Foot and Ankle

Achilles Pain

Pain in the region of the Achilles tendon is an extremely common injury especially among distance runners. Factors that may cause Achilles pain include:

• Direct injury to the Achilles tendon
• Repetitive overuse over a period of time that exceeds the ability of the Achilles tendon to endure that load
• Achilles tendonitis
• Calf strain

Physiotherapy for Achilles pain

The key to successful treatment of Achilles pain is early diagnosis and treatment.

Our physiotherapists provide specific stretching and strengthening programmes and correction of predisposing factors such as muscle tightness and abnormal biomechanics. These are all required together with appropriate progression to functional activities and any requirements for sport-specific rehabilitation programmes.

Physiotherapy treatment will settle pain and inflammation by using a combination of techniques which may include:

• Advice about footwear
• Soft tissue massage and mobilization of the Achilles tendon
• Intensive self-stretching program to maintain muscle and tendon length
• Progressive strengthening program
• Shockwave Therapy
• Injection Therapy
• Gait analysis
• Running program

Your treatment program will be tailored to your needs and lifestyle to ensure you make a speedy recovery and reach your maximum potential.

Achilles Tendonitis is also commonly caused by a lack of flexibility or flat footedness. Rigidity of the tendons comes with age and therefore as we get older, we become more susceptible to injury.

What are the Symptoms of Achilles Tendonitis?
The main symptom of Achilles Tendonitis is pain at the back of the heel, which is usually worse after long periods of inaction such as first thing in the morning or after sitting down for a while. Aggravating activities like running and jumping are also painful.

Physiotherapy treatment for Achilles Tendonitis
Physiotherapy treatment for Achilles Tendonitis should start as soon as possible to hasten recovery and to prevent further damage.

At Core Physio, treatment will aim to significantly reduce pain and inflammation in the initial phase of Achilles tendonitis and then gradually improve muscle strength and flexibility to ensure an optimal outcome.

Physiotherapy treatment will be tailored to you but may include:

• Ice and heat treatment
• Soft tissue massage
• Shockwave Therapy
• Injection Therapy
• Advice about footwear
• Advice on how to modify activity while your injury is healing
• Passive stretching
• Strength and conditioning
• Joint mobilisation
• Exercises to improve strength, flexibility and balance
• Sport specific exercises

Your physiotherapist will guide you through an individualised exercise program to ensure you make the best possible recovery and return to your sport as safely and as quickly as possible.

What causes an ankle sprain?
An ankle sprain is commonly caused by activities requiring rapid changes in direction, especially if these take place on uneven surfaces (e.g. grass fields) such as in football or rugby.

What are the symptoms/effects of an ankle sprain?
People may often notice an audible snap, crack or tearing sound at the time of injury, accompanied by:

• Pain
• Swelling
• Bruising
• Stiffness
• Difficulty weight bearing onto the affected leg

Diagnosis of an ankle sprain
Diagnosis of an ankle sprain can be made by a physiotherapist or doctor who will take a thorough look at your ankle and assess swelling, pain, movement and strength. An X-ray may be required to see the extent of the injury and rule out other injuries (particularly fractures).

Physiotherapy for an ankle sprain
At Core Physio we provide specialised assessment and treatment for people with ankle sprains.

Physiotherapy treatment will initially reduce pain and swelling through specific treatments and advice. Following this, range of motion and strength will be restored as quickly as possible through:

• Ankle mobilisations
• Soft tissue massage
• Specific stretching and strengthening exercises
• Balance training
• Sport-specific exercise programme

Your treatment programme will be centred on your lifestyle to increase sporting performance and reduce the risk of recurrence.
Physiotherapy will accelerate healing and get you back to your sporting activities as quickly as possible.

The tissue stabilising the peroneal tendons can sometimes be torn when an ankle is turned over and the tendons can relocate themselves on the wrong side of the malleolus. When this occurs repeatedly, it causes great damage to the tissue, resulting in inflammation.

What are the Symptoms of Footballers Ankle?
Footballer’s ankle causes great pain on movement of the foot. Other symptoms are swelling, bruising and tenderness and pain behind and around the malleolus.

Diagnosis of footballer’s ankle
Diagnosis of footballer’s ankle can be confirmed by a physiotherapist or doctor following a thorough subjective and objective assessment. An X-ray may be required to see the extent of the injury and rule out other injuries, such as fractures.

Physiotherapy for footballer’s ankle
Your physiotherapist at Core Physio will initially assess your foot and ankle to diagnose the injury and identify possible causes. A rehabilitation program will then be developed to promote healing, restore full flexibility, strength balance and proprioception and reduce reoccurrence of the injury.

Physiotherapy treatment may include:

• Cryotherapy to ease pain and inflammation
• Advice on how to modify activity
• Once the inflammation has gone, gentle stretching
• Soft tissue massage
• Progressive strengthening and balance program
• Sport-specific exercises to ensure that you are ready to return to training and competition

Physiotherapy treatment will return you to everyday and sporting activities safely and effectively and prevent the risk of re-injury

What are the symptoms/effects of plantar fasciitis?

