Physical Therapy: Treating Foot and Ankle Pain


Foot pain is a common problem for people who are active, but it can also afflict individuals who are relatively sedentary as well. The feet are capable of changing the entire structure of the body. They can transmit dysfunction up the leg and into the spine, and they also receive the shocks of dysfunctional movements from the upper portions of the body. Many variables contribute to the intensity of foot pain, and this includes the type of activities performed on a daily basis, foot tracking, shoes and many other factors. The dynamic interaction of different muscle groups can play a role in exacerbating foot pain, and this partially explains why the problem is so common.

Specific Foot Pain

The feet are responsible for transmitting the force of gravity through the body. They can absorb and deflect this force, and this makes them prone to develop conditions that relate directly to their weight-bearing function. Although this principle is consistent, individuals will still tend to experience foot pain in different portions of the foot or ankle. These differences provide physical therapists with clues about how to create a treatment plan that is relevant to the individual situation. This requires a detailed understanding of how the symptoms of pain in the foot or ankle reflect or reveal an underlying problem.

Physical Therapy for Foot Pain

Physical therapists are trained to evaluate the foot pain and recommend a viable course of treatment. This can include a variety of tests, which isolate the root problem from the symptoms. For example, foot pain on the medial side of the ankle can be caused by a nerve lesion in the sciatic nerve. This lesion can be located in the lower back, or in different areas of the hip. The pain appearing in the foot is just a type of referral pain in this situation. Treating the foot alone will have minimal benefits in this situation. Understanding the root cause is essential for creating a treatment plan that addresses the underlying cause of the foot pain.

There are certain conditions that are particularly receptive to this approach, and they include the following:

  • Ankle sprains and strains
  • Achilles tendonitis
  • Posterior tibialis syndrome
  • Pain after surgery
  • Arthritis
  • Repetitive motion injuries
  • General foot pain

What to Expect from Physical Therapy

Our team of experienced physical therapists understands how to isolate the cause of the pain and develop an effective, customized treatment plan for each patient. We take a complete medical history and ask detailed questions about the onset of the pain. We also analyze the walking patterns that might be contributing to the pain.
After examining the area for inflammation and limits in the range of motion, we then develop a treatment plan designed to restore the flexibility and strength to this area. This also involves a certain amount of pain management for some patients. The process of recovery is gradual, so we stress the importance of keeping every appointment. This will ensure optimal results, which are supported by practicing maintenance exercises correctly at home.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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