Physiotherapy For Ankle Pain
Gatley and Heatons Physio Clinics frequently see a variety of ankle and foot conditions most of which usually respond extremely well to physiotherapy treatment if treated early enough.
The ankle and foot (which contains 26 small bones) are complex joints, hardly surprising they can cause problems! Many different pathologies are seen (see below). Our physiotherapists are experienced in diagnosing, assessing, and treating the foot and ankle, including identifying the underlying cause of your condition and ensuring you get the right treatment. So, you don’t have to suffer with pain indefinitely, physiotherapy treatment can help.
It starts with an initial consultation which involves a thorough assessment and examination of your pain. We can then recommend appropriate physiotherapy treatment to get you back to your normal activities and sports.
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Call Gatley on 0161 491 1999 or the Heatons on 0161 432 3232
Our Experienced Physiotherapists Regularly Treat Patients with Ankle Pain at our Clinics in Gatley, Cheadle, Heaton Moor, Stockport and Didsbury
In the majority of cases physiotherapy treatment is the most effective way of treating pain in the ankle area. It will include a combination of soft tissue massage, joint mobilisations, postural advice and lifestyle alterations reducing pain and stiffness and getting you back to normal function as soon as possible.
What are the common causes of ankle pain?
The most common causes of foot and ankle pain that we see are tendon injuries (usually Achilles tendinosis) due to overuse, for example repetitive running, and ligament sprains, usually due to direct trauma, such as going over on the ankle.
How do I know if I need treatment?
- If your injury is acute and newly injured, for example a recent sprain causing pain, stiffness, bruising and swelling, you need advice as to how you start to make a recovery.
- If you have ankle or foot pain which has been present for more than 2 weeks and is not improving, it is worth getting your physio to examine it and give you exercises to do with strategies to continue with to speed up your recovery.
- If your pain and/or stiffness has been present for longer than 3 months (chronic), such as Achilles tendon pain or plantar fasciitis, physiotherapy advice and the exercises your physio give you will help to speed up the recovery.
What will happen if I don’t get it treated?
If you have a soft tissue injury, for example a ligament sprain that is not treated early enough, the scar tissue that develops can become very tight causing reduced ankle movement with pain that remains for much longer than if treated early, preventing an early return to sport.
Delays in treatment to the Achilles tendon causes chronic pain, stiffness and thickening of the tendon which will delay you returning to sport.
If your problem is a muscle strain such as the calf, adhesions will form in the muscle reducing its flexibility. In addition, the muscles will weaken, both of which making the calf more prone to strains in the future.
The longer you wait for treatment, potentially the more difficult it is to restore full pain free movement to your muscles and ligaments. It is therefore worth seeking physiotherapy attention as soon as possible.
How long does treatment typically take?
Treatment sessions are for 30 minutes.
Sessions are very likely to include ‘hands on’ treatment in the form of soft tissue massage and joint mobilisations and electrotherapy. In addition, your physio will give you an exercise programme to continue with at home to maintain your progress. Sport specific rehab will also be included.
The number of treatment sessions required depends on how quickly your ankle condition responds to the combination of therapies we use, and any lifestyle changes you make. On average 4-6 treatments are usually required.
We will track your progress carefully. It’ is important to fully rehabilitate any injury and discomfort, restore the ankle’s range of motion, muscle strength and balance to be fully confident that you make the best possible recovery to get you back to normal function and sport.
What are the most common foot and ankle problems?
The most common foot and ankle conditions we see at Gatley and Heatons physio clinics are:
Achilles tendinosis/tendinopathy is a condition frequently seen at physio. The Achilles tendon is the thick band of tissue which connects your calf muscle to the heel, with age, weakens making it more prone to injury. More common in men, it is an overuse injury most commonly seen in middle-aged people, usually runners who perform repetitive loading of the tendon or have suddenly increased the intensity or duration of their runs.
Some factors which increase the risk of developing tendinopathy are:
- Flat feet-this alters the natural biomechanical position of the tendon which puts more strain through the tendon when running. Your physio will assess this and give you advice about foot position / orthotics.
- Your physio will be able to assess if the trainers you have are suitable / too worn and advise you about the best trainer for you.
- Fatigue / dehydration
- Pain usually in the middle of the tendon particularly after running or sport.
- Stiffness in the tendon in the morning. Getting downstairs in the morning can be challenging!
- Swelling and thickening usually in the mid tendon.
The usual and most effective treatment is conservative using physiotherapy treatment to reduce swelling, improve flexibility of the tendon, biomechanical advice, with advice for controlled loading of the tendon for returning to running. Research shows the gold standard of treatment is eccentric strengthening.
Rupture of the Achilles Tendon
If the Achilles tendon becomes overstretched, it can rupture, either partially or totally. This is more likely to occur during sport, particularly with sudden propulsion movements like a jump. A pop may be heard or feel like a stone has been thrown at the tendon or you were kicked. It is more likely to occur in med between 30-40 years old.
- Sudden sharp pain at the time of the injury.
- Pain when walking, often causing a limp.
- Swelling at the back of the ankle and heel.
- Unable to lift yourself onto the toes on the injured leg.
