Can Massage Help Ankle Pain? What Research Finds

Americans today are anything but sedentary. Figures from the Sports and Fitness Industry indicate that 80 percent of Americans are physically active. That equates to 247 million people getting up off their couch and exercising versus 20 percent or 62 million for whom exercise is not on their calendar. [1]

While the trend to exercise has been apparent for some time, it has been fueled in part by a passion for Pickleball. Pickleball enjoyed a 46 percent increase in participants from 2023 to 2024 and a jump of 311 in the past few years. But Pickleball is not the only reason that Americans are passionate about physical activity, the Sports and Fitness Industry research found. Walking is the most popular physical activity for fitness for 115 million. Next comes trail hiking (63 million participants), treadmill running (56 million), free weights (also 56 million) and jogging (51 million).[2]

Whatever has propelled Americans to get up and out - some say the pandemic – the result is that it is goodness when it comes to health. Yet even the focus on fitness is not without a downside. The more active we are, the potential for sports injuries rises. One needs to look no further than Pickleball to see the increase in injuries from sports. Pickleball-related orthopedic injuries are on the rise, especially among older players. These include fractures and sprains/strains to the lower extremity and trunk. [3]

Ankle injuries are common

Among the most common Pickleball injuries are ankle sprains, which often occur during quick pivots or sudden direction changes on the court.[4] But Pickleball is hardly the only reason for a sprained ankle. According to the American Medical Association (AMA), ankle sprains are one of the most common reasons driving people to urgent care or follow-up care. The sprain may be the result of a sudden twist while running or a misstep when the ground is uneven. [5]

Physical therapy can help ankle sprains by decreasing swelling, improving range of motion and regaining a proper proprioception. [6]  This refers to the ability of your body to sense movement, action and position, which is critical to maintaining balance.

Ankle sprains are just one of the causes of ankle pain. There are other reasons for ankle pain and stiffness:[7]

·         Achilles tendonitis: The Achilles tendon connects the heel bone to the calf muscle. Achilles tendonitis results from overly stressing this tendon. It is common. About 24 percent of athletes will develop an Achilles tendon injury in their lifetimes. [8]

·         Arthritis: While arthritis often affects the hips and knees, it also can affect the feet and ankles.

·         Stress fractures: Ankle stress fractures are small breaks in the ankle bones resulting from high impact, repetitive stress.

Is ankle massage for pain effective?

There are studies that indicate that ankle massage for pain can be effective. However, it is not recommended if the pain is the result of recent, acute stress fractures. Recovery should involve cutting back on high-impact activities and giving the ankle sufficient time to heal. [9]

Among the studies on ankle massage for pain:

Effect of Friction Technique on Ankle Sprain Grade ll Treatment:[10]

The study investigated the effect of friction technique on grade ll sprained ankle. The research involved 24 young athletes with ankle sprain grade II, which is moderate ankle sprain that features a decent amount of pain, swelling, and bruising. Patients were divided into two groups. The experimental group received sports massage; second group was a non-training control group.

The massage group received the 15 minutes effleurage and friction massages on their ankles administered by a sport rehabilitation specialist and professional massager. The control group used ankle braces. Findings showed that treatment (massage) group had significant impact compared to control group.  Study suggests friction techniques is a most effective treatment for ankle sprain grade II.

Deep Tissue Massage and Soft Tissue Release in the Management of Chronic Ankle Injury:[11]

Deep Tissue Massage and Soft Tissue Release have been used extensively for rehabilitation after an injury. This study examined the effectiveness and the difference in massage approaches in managing ankle injuries. The study involved 40 research subjects who had chronic ankle injuries. Before and after the ankle massage for pain, researchers used the Visual Analog Scale (VAS) to assess the degree of pain perceived by participants, and the Adapted Foot and Ankle Ability Measurement (FAAM) to measure the level of ankle function. Results showed that Deep Tissue Massage and Soft Tissue Release Massage significantly decreased pain and increased ankle function. There was no significant difference in the effectiveness between the two types of treatments.

Massage can increase ankle flexibility and muscle power.

Other research has focused on ankle massage and preventing injury. Research[12] that appeared in Journal of Sports Science & Medicine in December 2007 aimed to determine if massage can be alternative to static stretching as part of warming up prior to an athletic event. The research evaluated how three minutes of petrissage and tapotement forms of massage would influence plantar flexors’ flexibility and muscle power. Plantar flexion is downward foot movement. The study involved 19 participants who were randomly subjected to control and two massages before performing two power tests. Before the test, the participants completed ankle joint flexibility assessments.

The results of this study found that three minutes of petrissage and tapotement forms of massage increased ankle flexibility. Massage did not adversely affect jump power measures. Researchers concluded that massage may be an effective alternative to static stretching as part of a pre-event warm up.

While massage can help with ankle pain – and also for warming up prior to exercise --  it is always best that clients check with their physician to ensure treatments are appropriate for them.