The main symptom of plantar fasciitis is pain underneath the heel and along the inner sole of the foot, which is worse in the morning and when walking or running.

Physiotherapy treatment for plantar fasciitis

Physiotherapy treatment will reduce pain and accelerate healing so that you can get back to your sports and everyday activities as quickly as possible.

Early physiotherapy treatment is vital to speed up recovery and ensure you make significant improvement in the short and long term.

At Core Physio, our specialised musculoskeletal physiotherapists will initially assess your injury to identify the underlying cause and develop a treatment program accordingly which may include:

• Soft tissue massage
• Joint mobilisation
• Shockwave Therapy
• Injection Therapy
• Advice on footwear
• Exercise program to improve balance, strength and flexibility
• Biomechanical correction
• Footwear assessment

Your physiotherapist will also devise an appropriate return to activity plan so you can return to your daily tasks and hobbies with confidence and success, as soon as possible.

When the heel gets injured, the fat pad stretches losing some of that cushion, which can make weight bearing very uncomfortable.

What causes fat pad syndrome?

Fat pad syndrome can be caused by a direct blow to the heel such as fall onto the heels or chronically from excessive heel strike with poor heel cushioning.

What are symptoms/effects of fat pad syndrome?

Symptoms of fat pad syndrome may include:

• Pain in the heel, usually on the middle of the heel which is aggravated by walking barefoot on hard surfaces like ceramic tile, concrete, hardwood floors, etc.
• A deep, dull ache that feels like a bruise.

Physiotherapy for fat pad syndrome

Physiotherapy treatment will reduce your pain and accelerate healing and cushioning of the heel so that you can get back to your hobbies much quicker and with more confidence.

An initial assessment at Core Physio will confirm a diagnosis and identify the cause of your injury.

Your physiotherapist will then develop a treatment program which may involve:

• Advice on how to modify activity
• Advice about appropriate footwear
• Taping the heel to provide pain relief and compress the soft tissue under the heel giving more protection to the bone.
• Stretching and strengthening program

Physiotherapy treatment will be tailored to your current symptoms and lifestyle to ensure you make the best progress and continue you to make long term improvements.

Calcaneal stress fractures are usually caused by repetitive force going through the heel bone in weight bearing activities such as marching or running. Sometimes stress fractures of the calcaneus occur when people increase their activity or change their training conditions.

What are the symptoms/effects of a calcaneal stress fracture?

The main symptom of a calcaneal stress fracture is pain on either the inner or outer aspect of the heel bone that increases with impact activity such as marching, running, jumping or landing. Other symptoms may include night ache or pain on firmly touching or squeezing the heel bone.

Physiotherapy treatment for a calcaneal stress fracture

Physiotherapy treatment for a stress fracture of the calcaneus initially involves a period of rest which may involve protective weight bearing using crutches or wearing a protective boot.

Your physiotherapist at Core Physio will then use a combination of hands-on techniques and exercise to promote bone healing and get you back to your normal activities as soon as possible.

Physiotherapy treatment may include:

• Soft tissue massage to lengthen any tight muscles around the heel
• Joint mobilisation to reduce stiffness and pain
• Advice about alternative exercises which place minimal weight bearing forces through the affected bone and to maintain fitness, such as swimming, cycling, and water running
• Hydrotherapy
• A graduated exercise program to strengthen the muscles in the legs, hips and glutes once weight bearing is appropriate
• Balance training
• Advice about insoles and orthotics
• Gait analysis
• Advice on a training program tailored to your sport to prevent re-injury

Physiotherapy treatment will not only speed up your recovery but also ensure get back to your sport and hobbies with confidence and success.

What are the signs and symptoms of a joint sprain?

Sudden onset of pain in the affected joint during activity is the initial symptom experienced if you have sprained a joint in your foot.

Some people may also experience pain and stiffness after the activity, particularly the next morning and the area may be tender to touch.

A joint sprain may also be accompanied by swelling, redness, and bruising depending on the extent of the injury.

Physiotherapy treatment for a joint sprain

Physiotherapy following a joint sprain will facilitate your recovery and get you back to your sport quicker.

Our experienced physiotherapists at Core Physio will initially assess your foot looking at pain, swelling, movement, and strength in order to develop a treatment program tailored to you.

Treatment may include:

• Protective or postural taping
• Ice or heat treatment
• Soft tissue massage
• Joint mobilization once pain and swelling has settled
• Passive stretching to regain range of movement and flexibility
• Structured exercise program to strength and balance
• Advice on training and how to return gradually and safely to your sport

Physiotherapy will reduce pain and swelling, improve muscle strength and flexibility and ensure your foot is functioning correctly before returning to sporting and everyday activities.