Foot and Ankle

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Foot and ankle pain

Pain in the foot or ankle can arise after an injury (e.g a fall), or develop with no known injury (e.g. a flare of arthritis). It can affect muscles, tendons, ligaments, bones or other tissues in the foot and ankle joints

There are several ways you can help yourself including:

Taking pain medication
Keep active and avoid static postures/positions
Find a balance between rest and some activity, try not to overdo things (alter activities that make it worse so they are less painful)
Using cold treatment, eg. ice packs, or heat treatment, eg. heat packs
Wear comfortable and supportive footwear

Go straight to Accident & Emergency if:

You have a new and visible deformed or misshapen ankle or foot
The ankle or foot pain was caused by a serious fall or accident (eg. a fall from height or high impact sports injury)
A recent fall or trauma if you have osteoporosis
You're unable to move your ankle or put any weight through your leg
You have ankle or foot pain with a temperature and feel unwell, especially after recent foot or ankle surgery or injections in the foot or ankle area - this can be a sign of infection

You should see your doctor (GP) if you:

Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
Have any tingling or loss of sensation in your foot
Have diabetes and foot pain – foot problems can be more serious if you have diabetes

If you do not have any of the above, you may be able to effectively self manage your condition

Common foot and ankle conditions

Achilles Tendinopathy

Achilles tendinopathy is one of the most frequent ankle and foot injuries which can occur when overworked. It is characterised by the combination of pain, swelling, and restricted function.

You are more at risk of having Achilles tendinopathy if:

You are Overweight
Have Diabetes (Types 1+2)
Have reduced muscle Strength
Have reduced ankle movement
There has been a sudden change in your usual activity

Often an umbrella term of tendinopathy is used (see our Tendinopathy information leaflet for more information).

The most common symptoms associated with Achilles Tendinopathy may include:

Pain often presents as being stiff and sore in the morning which will ease after several minutes of activity.
Stiffness and pain can often return after a period of rest or inactivity
Pain is often made worse by physical activity, that involves periods of time on your feet
You may also develop a lump on your Achilles, this may or may not be tender to touch and is more common in the middle of your Achilles

Images/scans are generally not needed to confirm Achilles Tendinopathy. Further tests such as Ultrasound scans may be performed if the Health Care Professional needs further information to finalise the diagnosis.

The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments.

Once your pain is under control, working on the movement and strength of your foot and ankle is what will help long term.

You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active.

Below are some basic exercises specific to your foot to get you started.

Wear shoes with cushioned heels and good arch support
Use insoles or heel raise in your shoes
Try regular exercises as shown below
Staying healthy helps your recovery and maintain a healthy weight
By reducing the load and impact on your Achilles, and follow the Keeping Active advice.

It is normal to experience some discomfort when doing exercises, and individuals may start at different points. Pain should not increase excessively during or immediately after the activity. Discomfort should return to pre-activity levels 24-48 hours after the activity has finished.

The number (reps) and frequency (sets) of exercises suggested here are a guide, and should be performed to your personal tolerable pain levels. This means repetitions will vary between individuals and you should only go as far as is reasonably comfortable for you.

Exercises for a tendinopathy need to be increased gradually to avoid aggravating the tendon. The exercises below are 3 stages that can be worked through to recondition your tendon. Only progress to the next stage once the stage you are currently on becomes easy and pain free.

Stage 1: Seated Heel Raise

Start by sitting in a chair with your feet flat on the floor. Raise your heels up and then return to the starting position. Then raise your toes off the floor and return to the starting position. Continue this movement.

Moving image of someone standing behind a chair, pushing up onto their toes Stage 2: Heel raises

Hold on to a solid object with your legs hips width apart. Keeping your knees straight, rise up on to your toes, and control the movement as you lower back down.

Moving image of someone standing on one leg, pushing up onto their toes Stage 3: Single leg calf raise on floor

Stand on your symptomatic leg. Maintaining your balance, rise up on to your toes so the heel comes off the floor, keeping your knee straight. Control the movement back to the start position, and repeat.

You should also see a Health Care Professional if you:

Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have pain, tingling, numbness or weakness in your feet
Are feeling clumsy or are falling more often
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
Have a history of recent injury (e.g. from a road traffic accident or a fall) or a history of foot or ankle surgery
Felt or heard a snapping or a popping in the back of your lower leg
There is severe bruising around the back of the lower leg and ankle
Have a new and visible deformed or misshapen foot
Are unable to point your toes, or you are dragging your foot when you walk
Have pain in the back of your heel that is severe or you are unable to put your heel to the floor
The pain is getting worse or keeps coming back

If you do not have any of the above, you may be able to effectively self-manage your condition.

Ankle Sprains

An ankle sprain occurs when the ankle moves to a position where it is overstretched. If the ligaments around the ankle reach their limit and the movement continues, the ligament can then become damaged. The most common way your ankle is sprained is by rolling or twisting your ankle.

