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Foot & Ankle Pain

The human foot is incredibly complex in both its structure and function. The two important functions of the foot are weight bearing and propulsion. These functions require a high degree of stability.

Ankle Ligament Strains

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Ligament strains at the ankle are more commonly referred to as a sprained ankle or a twisted ankle. This can occur when the foot rolls out from underneath you. This can cause micro-tearing to the ligaments that stabilize the ankle and in some cases, a complete tear of the ligament occurs. Most sprains occur due to trauma during contact sport but can also occur quite innocently.

The ankle normally swells up and is painful to weight bear on. Ankle ligament strains are classed from Grade 1 to Grade 3 depending on the damage to the ligament. Grade 1 is mild damage, grade 2 is a partial tear and grade 3 is a complete tear causing instability of the ankle joint.

Treatment may include:

  • Crutches
  • Cam boot/walker
  • Compression
  • Ice, heat
  • Osteopathy, Physiotherapy
  • Exercise Physiology
  • Pain and or anti-inflammatory medication
  • Clinical pilates

Plantar Fasciitis

Plantar fasciitis is characterized by pain on the bottom of the foot especially over the heel itself when weight bearing. Pain is often worse in the mornings and at the start of an activity (such as running). It is an inflammation of the tendons that run along the bottom of your foot. Plantar fasciitis is common in runners and is also common with sudden weight gain.

Treatment for plantar fasciitis may include:

  • Podiatry assessment for supports/orthotics for your shoes
  • Shockwave therapy
  • Osteopathy, Physiotherapy
  • Clinical pilates

Arthritis

Arthritis is a common condition that affects the foot and ankle. Commonly degenerative arthritis such as osteoarthritis affects the big toe of the foot. Inflammatory arthritis such as rheumatoid arthritis can affect all of the joints of the foot.

Seeking advice from a podiatrist to assess the best footwear or supports that can be added to your shoes during times of inflammation can be beneficial.

Treatment may include:

  • Referral to a rheumatologist
  • Assessment to a podiatrist
  • Osteopathy. Myotherapy, Physiotherapy
  • Exercise Physiology
  • Clinical pilates

Foot Joint Sprain

The foot is made up of complex rows of bones and as a result, there are many joints formed between them. A foot joint sprain refers to damage to the ligaments or the joints of the foot. A sprain may occur from landing awkwardly, wearing inappropriate footwear, or may occur secondary to an ankle sprain.

Treatment may include:

  • Rest
  • Podiatry
  • Osteopathy, Physiotherapy
  • Advise on footwear
  • Heat or ice

Achilles Tendinopathy

Achilles tendinopathy is a chronic inflammatory condition, which causes pain, swelling, stiffness, and weakness of the Achilles tendon. The Achilles Tendon joins the calf muscles to the heel bone of the foot. Sometimes the Achilles tendon becomes thickened as a result of the inflammation.

The main cause of Achilles tendinopathy is overuse and repetitive strain. This is common in runners or sports that require running such as tennis. Typically the Achilles tendon will become overworked when other muscles in our lower limb aren’t working efficiently to distribute the load.

Treatment may include:

  • Physiotherapy, Osteopathy
  • Podiatry
  • Shock wave therapy
  • Rest and load management planning
  • Ice/heat

Shin Splints

Shin splints are a common injury, especially amongst the running population. Shin splints is a term to describe shin pain along the inside of the shin (tibia) bone. Pain is generally felt in the lower two-thirds of the shin.

It is thought to occur due to muscular tightness most commonly in the tibialis anterior and posterior muscles. Pain can also arise due to inflammation around the periosteum, where the tendon of the muscle attaches to the bone. In some severe cases, there can be changes in the bone, and stress fractures can develop.

Shin splints usually develop due to:

  • Overtraining with inadequate recovery time
  • Excessive running on a hard surface
  • Poor footwear
  • Poor ankle flexibility
  • Poor gluteal (hip control) during the stance phase
  • Poor biomechanics of the foot, ankle, and leg.
  • Muscular imbalance of the foot and lower leg

Treatment may include:

  • Osteopathy, Physiotherapy
  • Podiatry
  • Clinical pilates/Exercise Physiology for rehabilitation
  • Rest
  • Ice/heat
  • Running technique assessment

Flat feet: Pes Planus

Pes Planus is a condition most commonly referred to as flat feet. This means your feet do not have a normal arch when standing, possibly causing pain when you do extensive physical activity. Sometimes flat feet can cause problems at the knee, hip, and lower back.

The condition is normal in infants and usually disappears by age 2 or 3 as the ligaments and tendons in the foot and leg tighten. However, it can last through to adulthood. It is very common and has a lot to do with lower limb biomechanics and genetic makeup.

Flat feet, whilst not reversible may easily be managed through:

  • Podiatry review
  • Orthotics
  • Re-training walking and running movements (gait analysis)
  • Exercise rehabilitation.

Navicular Stress Fracture

Navicular stress fractures are a serious injury to the load-bearing bone of your mid-foot. The cause is a repetitive chronic load to the midfoot often from dynamic sporting-type activities. Seen a lot at AFL level for example James Hird, it is also seen in runners and dancers. A navicular stress fracture is difficult to diagnose as it may not be seen on a regular x-ray.

Treatment may involve:

  • A period of non-weight-bearing.
  • If it is not healing well surgery may be required
  • Exercise rehabilitation
  • Podiatry review