Ankles pop and snap for many reasons. Ankle injuries are very common. Some ankle injuries lead to popping or snapping. Sometimes ankles snap and pop without an injury. The most common ankle injury is an ankle sprain. That involves an injury to at least one of the ligaments holding the bones around the ankle together. If the ligaments in your ankle remain loose the popping you feel might be due to the bones moving around more than usual because the ligaments are stretched or weak.
Under many circumstances snapping or popping of the ankle is not a worrisome issue. We are going to review occasions where your ankle should be evaluated and thoroughly examined.
Why Do Ankles Pop or Snap:
The 4 most common reasons your ankle might snap or pop include:
- Ankle Instability due to a chronic ligament injury
- A tendon snapping over the bones – usually the Peroneal Tendons
- OCD or Osteochondritis Dessicans: A loose piece of bone is formed in the ankle
- Many ankles pop and snap and have nothing wrong on exam and MRI.
Peroneal Tendon Instability:
This issue involves instability of the peroneal tendons on the outside or lateral side of your ankle. The peroneal tendons wrap around the fibula or the little bone on the outside of the ankle. If these tendons are not held tightly against the bone they may snap or pop. Popping or snapping of these tendons can occur without injury if your ligaments are a little loose. True peroneal tendon instability often occurs after a severe ankle sprain. When you roll your ankle the structure that normally holds the peroneal tendons in place may also tear. If that “retinaculum” tears, then every time you move your ankle the peroneal tendons can slide out of their groove and over the end of the fibula. This will create obvious snapping or pop on the outer side of your ankle. This post goes into far more detail on peroneal tendon subluxation.
OCD or Osteochondritis Dessicans:
Another reason for your ankle to pop or snap is osteochondritis dissecans or OCD of the ankle. OCD of the ankle involves a bone in the ankle called the Talus. Under certain circumstances, a portion of the cartilage and the bone can become loose within the ankle joint. OCD of the ankle can occur after a severe injury. OCD of the ankle can also occur due to chronic repetitive stress. This is mostly seen in young patients. When you have had OCD of the ankle a piece of bone and cartilage is loose within the ankle joint. When you use of the ankle that loose piece of cartilage and bone moving around can give you the sensation of popping, locking or snapping.
Ankle Sprains:
One of the most common causes of ankle popping is instability of the ankle joint itself. This usually occurs in someone who has suffered many ankle sprains. Sprains involve an injury to the ligaments holding the ankle bones together. After multiple sprains, the ligaments are no longer as tight as they were before the initial injury. Therefore, when you change direction, move sideways, or pivot and twist the ankle bones might be coming apart leading to instability and popping or snapping of the ankle bones as they come back together.
Many patients with ankle instability will respond quite well to wearing a compression sleeve, physical therapy program or bracing with certain athletic activities. If you do not respond to nonsurgical measures then your sports medicine professional may need to tighten the ligaments to minimize the risk of instability.
For those suffering from osteochondritis dissecans or OCD of the ankle with a loose piece of bone we typically need to perform a procedure called an ankle arthroscopy. This involves putting a small fiberoptic camera into the ankle to visualize all the surfaces. Sometimes the loose piece is able to be put back into place and repaired. On occasion, the piece of cartilage is too beaten up to repair. In that situation, the loose piece needs to be removed. OCD injuries are usually small. If a large piece of bone is involved we may need to consider a cartilage regeneration procedure. The goal of the cartilage regeneration is to minimize the risk of developing osteoarthritis.
When instability of the peroneal tendons on the outer side of the ankle is caught early, a short period of casting or bracing might allow the structure holding the tendons in place to heal. When bracing or casting does not work, then surgery to repair the structure holding the tendons in place will be needed to hold the peroneal tendons in place. If those tendons are allowed to snap and pop over the end of the fibula they might eventually tear if this injury is not addressed surgically.
As mentioned above, the most common cause of ankle popping or snapping is unknown. That means that your examination and an MRI may not reveal any obvious abnormality. Hopefully, a good exam and a good discussion with your doctor can explain why your ankle pops and put your mind at ease.
Ko
Hello From France
I broke my external malleolus 6 weeks ago and am currently out of cast. No bone displacement and no apparent diastasis.
Am light walking now with crutches and will start therapy on Tuesday. What is considered normal calf pain at this point? I feel the outside of my calf (peronii??) is very sore and irritated. In addition a bit of popping
On inside of ankle from time to time. I’m still on Lovenox but everyone is the US thinks this is nuts. Thank you for your advice!!
Howard J. Luks, MD
There are a some Orthos in the US who will use DVT prophylaxis for patients in a case/immobilization. Especially for those with high risk factors — family history, birth control pills, smoking, etc.
Tough to say what “normal” calf pain is. After a while in a cast — which is unusual in the US for a non-displaced lateral mal fracture — it is normal for the muscles to hurt as they start to see a resistance load once again.
Many people will experience discomfort, popping etc after a period of immobilization due to scar tissue formation, ligament stiffness, etc. Give it some time…
Ko
Thank you!
It’s comforting to have an opinion from back home.
I’ve been told to keep administering lovenox shots until I can walk for 1,5 hrs/day (far more than an average day for me)
I am able to walk with crutches on 40% weight but am unclear as to why I need to keep the shots.
No other Dvt factors….
Howard J. Luks, MD
I can’t offer that kind of advice in this forum.
Good luck!
Kris
While I am already going to get a 2nd opinion, that appointment is not for a month.
2 Fridays ago, and then 2 days ago, my right ankle popped rather painfully resulting in quite a bit of swelling.
I had ankle surgery on August 11th. It was lateral ligament reconstruction with peroneal tendon transfer and a scope of the talar cartilage.
2 Wednesdays ago, my ankle was tripped over, and x-rays showed several problems, one in particular was lucency involving the medial talar dome which could indicate focal subchondral osteopenia or osteochondral injury.
Can you explain what this means? My surgeon says it’s nothing.
Howard J. Luks, MD
An osteochondral injury means that both the cartilage and the bone on a small area of the talus has been injured. These can be traumatic or part of a process we call osteochondritis dessicans (OCD).
Jill
My 13 YO son’s ankle has recently started cracking/popping loudly when he walks. It is frequent – every third or fourth step. There is no pain associated with it. Interestingly, our older son had surgery on his knee for Osteochondritis Dessicans last year. We were told at the time there is a genetic link. I was researching the ankle cracking today to determine if I should take him in to have it looked at when I came across the suggestion that one cause can be osteochondritis dessicans. I guess I better get him in to see the doctor.
Howard J. Luks, MD
Not a bad idea… good luck
Matt Nichols
Injured my ankle. I had an avulsion fracture on the interior? malleolus (I think that is what it is called). I have had tendon issues since. I have had cortinzone shots and MRI/xrays. No diagnosis and continued pain.
I have a snapping/popping in the outside front of my ankle. The same spot as the popping is painful to firm palpation of the area. I also continue to have paid by the area that was the fracture.
The MRI was not conclusive and only showed some clouding in some of the tendons (possible longitudinal tears?)
I am hoping to find something to give some guidance to the doctor or to know what type of injury I may be looking at, but the information is generally vague on the websites for me to find anything.
Should I continue with the sports medicine expert I am seeing now, or should I go to a surgical podiatrist/orthopedist?
Howard J. Luks, MD
Check out our post on peroneal tendon subluxation. It can happen after these injuries. Then see a specialist for a diagnosis and treatment plan.