Physiotherapy for Foot & Ankle Pain

There are many different reasons why your foot or ankle might become painful.

Sometimes there is an obvious cause, such as an ankle sprain, fall, collision or sporting injury.

At other times, foot or ankle pain can develop gradually. This can happen after increasing your running, starting a new activity, changing your footwear, spending more time on your feet or simply placing more demand on your foot and ankle than they are used to.

Pain can also be influenced by problems affecting the muscles, tendons, ligaments and joints of the foot and ankle.

Importantly, pain doesn't always mean that you have seriously damaged your foot or ankle.

Your foot and ankle are strong and adaptable, and pain can be influenced by a combination of physical factors, the demands being placed on them and how your body is responding to those demands.

In many cases, it isn't possible — or necessary — to identify one specific structure responsible for your pain.

Your symptoms, movement, strength, activity levels, footwear and goals are often more useful in deciding how best to manage the problem.

One of the most common concerns people have when they develop foot or ankle pain is that they have damaged something and need to avoid putting weight through it.

Some injuries do involve damage to tissues such as ligaments, tendons or bones. However, the presence of pain doesn't always tell us how much damage has occurred or how well your foot or ankle is able to function.

Even after an injury, your tissues can gradually adapt and become stronger as you return to movement and loading.

Sometimes people also become worried about changes seen on an X-ray, ultrasound or MRI. These findings can provide useful information, but they don't always explain how much pain you should be experiencing or what you are capable of doing.

Your symptoms, clinical assessment and how your foot or ankle functions are much more important when deciding how best to manage your problem.

This is a common question, particularly when foot or ankle pain has been present for some time.

Scans can be useful in certain circumstances, particularly after a significant injury, when there is a concern about a fracture or other specific injury, or when the results are likely to change how your treatment is managed.

However, imaging isn't always necessary.

A good clinical assessment is often the starting point.

If you already have an X-ray, ultrasound or MRI report, we can help you understand what the findings mean in relation to your symptoms and what they mean for your activity.

Not every ankle sprain requires an X-ray.

Whether imaging is appropriate depends on the nature of the injury, your symptoms and clinical findings.

If you've had a significant injury and are unable to put weight through the foot or have significant tenderness around the ankle or foot, you should seek an appropriate medical assessment.

Plantar fasciitis is a common cause of pain underneath the heel and along the sole of the foot.

People often notice pain when taking their first steps in the morning or after sitting for a period of time. It can also become painful after longer periods of walking, standing or running.

Despite the name, plantar heel pain isn't simply an inflammation problem.

Symptoms can be influenced by the amount of load being placed through the tissues of the foot, changes in activity, calf and foot strength and how well the foot is able to tolerate those demands.

Treatment usually involves gradually building the capacity of the foot and calf, while modifying activities that are aggravating your symptoms where necessary.

Recovery can take time, particularly when symptoms have been present for several months, but there is often a lot that can be done to improve pain and function.

The Achilles tendon connects the calf muscles to the heel and plays an important role in walking, running and jumping.

Achilles tendinopathy can develop gradually, often following a change in activity such as increasing running, adding more hills or speed work, returning to sport or simply doing more than the tendon is currently used to.

It can also occur following a more sudden increase in load.

Pain and stiffness are often felt around the tendon, particularly when first getting moving or during activities such as running and jumping.

The Achilles tendon responds to appropriate loading, and a gradual strengthening programme is an important part of rehabilitation.

This doesn't necessarily mean that you have to stop all activity. We'll help you work out what you can safely continue doing, what may need to be modified and how you can gradually build your capacity again.

An ankle sprain is one of the most common sporting injuries.

Many people recover well following an ankle sprain, but some are left with ongoing pain, stiffness, weakness or a feeling that the ankle is going to give way.

This can increase the risk of further sprains.

Rehabilitation following an ankle injury isn't simply about waiting for the swelling and pain to settle.

Improving the strength of the calf and surrounding muscles, restoring movement, challenging your balance and gradually exposing the ankle to the demands of your sport or activity can all be important.

If you've had several ankle sprains, we'll also look at why the problem may be recurring and how you can improve the capacity and confidence of your ankle.

Sometimes you may need to temporarily modify what you are doing, particularly if your pain has followed an injury or a sudden increase in activity.

However, complete rest is rarely the long-term answer.

Your foot and ankle need appropriate movement and loading to maintain and build their capacity.

You may initially need to reduce activities that are aggravating your symptoms, such as running, jumping, long walks or prolonged standing.

That doesn't necessarily mean you need to stop them altogether.

We'll help you work out what you can safely do now, what may need to be modified and how you can gradually build your activity back up.

Running places significant demands on the foot and ankle, particularly through the calf, Achilles tendon and muscles of the foot.

Foot and ankle pain can develop after increasing your running distance, frequency, speed or hills. It can also happen when you return to running after a period away from it.

Your footwear, running surface, previous injuries, strength, recovery and overall training load can all be relevant.

Rather than simply telling you to stop running, we'll look at what may be contributing to your symptoms and work out how you can safely maintain or gradually return to running where appropriate.

For runners, the goal isn't simply to get the foot or ankle comfortable. It's to build enough capacity to tolerate the demands of running again.

Having one episode of foot or ankle pain can sometimes make future episodes more likely.

That doesn't necessarily mean that your foot or ankle is becoming weaker or more damaged.

Pain can flare when the demands placed on your body increase faster than your current capacity.

This might happen after a period of inactivity, increasing your running, returning to sport, changing your training, spending more time on your feet or simply doing more than you're used to.

Sometimes people also become cautious about using a painful foot or ankle, which can gradually reduce their strength and confidence.

One of the most useful things you can do is gradually build your capacity so that your foot and ankle are better prepared for the demands of everyday life and the activities you enjoy.

This is why our approach isn't just about getting you through the current episode. Where appropriate, we'll also look at how you can reduce the impact of future flare-ups and become more confident managing your foot and ankle yourself.

Not necessarily.

Depending on the cause and severity of your symptoms, it may be possible to continue running while modifying your training.

This might mean temporarily reducing your distance, speed, frequency or hills before gradually building back up.

We'll help you work out what level of running your foot and ankle can currently tolerate and how to progress from there.

Calf flexibility may be relevant for some people, but plantar heel pain isn't simply caused by tight calf muscles. Activity levels, strength, recent changes in load and the capacity of the foot and lower leg can all be part of the picture.

Your activity levels, strength, training load and the capacity of the tissues in your foot and lower leg can all be relevant.

Rather than focusing on one specific cause, we'll look at the bigger picture and work out what is likely to be contributing to your symptoms.

Not necessarily.

The Achilles tendon generally benefits from appropriate loading rather than complete rest.

You may need to temporarily reduce activities that place a high demand on the tendon, such as running or jumping, while gradually building your strength and capacity.

Some ankle sprains can take longer to recover than people expect.

Ongoing pain can sometimes be associated with reduced strength, stiffness, balance problems, instability or returning to activity before the ankle has regained enough capacity.

If your ankle is still painful or giving way months after an injury, a proper assessment can help identify what may be contributing and what you can do to improve it.

Yes.

Persistent foot and ankle pain can be more complicated than a recent injury, but that doesn't mean nothing can be done.

Treatment may involve gradually increasing your physical capacity, improving confidence with movement, addressing factors that may be contributing to flare-ups and developing strategies that allow you to manage your symptoms more effectively.