Foot and Ankle Pain.
What is causing your foot and ankle pain?
Feet and ankles play a crucial role in daily life, providing support, stability and mobility. As a result, they are also more prone to injuries that can cause significant pain and discomfort and affect the ability to perform daily activities. Ankle and foot injuries are fairly prevalent in Australia and frequently occur during sport, most commonly in soccer and rugby, with ankle injuries accounting for approximately 5.9% of all sporting injuries requiring hospitalisation.
The foot and ankle region contains numerous bones, joints, tendons, ligaments and nerves, and accurate diagnosis of which structure is producing symptoms is essential — the treatment for plantar fasciitis is quite different from that for Achilles tendinopathy, which differs again from a ligament sprain or tarsal tunnel syndrome.
Common causes of foot and ankle pain
How is foot and ankle pain diagnosed?
A physiotherapy assessment evaluates the likely pain source through gait analysis, specific provocation tests, strength and flexibility assessment, and neurological testing where nerve involvement is suspected. Weight-bearing X-ray identifies bony pathology and deformity. Ultrasound directly visualises tendon, ligament and soft tissue pathology. MRI provides comprehensive assessment for stress fractures, complex ligament injuries and nerve entrapments.
How can physiotherapy help?
The rehabilitation approach is specific to the diagnosis. Intrinsic foot muscle strengthening, calf strengthening and eccentric loading, proprioception and balance training, orthotic prescription, and gait retraining are the interventions most commonly drawn upon across foot and ankle conditions.
Real time ultrasound assists in retraining deep foot and ankle muscle activation. Clinical Pilates provides controlled lower limb strengthening and proprioceptive training appropriate for the rehabilitation of most foot and ankle conditions. Dry needling assists with pain management in the calf and plantar fascia.
For patients whose foot or ankle condition arose from a workplace or motor vehicle injury, WorkCover and CTP funded physiotherapy is available.
Our physiotherapists Eliane Machado, Mauricio Bara and Emma Cameron all have experience in foot and ankle conditions and are members of the Australian Physiotherapy Association. Eliane's doctoral research in lower limb biomechanics is directly relevant to the gait analysis and foot loading assessment that underpins good foot and ankle rehabilitation outcomes.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Feet and ankles play a crucial role in daily life, providing support, stability and mobility. As a result, they are also more prone to injuries that can cause significant pain and discomfort and affect the ability to perform daily activities. Ankle and foot injuries are fairly prevalent in Australia and frequently occur during sport, most commonly in soccer and rugby, with ankle injuries accounting for approximately 5.9% of all sporting injuries requiring hospitalisation.
The foot and ankle region contains numerous bones, joints, tendons, ligaments and nerves, and accurate diagnosis of which structure is producing symptoms is essential — the treatment for plantar fasciitis is quite different from that for Achilles tendinopathy, which differs again from a ligament sprain or tarsal tunnel syndrome.
Common causes of foot and ankle pain
- Plantar fasciitis — the most common cause of heel pain — involves degeneration and pain at the origin of the plantar fascia on the medial calcaneal tubercle. The characteristic presentation is severe pain with the first steps in the morning that eases after a few minutes of walking, returning with prolonged weight-bearing. It responds well to structured physiotherapy including specific tendon loading, calf stretching and orthotic management.
- Achilles tendinopathy — degeneration of the Achilles tendon from repetitive loading — produces pain and stiffness at the back of the heel that is characteristic worse in the morning and with the initiation of activity. Both mid-portion and insertional Achilles tendinopathy occur and have distinct management approaches. Heavy slow resistance loading and eccentric calf training are the evidence-based core interventions.
- Ankle sprains — the most common acute sporting injury in Australia — involve tearing of the lateral ankle ligaments from an inversion mechanism. Ankle injury types vary from fractures to ligament tears and tendon injuries. Physiotherapy for ankle injuries involves range of motion exercises, actively regaining stability, and motor coordination to improve balance to ensure a safe return to activity. Despite being frequently undertreated, residual proprioceptive deficits following ankle sprain significantly increase re-sprain risk if not specifically rehabilitated.
