Hip, Foot, & Ankle Pain


Hip, Foot, & Ankle Pain

The hip, foot, and ankle form the cornerstone of our body’s foundation, playing a pivotal role in our ability to move, balance, and engage in daily activities. Pain in these regions can stem from a myriad of causes, including acute injuries, chronic conditions, overuse, and biomechanical irregularities.

From the distressing inflammation of plantar fasciitis in the foot to the debilitating effects of osteoarthritis in the hip, and the instability brought on by ankle sprains, understanding the underlying causes is the first step towards effective treatment and recovery.

Causes of Hip Pain

Avascular Necrosis of the Hip


Avascular necrosis is a condition characterized by the weakening and eventual collapse of the bone in the head of the femur, which is the ball part of the hip joint.

This deterioration occurs when the bone’s blood supply is compromised, leading to the death of bone cells and, ultimately, painful arthritis in the hip. Blood flow to the femur head can be disrupted due to hip dislocation or fracture, as well as factors like alcoholism, certain medications, and medical conditions affecting circulation.

Initially, avascular necrosis may present without symptoms, but as the condition progresses, pain in the hip or buttocks emerges, typically worsening during physical activity. Over time, the pain can become constant, affecting the ability to stand or bear weight on the hip, and may even persist while lying down.

Bursitis of the Hip

Trochanteric bursitis is the inflammation or irritation of the trochanteric bursa, a small, fluid-filled sac located on the outer aspect of the femur, serving as a cushion for the iliotibial band, a significant tendon in the leg.

This condition can arise from various causes, including repetitive stress on the area, a direct impact from a fall or blow to the hip, poor posture, or underlying diseases and conditions.

The primary symptom experienced by individuals with trochanteric bursitis is pain on the outer side of the hip, which can vary from a sharp pain to a dull ache and may extend down to the thigh and buttock. The pain typically intensifies during activities that engage the hip or when lying on the affected side.

Labral Tear of the Hip


If you’re experiencing pain in your hip joint, or if it catches or clicks during leg movement, you might be dealing with a torn labrum. This rim of tissue encircles the hip’s socket, playing a crucial role in deepening the socket and providing cushioning for the joint.

Labral tears disrupt the smooth functioning of the hip joint and can occur during various athletic activities, including football, soccer, golf, hockey, or ballet. Additionally, labral tears can be attributed to the hip joint’s anatomical issues or develop as a consequence of degeneration from osteoarthritis.

Symptoms of a torn labrum include pain in the groin or front of the hip, particularly during activity, along with a noticeable catching or clicking sensation in the joint when moving.

Osteoarthritis of the Hip

Osteoarthritis of the hip-treatment-nashville

Osteoarthritis, also known as degenerative joint disease, involves the gradual breakdown of cartilage within the hip joint, leading to bone-on-bone friction and the potential development of bone spurs. This condition can significantly impact your activity levels due to pain.

The causes of osteoarthritis include age-related wear and tear, genetic predisposition, being overweight, previous hip injuries, or anatomical irregularities in the hip joint.

Symptoms of osteoarthritis range from pain and stiffness in the hip that may worsen in the morning, after sitting or resting, or during damp weather, to sudden flare-ups during physical activity. Pain might extend to the thigh, buttock, and knee. Additionally, sufferers may experience locking or grinding sensations during movement, contributing to a reduced range of motion.

Causes of Foot & Ankle Pain

High Ankle Sprain

A high ankle sprain is an injury involving the stretching or tearing of the ligaments above the ankle, specifically those forming the syndesmosis that connects the tibia and fibula bones of the lower leg, crucial for ankle stability.

This type of sprain typically occurs when the foot is forcefully twisted outwards, often during high-impact sports such as football, soccer, lacrosse, and basketball, where running, jumping, or quick directional changes are common.

It can also occur as a result of an ankle fracture. Symptoms of a high ankle sprain include pain that extends up the leg, particularly when turning the foot outward or walking up steps, and might not be accompanied by significant swelling or bruising, which can sometimes lead to underestimating the severity of the injury.

Plantar Fasciitis

Plantar fasciitis, a common foot condition, arises from irritation of the plantar fascia, a dense strip of connective tissue stretching across the foot’s underside from the toes to the heel, crucial for supporting the natural arch of the foot.

This condition often results from repetitive stress or undue tension on the plantar fascia, leading to small tears and inflammation within the tissue.

Symptoms of plantar fasciitis are characterized by a sharp, stabbing pain in the heel, which typically develops gradually and is most severe during the first steps after waking up. While plantar fasciitis can affect just one foot, it is not uncommon for both feet to experience discomfort.

Accessory Navicular Problems

An accessory navicular is a supplementary bone located on the inner side of the foot, adjacent to the navicular bone which plays a pivotal role in forming the foot’s arch.

While most individuals do not possess this additional bone, and many of those who do are not affected by it, it can lead to discomfort in some cases. This extra bone emerges during the developmental stages of foot bones and in a typical scenario, would fuse with the navicular to become a singular bone. However, if these two parts remain unfused, they exist as separate entities connected by fibrous tissue or cartilage.

Problems can arise from the accessory navicular due to irritation from tendon attachment, a bump on the instep causing friction with footwear, or injury to the connecting tissue.

Symptoms predominantly manifest on the inner side of the foot as irritation, swelling, pain, or throbbing in the mid-foot and arch area, particularly exacerbated by physical activity.

Peroneal Tendonitis

Peroneal Tendonitis-Treatment-Nashville

Peroneal tendonitis, characterized by painful inflammation of the peroneal tendons extending from the lower leg to the foot along the ankle’s outer side, demands immediate attention to prevent evolution into peroneal tendinosis, a more persistent condition.

This inflammation primarily results from overuse, making it a common ailment among new runners, athletes who suddenly increase their training intensity, or those engaged in sports necessitating rapid directional changes. Additionally, individuals with high foot arches or a history of frequent ankle sprains are at increased risk, as are those wearing unsupportive footwear.

Symptoms of peroneal tendonitis include pain and swelling near the outer ankle, particularly below and behind the ankle’s bony protrusion, with pain typically exacerbating during physical activity and potentially alleviating with rest.


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