Common symptoms associated with ankle sprains are:

Pain, especially when you put weight on the affected foot eg, standing up from sitting or walking
Tenderness when you touch the ankle and maybe even the lower leg
Swelling
Bruising
Restricted range of movement
Weakness of the ankle and feeling like it will give way

The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments.

Once your pain is under control, working on the movement and strength of your foot and ankle is what will help long term.

You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your foot to get you started.

Once your pain is more manageable, exercises can be helpful in restoring movement, increasing or maintaining strength and returning to function.

It is normal to experience some discomfort when doing exercises, and individuals may start at different points. Pain should not increase excessively during or immediately after the activity. Discomfort should return to pre-activity levels 24-48 hours after the activity has finished.

The number (reps) and frequency (sets) of exercises suggested here are a guide, and should be performed to your personal tolerable pain levels. This means repetitions will vary between individuals and you should only go as far as is reasonably comfortable for you.

Alphabet exercise

Sit down with your legs extended or hanging off the table. Draw the capital letters of the alphabet with your ankle, accentuating all of the ranges of motion.

Moving image of someone balancing on one leg Single-leg stand

Balance on one leg. Remember to stand tall, with weight evenly on your foot and toes pointing forwards.

Heel raises

Hold on to a solid object with your legs hips width apart. Keeping your knees straight, rise up on to your toes, and control the movement as you lower back down.

Unless you have a serious injury or have sudden continuous severe pain, you can usually treat your ankle pain without having to see your doctor. If after 2 weeks of treating yourself you feel the pain isn’t any better or is worsening, you should see a Health Care Professional

You should also see a Health Care Professional if you:

Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have pain, tingling, numbness or weakness in your legs and feet
Develop sudden stiffness in the ankle resulting in a complete loss of movement (also known as locking)
Are noticing changes to your balance or walking pattern
Are feeling clumsy or are falling more often
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
Have a history of recent injury (e.g. from a road traffic accident or a fall) or a history of ankle surgery
Have a new and visible deformed or misshapen ankle
Find your ankle is giving way, causing you to fall
Notice your calf becomes red, swollen and hard to the touch, with pain increasing when walking (signs of a DVT)

If you do not have any of the above, you may be able to effectively self-manage your condition

Ankle Osteoarthritis (OA)

Ankle Osteoarthritis is a natural degenerative process where the cartilage that spaces a joint starts to change and over time thins, meaning the bones get closer together, and can occur in any joint in the body. Osteoarthritis is a part of the normal ageing process and is most commonly seen in people over the age of 40.

Ankle Osteoarthritis can also be impacted by your occupation or your sporting hobbies. Past injury/trauma to your ankle or lower leg such as a fracture, dislocation, infection or cartilage tears can also impact osteoarthritis. Altered foot posture may also contribute to osteoarthritis of the ankle.

Limited function in daily tasks
Pain  
Reduced movement of the ankle joint  
Pain is worse during or after activity 
Stiffness worse with inactivity 
Symptoms can flare or settle with changing seasons
Changes to walking pattern (Gait) due to reduced movement
Changes to gait over time can start to affect other joints
The ankle has gradually changed in shape and size over time

An image/x-ray is generally not needed to confirm osteoarthritis. One may be performed if the Health Care Professional needs further information to finalise the diagnosis or if surgery is being considered.

Once your pain is under control, working on the movement and strength of your ankle is what will help long term.

You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your ankle to get you started.

It is normal to experience some discomfort when doing exercises, and individuals may start at different points. Pain should not increase excessively during or immediately after the activity. Discomfort should return to pre-activity levels 24-48 hours after the activity has finished.

The number (reps) and frequency (sets) of exercises suggested here are a guide, and should be performed to your personal tolerable pain levels. This means repetitions will vary between individuals and you should only go as far as is reasonably comfortable for you.

Alphabet exercise

Sit down with your legs extended or hanging off the table. Draw the capital letters of the alphabet with your ankle, accentuating all of the ranges of motion.

Isometric Ankle Dorsiflexion

Sit on a chair or on the floor. Put one foot on top of the other foot. Try to lift the foot that is under while preventing any movement with the foot that is on top.

Moving image of someone sat with on foot on top on the other. One foot is pushing up while the other is pushing down Isometric ankle plantarflexion

Sit on a chair or on the floor. Put one foot on top of the other foot. Try to point the toes of the foot that is on top while preventing any movement with the foot that is underneath.

Moving image of someone balancing on one leg Single-leg stand

Balance on one leg. Remember to stand tall, with weight evenly on your foot and toes pointing forwards.

You should also see a Health Care Professional if you: 

Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help 
Have pain that has rapidly deteriorated or suddenly worsened despite self help 
Have pain, tingling, numbness or weakness in your legs and feet  
Develop sudden stiffness in the ankle resulting in a complete loss of movement (also known as locking) 
Are noticing changes to your balance or walking pattern  
Are feeling clumsy or are falling more often 
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection 
Feel unwell, have a fever, or unexplained weight loss 
Are experiencing significant and regular changes to your usual sleeping pattern 
Have a history of recent injury (e.g. from a road traffic accident or a fall) or a history of ankle surgery 
Have a new and visible deformed or misshapen ankle   
Notice your ankle is giving way, causing you to fall

If you do not have any of the above, you may be able to effectively self-manage your condition.