- Posterior tibial tendon dysfunction (PTTD) — progressive failure of the posterior tibial tendon producing adult acquired flatfoot deformity — is most common in middle-aged women and produces inner ankle pain and progressive arch collapse. Early physiotherapy and orthotic management prevents progression to surgical reconstruction.
- Morton's neuroma — perineural fibrosis of the interdigital nerve, most commonly between the third and fourth metatarsals — produces burning, tingling and numbness in the forefoot with weight-bearing. Metatarsal padding, orthotics and neural mobilisation are the primary conservative interventions.
- Tarsal tunnel syndrome — compression of the tibial nerve behind the medial malleolus — produces burning and tingling along the sole of the foot, the foot equivalent of carpal tunnel syndrome. Orthotic correction of valgus heel alignment is central to management.
- Sesamoiditis — inflammation of the sesamoid bones under the first metatarsophalangeal joint — produces forefoot pain under the big toe joint with push-off, common in dancers, runners and jumping sport athletes.
- Stress fractures of the metatarsals, navicular and calcaneus develop from repetitive impact loading exceeding the bone's adaptive capacity. Navicular stress fractures are particularly serious and require MRI for diagnosis. Load management and graduated return to activity are the management foundations.
- Flat feet — whether flexible or rigid, congenital or acquired — alter foot and lower limb mechanics in ways that predispose to a range of overuse injuries including plantar fasciitis, PTTD and shin splints. Orthotic support, intrinsic foot strengthening and proximal hip control work address both the local and systemic contributors.
- Peroneal tendon injuries — peroneal tendons provide active stability to the ankle and assist in eversion of the foot. Tendon ruptures can occur with inversion mechanisms similar to lateral ankle sprains, or tendinopathies can develop gradually from overloading. These are frequently missed when ankle pain is assumed to be a simple sprain.
- Anterior ankle impingement — soft tissue or bony impingement at the front of the ankle during dorsiflexion — produces pain with squatting, lunging and deep ankle flexion, common in footballers, dancers and gymnasts.
- Bunions — hallux valgus deformity of the first metatarsophalangeal joint — produce medial forefoot pain and progressive deformity that alters forefoot mechanics and loading.
- Flatfoot reconstruction and other foot and ankle surgeries require structured post-surgical physiotherapy rehabilitation to restore strength, mobility and function.
How is foot and ankle pain diagnosed?
A physiotherapy assessment evaluates the likely pain source through gait analysis, specific provocation tests, strength and flexibility assessment, and neurological testing where nerve involvement is suspected. Weight-bearing X-ray identifies bony pathology and deformity. Ultrasound directly visualises tendon, ligament and soft tissue pathology. MRI provides comprehensive assessment for stress fractures, complex ligament injuries and nerve entrapments.
How can physiotherapy help?
The rehabilitation approach is specific to the diagnosis. Intrinsic foot muscle strengthening, calf strengthening and eccentric loading, proprioception and balance training, orthotic prescription, and gait retraining are the interventions most commonly drawn upon across foot and ankle conditions.
Real time ultrasound assists in retraining deep foot and ankle muscle activation. Clinical Pilates provides controlled lower limb strengthening and proprioceptive training appropriate for the rehabilitation of most foot and ankle conditions. Dry needling assists with pain management in the calf and plantar fascia.
For patients whose foot or ankle condition arose from a workplace or motor vehicle injury, WorkCover and CTP funded physiotherapy is available.
Our physiotherapists Eliane Machado, Mauricio Bara and Emma Cameron all have experience in foot and ankle conditions and are members of the Australian Physiotherapy Association. Eliane's doctoral research in lower limb biomechanics is directly relevant to the gait analysis and foot loading assessment that underpins good foot and ankle rehabilitation outcomes.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
