Ankle and foot pain can be annoying because it changes the way you move. Once you start limping, avoiding pressure through one side, or walking differently to protect the sore spot, it can quickly lead to calf tightness, knee irritation, or even hip and back flare-ups.
The good news is that most ankle and foot pain improves really well with the right plan. The key is matching the plan to your pain pattern, because “foot pain” can mean very different things depending on where it is and when it shows up.
At PhysioCentral, we regularly help people in Miranda and across the Sutherland Shire get back to comfortable walking, running, work, sport, and gym training with a clear plan and simple milestones.
Quick summary
- Location matters. Heel, Achilles, midfoot, forefoot, inside ankle, and outside ankle often behave differently
- Most cases settle with the right balance of load management and progressive strengthening
- If it is swollen after you’ve rolled or sprained it, feels unstable, or you cannot weight-bear normally, get it assessed early
- Morning heel pain improves with calf and foot strengthening. It might feel tight, but it’s not all about stretching
- Tendon pain is usually load related and responds well to a structured strength plan
- If it is not improving within 2 to 3 weeks, book an assessment so you’re not guessing
On this page
- Common ankle and foot pain patterns
- The most common causes we see
- What you can do right now
- When to get it checked
- How physiotherapy helps
- The simple rehab framework we use
- Link to heel pain exercise library (videos and progressions)
- FAQs
- Booking and next steps
Common ankle and foot pain patterns
If you are not sure what is going on, these patterns can help you narrow down the likely driver and the best first step.
Pain under the heel (often worst on the first few steps)
The dreaded Plantar Fasciitis! This is a common plantar heel pattern. It often flares after a sudden jump in walking, running, standing, or being barefoot when you’re not used to it (like on holidays).
Pain at the back of the heel
Typically insertional Achilles tendinopathy and bursitis. It is often sensitive to shoe pressure and stretching.
Pain in the Achilles tendon (higher up the tendon)
This is commonly a tendon load tolerance pattern. It may feel stiff at the start, ease once you warm up, then flare later or the next morning if the load was too high.
Pain on the outside of the ankle or outside of the foot
Often linked with a history of ankle sprains, peroneal tendon irritation, an “outside edge overload” pattern, or even an avulsion fracture.
Pain on the inside ankle or arch
This can be tibialis posterior overload, arch load sensitivity, or a gradual overuse pattern that builds with hills and walking volume.
Pain in the ball of the foot or toes
Often forefoot overload, irritation around the big toe joint, or nerve sensitivity between the toes.
Swelling after rolling the ankle
Treat this like an ankle sprain pattern until assessed. Early rehab matters, especially balance and strength, because stiffness and instability can linger even after pain settles.
The most common causes we see
Ankle
- Lateral ankle sprain
- High ankle sprain (Syndesmosis)
- Recurrent ankle sprains and instability
- Ankle impingement (pinching at the front of the ankle)
- Peroneal tendon irritation (outside ankle pain)
- Tibialis posterior overload (inside ankle pain)
Foot
- Plantar heel pain (plantar fascia or heel pad irritation)
- Achilles tendinopathy (mid tendon or insertional)
- Metatarsalgia (forefoot overload)
- Big toe joint irritation or arthritis
- Midfoot sprain or overload
- An avulsion fracture on the outside of the foot after rolling your ankle
- Forefoot nerve irritation (often described as burning or tingling)
What you can do right now
If this started after a rolled ankle, fall, or sudden sharp pain
- Protect it for 48 to 72 hours
- Gentle movement is helpful, but avoid repeatedly “testing it” with long walks early
- Compression can help swelling
- If you cannot weight-bear or move your ankle more than half it’s normal range we strongly recommend getting an X-Ray. We can refer you for one after we’ve done a full assessment
If this built up gradually (overuse pattern)
- Reduce the one thing that spikes it most (often hills, long walks, running volume, jumping, or barefoot time)
- Keep moving, but keep symptoms in a manageable range
- decrease load and take your time to rebuild up to previous activity levels. 6-8 weeks is a good rule of thumb.
A simple rule that keeps you progressing
If symptoms are clearly worse the next morning or worse across the next 24 hours, that was probably too much for the current stage. Scale it back, then build again more gradually.