Treatment for a ruptured Achilles tendon depends on your age, what sports/activities you do and whether the tendon is totally or partially ruptured. For a total rupture, younger athletes tend to choose surgery whereas older ones tend to choose conservative treatment which involves immobilisation in a boot. Which ever treatemntt is chosen, intensive physio is required after to reain ankle movement, strength, normal gait pattern and return to activity and sport.
Posterior tibial tendon dysfunction
Ankle sprains can occur on either side of the ankle but the most common is on the outer (lateral side), known as an inversion injury caused but the ankle rolling outwards whilst the foot turns inwards causing the ligament to stretch too far so it tears. Most injuries occur during sport, for example when landing badly from a jump in netball causing the ankle to roll over.
- Pain on the outside of the ankle particularly when putting weight on the foot. This may cause you to have a limp
- Bruising on the outside of the ankle may occur
- Restricted ankle movements due to pain
The most effective treatment is using physiotherapy treatment to reduce swelling and pain, improve movements of the foot and flexibility of the ligament. Proprioception exercises, strengthening exercises and rehabilitation to gradually get you back to your sport.
The Plantar fasciitis is the most common cause of heel pain that we see at Gatley and Heatons physio clinics. The plantar fascia is a thick band of collagen tissue which runs along the sole of the foot from the heel to the toes which absorbs shock when walking. If the plantar fascia is repeatedly overstretched, small tears can occur causing pain.
- Stabbing heel pain when putting weight on the foot which may cause a limp.
- The pain is usually worse in the morning, when barefoot on hard surfaces and with stair climbing.
- Tenderness to touch on the heel.
Plantar fasciitis can occur for no obvious reason but there are several factors which can predispose to getting it, including:
- It most commonly occurs between 40-60 year old.
- Flat feet can stretch the plantar fascia which over time can cause strain. Your physio will assess this and give you advice about foot position / orthotics.
- Sports which involve heavy impact on the heel and foot can cause strain on the plantar fascia, including long distance running, particularly if your trainers are not suitable and supporting the foot. Your physio will be able to assess and advise about this.
Physio treatment for plantar fascia includes massage, electrotherapy, taping stretching and strengthening exercises for the lower leg. In addition, advice for footwear/orthotics and management of your pain. Your physio might recommend a splint to wear at night which stretches the calf and plantar fascia whilst you are asleep.
Call Gatley on 0161 491 1999 or the Heatons on 0161 432 3232
How is ankle and foot pain usually treated by a physiotherapist?
There are several ways to treat ankle conditions using physiotherapy treatment. Your physiotherapist may combine these techniques together for the best outcome.
Some examples include:
- Soft tissue massage
- Strengthening exercises for the foot and lower leg muscles
- Joint mobilisations
- Kinesiology Taping
- Mobility exercises to regain ankle movements
- Advice for the self-management of your pain
- Sport specific rehabilitation
How will I know if I need an X-Ray or an MRI scan?
Following the assessment, if your physiotherapist feels that physio is not appropriate, they will advise you of the most appropriate investigation required. The physiotherapist will liaise with your GP/Consultant if needed.
Will surgery to help my ankle injury be likely?
There are few foot and ankle conditions that require surgery.
- If your Achilles tendinopathy is not improving with a structured rehab programme and time, your physio may suggest a referral to an Orthopaedic Surgeon to discuss other medical management such as injections or surgery.
- If the Achilles tendon is totally ruptured, you will be referred to an Orthopaedic Consultant who will either treat it conservatively or surgery may be advised.
- If your ankle sprain is very severe causing at total rupture leading to instability of the ankle, your physio yay suggest a referral to an Orthopaedic Surgeon to discuss surgery to repair the ligament.
Your physiotherapist can discuss surgical possibilities with you and advise the best way to gain medical advice.
Is there anything I can do at home to help reduce ankle pain?
- Avoid painful activities such as running and sport.
- If the condition is swollen or acute, start the PEACE and LOVE regime.
- Wear orthotics if indicated.
- Get your trainers looked at to see if they are fit for purpose.
- Continue your strengthening and stretching exercises.
- Carrying extra weight can put more load on the plantar fascia.
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Please don’t suffer in pain or discomfort. If you have shoulder pain that is severe, that is either not improving or getting worse or you have lost shoulder movement, consult us and together we can start your road to recovery.
Why Choose Gatley & Heatons Physio?
We provide expert physiotherapy treatments from our clinics in Heaton Moor, Gatley and Didsbury and we regularly help patients from across Stockport and Manchester reduce their pain and return to normal activities.
We frequently work with clients in Cheadle, Bramhall, Poynton, Wilmslow, Northenden, Altrincham, Sale, West Didsbury, Withington, Burnage, Heaton Moor, Heaton Chapel, Heaton Norris, Heaton Mersey and Reddish, and we are regularly able to provide home visits for those who are not able to attend one of our clinics.
We have been established in these areas for many years and have a fantastic relationship with most of the Doctors in these areas. If needed, we will liaise with your Doctor about your condition, for example if medication is needed or a referral to another speciality.
We have an excellent reputation of providing high standards of clinical physiotherapy and a professional service through a trusted, personal and friendly approach.
We offer flexible appointment times to all patients including extended working hours and home visits.
Professional and caring treatment received with sound follow up advice. Would recommend to others without hesitation!