Foot and Ankle Pain


Signs and Symptoms

The symptoms of foot and ankle pain can vary a great deal, but one of the most common conditions that causes foot and heel pain is plantar fasciitis. Supporting the arch, the plantar fascia, a thick band of tissue connecting the heel to the ball of the foot, can become inflamed or can tear. The condition develops when repeated weight-bearing activities put a strain on the plantar fascia. People who are diagnosed with plantar fasciitis also may have heel spurs, a bony growth that forms on the heel bone. However, people with heel spurs may not experience pain. Plantar fasciitis occurs most frequently In people in their 40s but can occur in all age groups. The condition can develop in athletes who run a great deal and In non-athletes who are on their feet most of the day, such as police officers, cashiers, or restaurant workers. People with foot and ankle pain often experience pain in the following situations:

  • In the morning, when stepping out of bed and taking the first steps of the day 
  • With prolonged standing
  • When standing up after sitting for awhile 
  • After an intense weight-bearing activity such is running 
  • When climbing stairs 
  • When walking barefoot or in shoes with poor support 

As your body warms up, your pain may actually decrease during the day but then worsen again toward the end of the day because of extended walking. Severe symptoms may cause you to limp.

How We Evaluate

Our diagnosis is based on your health and activity history and a clinical evaluation. We also will take a medical history to make sure that you do not have other possible conditions that may be causing the pain. Sharing information about the relationship of your symptoms to your work and recreation, and reporting any lifestyle changes, will help the physical therapist diagnose your condition and tailor a treatment program for your specific needs. To diagnose plantar fasclitis or another foot injury, we may conduct the following physical tests to see if symptoms occur:

  • Massaging and pressing on the heel area (palpation) 
  • Gently stretching the ankle to bend the top of the foot toward the leg (dorsiflexlon) 
  • Gently pressing the toes toward the ankle 

For most cases of low back pain imaging tests, such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) are not helpful for recovery. For example, in a recently published article comparing patients who received an MRI first vs physical therapy first for low back pain, the patients who received an MRI first spent on average $4,793 more (with similar outcomes in each group). If we suspect that your low back pain might be caused by a serious health condition, we will refer you to other health care professionals for further evaluation.

 

How We Can Help With Foot. Ankle, and Heel Pain

Our physical therapists are trained to evaluate and treat plantar fasciitis. When you are diagnosed with plantar fasciitis, we will work with you to develop a program to decrease your symptoms that may include:

  • Stretching exercises to improve the flexibility of your ankle and the plantar fascia 
  • Use of a night splint to maintain correct ankle and toe positions
  • Selection of supportive footwear and/or shoe inserts that minimize foot pronation and reduce stress to the plantar fascia 
  • Application of ice to decrease pain and inflammation 
  • Iontophoresis (a gentle way to deliver medication through the skin) 
  • Taping of the foot to provide short-term relief 

Information provided by the American Physical Therapy Association.