Plantar fasciitis (plantar heel pain)

Plantar heel pain, also known as plantar fasciitis, is a common foot condition.

Plantar heel pain causes discomfort and sometimes inflammation of the thick band of tissue (fascia) that runs across the bottom of each foot and connects the heel bone to the toes.

You are more at risk of having plantar heel pain if:

Recently started or a sudden change / increase in activity (long standing or started running)
Have a tight calf or heel region
Sudden overstretching of the sole of your foot
Wear shoes with poor cushioning or support
Are overweight.

The most common symptoms associated with plantar heel pain may include:

Pain is often felt on the underside of the heel where the foot strikes the floor when walking
A sharp stabbing pain or bruising sensation on the underside of the heel
Pain where the heel strikes the floor when walking.
Pain / stiffness is often worse first thing in the morning or after periods of rest
Pain around the heel on long standing
Increased pain with less supportive footwear such a flip flops
In more severe cases the inability to place heel to the floor when walking

Images/scans are generally not needed to confirm plantar fasciitis. Further tests such as ultrasound scans may be performed if the Health Care Professional needs further information to finalise the diagnosis.

Once your pain is under control, working on the movement and strength of your foot and ankle is what will help long term.

You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your foot to get you started.

Wear shoes with cushioned heels and good arch support
Use insoles or heel pads in your shoes
Try regular exercises as shown below
Staying healthy helps your recovery and maintain a healthy weight
By reducing the load and impact on your feet, and follow the Keeping Active advice

Heel raises with toes on a towel roll

Stand up straight facing a wall or supportive surface. Position a rolled towel on the floor. Place your toes onto the towel. Perform a calf raise, pushing up onto your toes. Hold this position briefly. Control the movement as you slowly lower your heels back down to the floor. Ensure you keep your knees straight throughout the movement.

Moving image of someone sat with their foot on a towel, scrunching up their toes Towel scrunch

Start in a seated position. Spread a thin towel on the floor in front of you and place your foot on the end of the towel. Keep your heel on the floor and use your toes to try to pull the towel towards you.

Moving image of someone sat down rolling a ball under their foot Plantar fascia ball roll

Start in a seated position. Place a small ball underneath the arch of your foot. Apply pressure down on the ball, and roll the ball from the base of the heel up to the base of the great toe.

You should also see a Health Care Professional if you:

Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
Have pain that has rapidly deteriorated or suddenly worsened despite self help
Have pain, tingling, numbness or weakness in your feet
Are feeling clumsy or are falling more often
Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
Feel unwell, have a fever, or unexplained weight loss
Are experiencing significant and regular changes to your usual sleeping pattern
Have a history of recent injury (e.g. from a road traffic accident or a fall) or a history of foot or ankle surgery
Have a new and visible deformed or misshapen foot
Have pain in the bottom of your foot that is severe or you are unable to put your heel to the floor
Find the pain is getting worse or keeps coming back

If you do not have any of the above, you may be able to effectively self-manage your condition

Mortons Neuroma

Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. Morton's neuroma may feel as if you are standing on a pebble in your shoe or have a fold in your sock.

Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. This can cause a sharp, burning pain in the ball of your foot. You may have stinging, burning or numbness in the affected toes.

High-heeled or tight shoes have been linked to the development of Morton's neuroma. Many people experience relief by switching to lower heeled shoes that are wider fitting.

Typically, there's no visible sign of this condition, such as a lump. Instead, you may experience the following symptoms:

A feeling as if you're standing on a pebble in your shoe
A burning pain in the ball of your foot that may radiate into your toes
Tingling or numbness in your toes
Removing your shoe and rubbing your foot often helps to relieve the pain

Diagnosis is usually made from a consultation with your Health Care Professional, involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability. This may involve looking at your walking and a review of your footwear, so it may be helpful to bring your most commonly worn shoes to your appointment.

An image/ultrasound scan is generally not needed to confirm Morton's Neuroma. One may be performed if the Health Care Professional needs further information to finalise the diagnosis or if surgery is being considered.

Once your pain is under control, working on the movement and strength of your ankle is what will help long term.

You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your ankle to get you started.

To treat Morton's neuroma you can also try:

Changing your footwear (Avoid wearing shoes that are narrow, tight or high heels)
Trying a shoe insert with a Metatarsal Dome Pad or a separate Metatarsal Dome Pad.

Alphabet exercise

Sit down with your legs extended or hanging off the table. Draw the capital letters of the alphabet with your ankle, accentuating all of the ranges of motion.

Towel scrunch

Useful links for more detailed information

We are all individuals, "one size does not fit all", the links below may offer more detailed information and advice, but may not be suitable for everyone.

Foot and Ankle

On this page…

Foot and ankle pain