Ankle and Foot Pain FAQs

What does it mean to “roll my ankle?”

Most people who “roll” their ankles are referring to an “inversion or lateral ankle sprain,” which can occur when stepping on or landing on the foot with their ankle turned inward, causing strain or injury to the tissues on the outer (or lateral) portion of the ankle. Examples of this could be stepping off a curb or step wrong or landing with your ankle turned inward while running or jumping. Pain will likely be felt on the outer part of the ankle and foot and swelling, inflammation or bruising on the outer part of the ankle/foot commonly develop when this injury occurs. Ankle sprains can be classified as “mild,” “moderate,” and “severe” based upon the degree of microtearing/injury present to the surrounding tissues and joint ligaments. Following imaging to rule out fracture or severe ankle injury and a period of “RICE” to allow inflammation to reduce and initial healing to occur, physical therapy can be helpful for rebuilding strength, stability, balance, proprioception, and range of motion in your feet and ankles following ankle sprain and to help prevent future injury.

Why does the bottom of my foot or heel hurt?

There are many reasons for bottom of foot (or plantar) foot pain. One of the most common causes is a condition called “plantar fasciitis,” which occurs when the connective tissue that overlays the muscles and tendons on the bottom of the foot and assists with dispersing force while walking (or plantar fascia) becomes inflamed or irritated, causing pain. This usually occurs due to overuse, overused or improper footwear, prolonged periods of being on the feet during the day (i.e. jobs that require excessive walking and standing), or possibly due to “flat feet.” Symptoms of plantar fasciitis include bottom of foot or heel pain that increases first thing in the morning or after prolonged sitting. Following imaging to rule out fracture or other ankle injury, physical therapy can be helpful for plantar fasciitis. Treatment may include the use of ice/ice massage, soft tissue mobilization, stretching, ankle and foot mobilizations, gait training (or assessing and correcting running/jumping/landing mechanics), correcting musculature or joint mobility imbalances side to side, and instruction in range of motion and strengthening exercises to assist with reducing irritation to the plantar fascia and allow your foot to better be able to disperse forces during daily activities and therefore reduce pain.

I’ve been told I have “flat feet,” or I “over-pronate” when I walk/run; what does that mean?

Pronation refers to the motion that occurs AFTER your heel strikes the ground when walking or running, which is when the arch of the foot and bones on the middle bottom of the foot flatten out or turn “inward” mid-stride as you move forward from the heel to the ball of the foot while pushing through stance in walking. Your foot is meant to be flexible and mobile during walking to allow for dispersal of forces from joint to joint and from one foot to the other to propel you forward, otherwise we would be extremely “stiff-legged” while walking. Along with that, your arch IS supposed to flatten out or collapse inward some when walking. Everyone should have some pronation and supination when walking as this is the foot’s natural motion during walking. Some people can have an excessive amount of pronation during the “foot flat” phase of walking, meaning the foot collapses a bit too much inward and flattens the arch of the foot more than it should. This can potentially lead to increased strain and stress on the tissues of the ankle and foot and may increase risk of injury over-time.

How can physical therapy help address foot or ankle pain?

Physical therapy can assist with any of these foot/ankle conditions described above, following ankle and foot surgery (once cleared by your doctor), and much more. Your physical therapist will first evaluate your range of motion, strength, balance, proprioception, joint mobility, and walking/running mechanics to find impairments and functional limitations that may be contributing to your symptoms. Physical therapy can be extremely helpful not only by addressing and improving range of motion, strength, flexibility, and joint mobility in BOTH ankles and feet, but also by assessing and correcting muscular strength and flexibility imbalances up the chain, including in the knees, hips, pelvis, and even low back/trunk musculature, which can all contribute to foot and ankle pain and strain. Your physical therapist will also work with you to instruct you in a home exercise program so that you can carry over improvements made in therapy to outside the clinic and into your daily activities and help prevent injury in the future. They can also do a “gait assessment,” or evaluate how you walk or run and assist with correcting any joint, postural, or body mechanics asymmetries during these activities. Your PT will help guide you in returning to your desired household, daily, work, or sport activities while monitoring symptoms over time.