthritis (OA). OA is fairly common years after trauma or injury to the joint.

X-rays are usually taken to confirm the diagnosis. The physician looks for narrowing of the joint spaces. The X-ray may also show the formation of osteophytes or bone spurs. A smaller joint space means more pressure is placed on the ankle joint. There may even be bone-to-bone contact.

Likewise bone spurs can cause bone-to-bone contact and increased compression. Sometimes they pinch against the nearby soft tissues or get squeezed between the joints causing pain. This is called impingement.

One other cause of joint pain after injury is the stretching of the joint capsule. The joint capsule is a band of thick connective tissue and ligaments around each joint in the foot. It provides stability and keeps the joints from slipping and sliding. Once it's stretched the stability is lost and uneven and excessive joint wear and tear can occur causing painful osteoarthritis.

Reference: 

Yu-Chi Huang, MD, et al. Effects of Ankle-Foot Orthoses on Ankle and Foot Kinematics in Patient with Ankle Osteoarthritis. In Archives of Physical Medicine and Rehabilitation. May 2006. Vol. 87. No. 5. Pp. 710-716.

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