Foot and Ankle Conditions
Foot and ankle pain can be caused by a number of different conditions. Outlined below are the most common causes of pain in the foot and ankle:
Plantar fasciitis (pain in the heel and arch of the foot)
Plantar fasciitis is inflammation of the soft tissue (plantar fascia) running from the heel bone to the bones in the arch of your foot. The pain is usually felt in the heel or arch of the foot and is generally worse first thing in the morning or when you take your first step after a period of inactivity.
Your physiotherapist will advise you on stretching and strengthening exercises for the muscles of the foot and lower leg. Icing the foot, losing weight and wearing a well fitting shoe that supports the arch of your foot can help with the pain. Occasionally, if pain does not settle an injection into the sole of the foot may be required.
The Achilles’ tendon is the large tendon at the back of the ankle which connects your calf muscles to your heel bone. Pain in this area is usually due to a condition called Achilles’ tendonopathy. It is caused by tightening and swelling of the tendon and is particularly common in people who have started a new exercise or have increased the amount that they do.
Physiotherapy will concentrate on stretching and strengthening the calf muscles and tendon and offer advice with your training regime and technique. Ice, pain-killers and anti-inflammatories can also be helpful to reduce the swelling and pain. Your physiotherapist may also refer you to podiatry to look at your foot position and assess whether insoles for your shoes may be helpful.
Lower limb fractures (broken bones in the leg)
Fractures are breaks or cracks in bones. They can be treated conservatively by immobilising the limb in a cast or may be surgically repaired. Your orthopaedic surgeon will decide which option is best for you, based on your x-ray or scan findings. Once the surgeons are happy with how the fracture is healing you will usually be referred to physiotherapy to help you get the movement, strength and mobility back into your leg.
Because broken bones have to be immobilised in order to heal, it is usual for the joints around the fracture to become stiff and the muscles to become weak. This can cause pain in around the joint initially, however this usually improves once you get things moving. Once your fracture has healed you should try and walk as normally as possible, however, you may have to gradually re-introduce more difficult activities (e.g. jogging). If you have any concerns about specific activities, discuss this with your physiotherapist. Occasionally, broken bones can cause a condition called Complex Regional Pain Syndrome (CRPS).
Ankle Sprains (ligament injuries)
Ankle sprains occur when the soft tissues (mainly ligaments) around the ankle joint are damaged following trauma or a twisting injury. Pain can be felt on the inside or outside of the ankle and is often accompanied by swelling and bruising. Movement is often reduced and it can be difficult and painful to weight bear through the ankle. Putting ice on the ankle can be helpful to reduce the swelling and ease pain.
Your body will repair the damage to your ligaments. However, it is quite common for the ankle to remain stiff and painful due to scar tissue in the area. Regaining the movement in the ankle and strengthening the muscles around the joint will help to return the ankle to normal. Your physiotherapist will advise you on exercises to improve the movement, strength and balance in the ankle. They will also focus on improving your walking pattern and returning you to your previous activities.