When to get it checked
Book an assessment sooner if:
- you cannot weight-bear normally or move the joint more than 50% of normal
- swelling and bruising are significant after an injury
- the ankle feels unstable or keeps giving way
- there is numbness, pins and needles, or burning pain that is spreading
- the pain is worsening week to week
- you are still stuck after 2 to 3 weeks despite sensible changes and basic rehab
How physiotherapy helps
We commonly assess:
- all ligaments for integrity
- all bony points for any hint of a fracture
- all tendons for tendinopathy or tears
- ankle mobility, especially calf and joint range
- strength and endurance of the calf, and foot intrinsics
- balance and proprioception (especially after sprains)
- load tolerance and a clear return to walking, work, and sport plan
- footwear and training factors that are keeping symptoms irritated
What treatment commonly involves:
- settling irritability early with pacing, education, and simple symptom modifiers
- restoring mobility and flexibility where it matters
- progressive strengthening matched to your pain pattern
- a graded return to walking, standing, running, or gym training
- a flare-up plan so you do not panic when symptoms temporarily spike
The rehab framework we use
Assuming no major damage – If you want a simple structure to follow, this is it.
Calm it down enough to start building
Reduce the main trigger. You do not need full rest, you just need less irritation.
Mobility
Restore comfortable movement where it is stiff, without pushing into sharp pain.
Flexibility
Targeted calf or foot flexibility only if it helps, and only within comfort.
The response when you first walk on it the morning is a good guide. Back off on the stretching a little if you’ve overdone it. Sometimes there’s some trial and error involved. So start gently.
Strength
This is the long-term fix for most ankle and foot problems:
- calf raises and soleus strength
- foot intrinsic strength (short foot, toe control)
- tendon specific loading where needed
- balance progression after sprains
Heel pain exercise library (videos and step-by-step progressions)
If your pain is mainly around the heel or Achilles, start here. These guides include exercise videos and progressions so you can follow a plan rather than guessing.
- Heel Pain: A Practical Guide to Overcoming Heel Pain
https://physiocentral.net.au/heel-pain/ - Heel Pain Part 1: Pain Under the Heel
https://physiocentral.net.au/heel-pain-part-1-pain-under-the-heel-a-practical-self-help-guide/ - Heel Pain Part 2: Pain at the Back of the Heel
https://physiocentral.net.au/heel-pain-part-2-pain-at-the-back-of-the-heel-a-practical-self-help-guide/ - Heel Pain Part 3: Pain in the Achilles Tendon
https://physiocentral.net.au/heel-pain-part-3-pain-in-the-achilles-tendon-a-practical-self-help-guide/
FAQs
How long does an ankle sprain take to settle?
Many mild sprains improve in 3 to 4 weeks, but stiffness and reduced balance can linger if rehab is skipped. A simple strength and balance plan usually reduces recurrence.
Why does my heel hurt on the first few steps in the morning?
That pattern is common when the tissues under the heel and the calf complex are irritable. Gradual strength work often helps more than stretching alone.
Is it normal for tendon pain to feel better when I warm up, then worse later?
Yes. That can be a classic tendon load tolerance pattern. It usually responds well to a structured strengthening plan and smarter load management. They take time to fully regain their strength though. Patience is part of the program.
Should I stretch my calf if my Achilles is sore?
That’s part of it. But ramp it up slowly so as not to overdo it. Stretching into pain can exacerbate certain patterns of heel pain. Strength-based rehab is often the priority, but we need to slowly build into it to allow tendons to adapt. Tendon strength lags behind any increase in muscle strength by 4-6 weeks
Why does my ankle keep rolling even after it “healed”?
Often, because balance, reaction time, and peroneal strength were not rebuilt. Recurrent sprains are common but highly treatable with appropriate progression. Most people stop rehab once the pain dissipates. We need you to strengthen for several weeks after they feel better to prevent a recurrence.
Do I need orthotics?
Some people benefit from certain pain patterns, especially during a flare. Many foot and ankle conditions improve without them once strength and load tolerance are rebuilt. The best option depends on your foot mechanics, footwear, and activity goals.
Book physiotherapy in Miranda and the Sutherland Shire
If you want clarity and a plan you can actually follow, book an appointment at PhysioCentral. We will help you work out what is driving your symptoms, what to stop doing for now, and what to build back in week by week.
Related reading
- Physiotherapy in Miranda and the Sutherland Shire
https://physiocentral.net.au/service/physiotherapy-miranda-sutherland-shire/ - Running Injury Avoidance: A Beginners Guide
- The Injury Recovery Process: A Simple Guide to Healing Phases and Treatment Timing