Ankles and Feet

Ankle sprains occur when the ligaments that support the ankle are overstretched or torn, often from twisting injuries. Sprains can vary from mild to severe depending on how many fibers are damaged. Without proper rehabilitation, even minor sprains can lead to chronic instability. Therapy focuses on restoring strength, improving balance, and preventing future ankle injuries.

Symptoms may include:

• Pain on the outside or inside of the ankle
• Swelling and bruising around the joint
• Instability or giving way when walking
• Tenderness when touching the ankle
• Difficulty bearing weight on the foot

Achilles tendinitis is an overuse injury causing inflammation of the tendon that connects the calf muscles to the heel bone. It commonly occurs in runners, athletes, and individuals who increase their activity levels too quickly. If left untreated, Achilles tendinitis can lead to tendon degeneration or rupture. Therapy focuses on reducing tendon strain, restoring flexibility, and strengthening the ankle and calf.

Symptoms may include:

• Pain and stiffness along the back of the heel
• Tenderness and swelling along the Achilles tendon
• Pain that worsens with walking, running, or jumping
• Morning stiffness in the ankle
• Weakness with pushing off the foot

Plantar fasciitis is one of the most common causes of heel pain, resulting from inflammation of the thick band of tissue running across the bottom of the foot. It often develops from prolonged standing, running, or wearing improper footwear. Without treatment, the condition can worsen and affect walking mechanics. Therapy focuses on relieving plantar fascia strain, improving foot flexibility, and strengthening supportive muscles.

Symptoms may include:

• Sharp heel pain with the first steps in the morning
• Pain that worsens after long periods of standing
• Tenderness along the arch or bottom of the foot
• Stiffness in the foot, especially after rest
• Difficulty walking or exercising comfortably

Posterior tibial tendon dysfunction occurs when the tendon that supports the arch becomes weakened or torn, leading to flatfoot and ankle instability. It is often seen in middle-aged adults and can worsen without early treatment. Therapy focuses on strengthening the ankle and foot, improving arch support, and correcting faulty mechanics to restore normal function.

Symptoms may include:

• Pain and swelling along the inside of the ankle
• Flattening of the foot’s arch
• Difficulty standing on tiptoes
• Instability or rolling inward of the ankle
• Fatigue in the foot and lower leg during walking

Peroneal tendinitis involves inflammation of the tendons along the outer ankle and foot, often due to overuse or ankle instability. It is common in athletes who perform repetitive side-to-side motions. If untreated, it can contribute to chronic ankle weakness and instability. Therapy helps reduce tendon irritation, improve ankle strength, and correct movement patterns.

Symptoms may include:

• Pain or swelling along the outer ankle
• Tenderness behind the ankle bone
• Pain that worsens with walking or running
• Weakness with ankle stability
• Instability during side-to-side movements

Stress fractures are small cracks in the bones of the foot or ankle caused by repetitive stress or sudden increases in activity. They are common in runners, dancers, and military recruits. Without appropriate rest and rehab, stress fractures can worsen into full breaks. Therapy focuses on promoting safe healing, correcting foot mechanics, and strengthening the surrounding muscles.

Symptoms may include:

• Localized pain that worsens with weight-bearing
• Tenderness over a specific bone in the foot or ankle
• Swelling in the area of pain
• Pain that improves with rest
• Difficulty walking or exercising

Ankle impingement occurs when soft tissues in the ankle become pinched during movement, leading to pain and restricted motion. It can result from previous injuries, bone spurs, or chronic inflammation. Therapy aims to reduce swelling, improve joint mobility, and strengthen the surrounding muscles to relieve compression and restore full function.

Symptoms may include:

• Pain at the front or back of the ankle
• Stiffness and limited ankle motion
• Pain that worsens with deep squatting or stair climbing
• Swelling around the ankle
• Tenderness when pressing on the ankle joint

Tarsal tunnel syndrome involves compression of the posterior tibial nerve as it passes through a narrow space inside the ankle. It can cause pain, numbness, or tingling in the foot and ankle. Without treatment, nerve compression can worsen and lead to lasting weakness. Therapy focuses on relieving pressure, improving nerve mobility, and correcting foot and ankle mechanics.

Symptoms may include:

• Burning or tingling pain along the inside of the ankle and foot
• Numbness in the sole of the foot
• Pain that worsens with prolonged standing or walking
• Weakness in the foot muscles
• Sensitivity when tapping over the tarsal tunnel

Sesamoiditis is inflammation of the small bones (sesamoids) located under the big toe joint. It commonly affects dancers, runners, and individuals who place repetitive pressure on the forefoot. Therapy focuses on offloading the irritated area, reducing inflammation, and strengthening the foot to restore healthy movement patterns.

Symptoms may include:

• Pain under the ball of the foot, especially near the big toe
• Swelling around the forefoot
• Difficulty pushing off the foot when walking
• Tenderness when pressing under the big toe
• Increased pain with running or jumping

Open Reduction Internal Fixation (ORIF) is a surgical procedure used to repair severe fractures in the ankle, foot, or other bones when simple casting isn’t enough. It involves realigning the broken bone fragments and securing them with plates, screws, or rods. While surgery restores bone stability, rehabilitation is essential for regaining strength, flexibility, balance, and full joint motion. Physical therapy focuses on protecting the healing bone, gradually restoring movement, rebuilding muscle strength, and correcting walking mechanics. A structured rehab plan helps maximize recovery and supports a safe return to daily activities, sports, and work.

Post-ORIF recovery challenges may include:

• Stiffness and reduced ankle or foot mobility
• Pain or swelling with weight-bearing
• Weakness in the muscles around the surgical site
• Difficulty walking or balancing on uneven surfaces
• Scar tissue tightness or sensitivity near the incision