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SportsCare Physical Therapy

Conditions

Ankle & foot pain and injuries

Ankle sprains are the most common injury in sport and one of the most under-treated: most people never rehabilitate them, and up to a third go on to a chronically unstable ankle. The foot, meanwhile, carries everything you do all day. Both reward a proper plan more than almost any other region.

Request an appointmentWhen to see a doctor first
A physical therapist examining a patient's ankle

See a doctor first

An ankle or foot with any of the following needs an X-ray at an urgent care or emergency department before a therapy visit:

  • You could not take four steps on it immediately after the injury, and still cannot
  • Bone tenderness at the back edge or tip of either ankle bone, or over the midfoot or the base of the fifth metatarsal
  • Obvious deformity, or a foot that looks or feels wrong
  • A hot, red, swollen joint with fever, or a wound that will not heal — especially if you have diabetes
  • A sudden "kicked in the back of the leg" feeling with weakness pushing off, which can be a ruptured Achilles

What we see most

Ankle & foot conditions we treat, and what therapy does for each.

  • Ankle sprains

    A stretch or tear of the ligaments on the outside of the ankle, from rolling it. Graded by severity; even a mild sprain leaves the ankle's position sense impaired for weeks.

    What therapy does: After an X-ray is ruled out or clear, the guideline-supported treatment is early weight-bearing and movement — not prolonged rest — followed by balance and strength training, which is what lowers the risk of the next sprain. Bracing during sport for the following year cuts recurrence further. Most people skip the rehabilitation; that is the single biggest reason ankle sprains keep coming back.

  • Chronic ankle instability

    An ankle that keeps rolling, or feels as though it might, months or years after a sprain that was never properly rehabilitated.

    What therapy does: Balance training on unstable surfaces, hip and ankle strengthening, and retraining how you land are effective for most people, with good trial evidence. Where the ligaments are genuinely lax and rehabilitation has not worked, surgical repair is an option, and we will tell you when it is worth a conversation.

  • Plantar fasciitis (heel pain)

    Sharp heel pain with the first steps of the morning and after sitting, from overload of the thick band under the arch. Common in runners, in people who stand all day, and after a jump in activity.

    What therapy does: The clinical practice guideline for heel pain supports stretching of the plantar fascia and calf, manual therapy, taping, and in some cases night splints or orthoses — a combination that settles most cases over two to three months. It is slow, and we say so. Injections and shockwave have a role when a proper course of the above has not worked.

  • Achilles tendinopathy

    Pain and stiffness in the Achilles tendon, worst in the morning and at the start of activity. Mid-tendon cases are common in runners; cases at the heel bone are more common in older, less active people.

    What therapy does: Progressive loading of the calf — heavy, slow, and continued for months — has the strongest evidence of any treatment for Achilles tendinopathy, and it is what we build the plan around. Tendons adapt slowly; three to six months is a normal course. Stretching an irritated Achilles usually aggravates it.

  • Recovery after ankle or foot fracture

    Rehabilitation once a broken ankle, heel, or metatarsal has been cleared to bear weight, whether it was treated in a boot or with surgery.

    What therapy does: Weeks in a boot leave a stiff, weak ankle and a calf that has visibly shrunk. We restore movement, rebuild strength and balance, and retrain walking so the limp goes rather than settling in. Your surgeon's weight-bearing timeline comes first.

Do you need an X-ray?

For an ankle sprain, the Ottawa Ankle Rules are the standard: an X-ray is needed if you could not take four steps immediately after the injury and still cannot, or if there is bone tenderness at the back edge of either ankle bone, over the midfoot, or at the base of the fifth metatarsal. Your therapist applies the same rules at the first visit and sends you for imaging if they are met.

For heel pain and Achilles pain without trauma, imaging rarely changes the plan and is not needed to start treatment.

What treatment looks like

The evaluation looks at how the ankle moves, how stable it is, how strong the calf and hip are, how you walk and — for athletes — how you land and change direction. Footwear comes into it, and so does what your training has looked like in the last few weeks.

Treatment is mainly progressive exercise: calf loading, balance and proprioception, and hip strength, because the hip controls where the foot lands. Hands-on treatment, taping and bracing have supporting roles. For runners we manage the return to running as part of the plan rather than leaving it to guesswork.

Sprains are typically seen for four to eight weeks; tendon problems and heel pain for longer, because tendons adapt slowly.

How we treat it

The services that apply.

FAQ

Common questions

Should I rest a sprained ankle, or walk on it?
Once a fracture is ruled out, walk on it as soon as you comfortably can. Early weight-bearing and movement recover faster than prolonged rest, and balance training afterward is what prevents the next sprain.
How long does plantar fasciitis take to get better?
Most cases improve over two to three months with a consistent program of stretching, loading and footwear changes, and the large majority resolve within a year. It is slow but it does get better.
Should I stretch my Achilles tendon if it hurts?
Usually not. Stretching compresses an irritated Achilles against the heel bone and tends to aggravate it. Progressive calf strengthening — slow, heavy heel raises, continued for months — is the treatment with the best evidence.
Can I get physical therapy for a broken ankle at SportsCare?
Yes. Once your physician or surgeon clears you to bear weight, rehabilitation after fracture is offered at every SportsCare clinic.

Sources

  1. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline — British Journal of Sports Medicine, 2018
  2. Heel Pain — Plantar Fasciitis: Revision 2014 — Clinical Practice Guidelines — Journal of Orthopaedic & Sports Physical Therapy (APTA)
  3. Sprained Ankle — OrthoInfo, American Academy of Orthopaedic Surgeons
  4. Achilles Tendinitis — OrthoInfo, American Academy of Orthopaedic Surgeons
  5. Plantar Fasciitis and Bone Spurs — OrthoInfo, American Academy of Orthopaedic Surgeons
  6. Sprains and strains — NHS

This page is general information, not a diagnosis. A physical therapist at any SportsCare clinic can evaluate your specific situation.