Question: My right ankle hurs when I wear flats. This happens especially when it is rotated at a certain angle. I have not sprained my ankle before and I usually alternate between heels and flats throughout the week. What could be the cause? Should I see a physiotherapist or chiropractor? Answer: lt sounds like your symptoms are related to certain positions of the ankle joint, such as when the toes point downwards away from you or upwards towards you. If there has not been any trauma to the foot or ankle, the pain is probably due to impingement or tendinitis, depending on where the symptoms arise from in the ankle. Impingement can be caused by wear and tear of the joint cartilage or ligaments. This is often due to overuse or in persons with poor foot biomechanics such as flat feet or foot overpronation (where the inner arch of the foot tends to roll inwards and downwards). Tendinitis is also a common injury where tendons are possibly overworked due to poor foot biomechanics and muscular weakness or tightness. It is important to get this evaluated by a doctor who is experienced in dealing with musculoskeletal conditions. Imaging the joint with X-ray or ultrasound scans may be necessary to complete the diagnosis. Depending on your condition, treatment may involve correcting the risk factors such as podiatry treatment for foot abnormalities and physiotherapy for muscular issues. Dr Kelvin Chew, Consultant sports physician at the Singapore SportsMedicine Centre, a subsidiary of Singapore Medical Group Llimited in partnership with Changi Sports Medicine Centre |