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Question: My right ankle hurts when I wear flats, especially when I rotate it. I have not sprained my ankle before and I usually alternate between wearing heels and flats during the week. What could be the cause?
 Answer: Your symptoms seem to be related to certain positions of the ankle joint. If there has not been any trauma to the foot or ankle, the pain is likely due to impingement – when the tissues in the ankle joint get trapped in the surrounding bones – or tendonitis, an inflammation of the tendon.
Impingement can be caused by wear and tear of the joint cartilage or ligaments. It often occurs when the joint is overused or in people with poor foot biomechanics, like flat feet or foot over-pronation. The latter occurs when the inner arch of the foot rolls inwards and downwards.
Tendonitis is also a common injury due to overuse. Tendons can be overworked due to poor foot biomechanics and muscular weakness or tightness.
It is important to get your condition evaluated by a doctor experienced in dealing with musculoskeletal conditions. X-rays or ultrasound scans may be necessary to complete the diagnosis.
Treatment may involve correcting the risk factors. For example, you may need podiatric treatment for foot
abnormalities or physiotherapy for muscular issues.
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