Ankle / Foot

Ankle Sprains
Then ankle is commonly injured following a twisting mechanism and the symptoms are often varied depending on what direction the ankle twists and the degree of the trauma. Swelling and bruising are common with these injuries. An ankle sprain generally happens when playing sports but can also occur in everyday life from a simple trip or change of direction or awkward landing on one foot. There are three varying levels to an ankle sprain with grade 1 being a mild sprain, 2 being moderate and 3 being a full rupture of a certain ligament(s). It is important that the degree of injury is diagnosed as this determines the management. Pain normally dissipates after a few weeks however the greatest risk for an ankle sprain is a previous injury/sprain so a good rehabilitation plan is needed to avoid a future injury. It is recommended to consult a physiotherapist to help increase the chances of an optimal recovery. During your session the physiotherapist will evaluate your ankle stability and overall strength of the area and assess the surrounding joints (knee and the hip) to identify any compensations that can be addressed. This will be key to minimise the risks of re-injury and help the you return in an improved physical state compared to before the initial injury.
Achilles Tendinopathy
The Achilles tendon is located behind the ankle and above the heel and serves as the connection between the calf muscles (gastrocnemius, soleus and plantaris) to the heel bone (calcaneus). During walking, running or jumping the achilles tendon main role is to absorb, store and use energy to act in a spring like manner to propel the body forwards. An imbalance in this storing/recovering system can lead to the tendon becoming overloaded or worse a tear which can be partial or full. An irritation of the achilles tendon can happen due to overloading, repetitive strain, or even a trauma. The most common context leading to achilles tendon pain is running. Multiple factors can cause these symptoms that include returning to activity after a period of inactivity, imbalances of posture during activity further up the leg (kinetic chain), poor shoe wear support or restricted foot mobility. Typical symptoms include swelling, redness of the area or even a sensation of heat can be felt. The achilles becomes painful on walking, running or hopping and a common characteristic is stiffness in the mornings that can be relieved with rest. The treatment options vary according to the individual, a physiotherapist can help advise the correct exercises and management for your injury. Shockwave therapy has been shown to have excellent results in the resolution of Achilles tendinopathy issues and is something we use here at Flex physio.
Plantar Fasciitis / plantar heel pain / plantar fasciopathy
Plantar foot pain is the most common cause of pain in the sole of the foot, commonly located around the heel and arch of the foot. In fact, plantar foot pain is a result of there being an irritation of a connective tissue band, known as the plantar fascia, which stretches from the heel to the toes.

Pain is worse when you start walking after prolonged periods of resting, for example getting out of bed in the morning. For some, exercising and walking may help alleviate the pain, however for others this may exacerbate the pain. For some people there can be no evident cause of this issue but factors such as older age, higher weight, issues with foot and ankle biomechanics, trauma to the foot and those who spend a lot of time on their feet for both occupation and recreational activities. Your physio will take a detailed history in order to diagnose and find out the root cause of your issue before treatment begins. Treatment generally consists of specific exercises to target the painful area and its root cause. Your physiotherapist will advise regarding pain management and potentially suggest use of orthotics. As a second line option here at the clinic we also use shockwave therapy which has been proven to provide excellent results when it comes to plantar foot pain. These symptoms usually resolves within 6 to 18 months without treatment. With accurate precautions and consistent therapy, the 95% of people with plantar fasciitis are able to recover within 6 months.

Stress Fracture

Stress fractures are a type of fracture that can develop over time verses a sudden trauma. Small micro fractures can occur through repetitive loaded activity. If they are not allowed to heal and are subjected to further loading then the micro fractures remain an increasing symptom. Symptoms may include a gradual onset of “tooth aching” pain, tenderness when palpated and pain on “normal” activities such as walking. The main causes are linked to overuse injuries such as running or sports involving high levels of endurance. People who are at risk of developing a stress fracture are those who have changed surface or increased their training load. A physiotherapist will be able to assist in diagnosing these symptoms and that will involve imaging the painful area. Once confirmed appropriated management will be advised and support provided with a graded return to your activity. 


Morton’s Neuroma

Morton’s neuroma is classed as a compressive neuropathy (pinching of nerve tissue) commonly affecting the 3rd webspace of the foot. It can also affect the other web spaces. Symptoms include burning and aching pain in foot spreading to 3rd and 4th toes. These symptoms are normally aggravated with walking or running.  

Generally, more females than men experience this condition with research linking an association to footwear eg wearing heeled shoes or narrow footwear that can increase the risk. 

Physiotherapy has been shown to help in a number of ways. Manual therapy can increase range of movement around the foot that might be applying increased pressure to the toes during walking. Additionally, Physiotherapists can advise on footwear and provided exercises targeted to stretch or strength areas that contributing to the symptoms. If symptoms are not improving Physiotherapists are well placed to work with or referral on to other services to trial alternative treatments (Podiatry and orthopaedics).