Whether you’re feeling ready to start your fitness journey, you’re training for an event, or you simply enjoy an evening walk, getting a foot or ankle injury throws a big spanner in the works, with many finding it difficult to perform even simple tasks like getting outdoors to take the dog for a walk.
This is where prevention plays a big role - as while many foot and ankle injuries are common (at least to us who see and treat them regularly), they are also preventable - often with very little effort. Here’s a breakdown of four of the top preventable foot and ankle injuries we see and treat, and expert tips on how you can prevent or rehabilitate them while keeping your feet and ankles strong and healthy.
Ankle Sprains
An ankle sprain occurs when you accidentally roll outwards (or inwards) on the side of your ankle, which overstretches and strains the ankle ligaments that work to stabilise and support the joint. Most people will have experienced one (if not many) ankle sprains throughout their lifetime, which means that many may not take it seriously and work to effectively rehabilitate the ankle. This can actually lead to a subsequent condition called chronic ankle instability, leaving your ankles in an unstable state from having weakened ankle ligaments. This renders you much more likely to repeatedly sprain your ankles, whether that’s during side-to-side movements or pivots in sports, or when you're going for a walk over uneven ground on the weekend.
Tip: strong ankle ligaments and muscles make for strong ankles that can better withstand a range of forces and pressures from your daily activities, so start by building those foundations.Try:
The Ankle Alphabet
The ankle alphabet is a simple and effective exercise that can help improve ankle mobility and strengthen the muscles around the ankle joint.
- Sit in a comfortable chair with your feet extended in front of you or sit on the floor with your legs extended.
- Lift one foot off the ground, keeping your knee straight.
- Using your big toe as a "pen," draw the letters of the alphabet in the air.
- Complete the alphabet with one foot, and then switch to the other foot.
- Perform this exercise for 2-3 rounds on each ankle.
Calf Raises
Calf raises target the calf muscles, which play a significant role in ankle stability and strength.
- Stand with your feet hip-width apart and your weight evenly distributed.
- Slowly raise your heels off the ground as high as you can, coming up onto the balls of your feet.
- Hold the raised position for a second to feel the stretch in your calf muscles.
- Lower your heels back to the ground.
- Perform 3 sets of 10-15 repetitions for each foot. You can increase the difficulty by doing single-leg calf raises.
Negative Calf Raises
Negative calf raises, also known as eccentric calf raises, are a useful exercise for building strength and stability in the calf muscles and Achilles tendon.
- Stand on an elevated surface with your heels hanging off, holding onto support if needed.
- Lift your heels as high as possible using your calf muscles. Hold for a moment.
- Slowly lower your heels below the step, emphasising the calf stretch.
- Do 3-4 sets of 8-12 reps. Progress by adding weights for a greater challenge.
Resistance Band Ankle Eversion and Inversion
This exercise focuses on the muscles responsible for ankle stability and control, and requires a resistance band, which is available from our clinic if you don’t have one at home.
- Sit on a chair with your knees bent at a 90-degree angle.
- Secure one end of a resistance band around a sturdy object, like a table leg.
- Loop the other end of the resistance band around your foot, just above your toes.
- Sit upright and keep your heel planted on the ground.
- Push your foot outwards (eversion) against the resistance of the band, then return to the starting position.
- Perform 2-3 sets of 10-15 repetitions for each foot.
- To work on ankle inversion, simply change the direction and pull your foot inward.
Plantar Fasciitis Heel Pain
Plantar fasciitis is one of the most common causes of pain at the back of the heel bone. You have a thick band of connective tissue called the plantar fascia that starts at your heel and then spreads across your foot like a fan to connect to all five toes. The plantar fascia helps support the function of the foot (and shape of the arch), while helping promote foot strength and flexibility. When the plantar fascia is overloaded from excess pressure or strain, it can sustain micro-tears and become damaged, inflamed and painful. This creates the condition known as plantar fasciitis.
Plantar fasciitis is characterised by pain at the bottom (and sometimes inside) of the heel bone that is particularly painful when you stand up after resting – often this is during your first steps in the morning, or when you’re standing after a period of having your feet up and resting.
Tip: incorporating Achilles stretches into your daily routine can help prevent plantar fasciitis by helping to reduce the strain on it, given that plantar fasciitis is linked to tight calf muscles. Try this wall calf stretch:
- Stand facing a wall, about arm's length away from it. Place your hands on the wall at shoulder height.
- Step one foot back while keeping the other foot forward. Both feet should be pointed straight ahead.
- Keep your back leg straight and bend your front knee slightly. Press your back heel into the floor. You should feel a stretch in your calf and Achilles tendon of the back leg.
- Hold the stretch for 20-30 seconds, feeling the tension in your calf and Achilles tendon. Don't bounce; maintain a steady, gentle stretch.
- Switch to the other leg and repeat the stretch
Achilles Tendinopathy
Another common injury we see is one to your Achilles tendon, the thick, cord-like tendon at the back of the heel. Your Achilles is the strongest and largest tendon in your body, and is used extensively anytime you walk, run and jump. When the Achilles is overloaded, overused or strained, pain can occur either at the mid-portion of the tendon or at its insertion. Overloading tends to occur during exercise, where activities like running can place forces of several times your body weight on the tendon. If you have Achilles pain, you may experience pain when pressing on the tendons at the back of the heel, when pushing off the ground during walking, or when standing on your tip-toes.
Tip: strengthening the Achilles tendon helps with both rehabilitation of an existing injury, as well as preventing reinjury in the future. Try this eccentric heel drop:
- Stand on the edge of a step or a stable platform, with the balls of your feet on the step and your heels extending off the edge.
- Hold onto a rail or support for balance.
- Begin by lifting both heels, standing on your toes.
- Shift your weight to one foot while lifting the other foot, keeping your toes on the step.
- Slowly lower your heel down below the level of the step.
- Use your non-working foot to return to the starting position.
- Repeat this eccentric (lengthening) phase with the affected Achilles tendon. You're essentially lowering your heel slowly and under control.
Stress Fractures
While a regular fracture happens when you get a notable crack in a bone (what is commonly known as a “broken bone”), stress fractures occur when a bone is repetitively overloaded, creating micro-cracks that grow bigger as the pressure isn’t managed and offloaded. There’s no big event like a fall that causes a stress fracture, instead it builds over time. As such, the pain tends to be gradual at first, feeling more like a niggle or dull ache, and gradually progresses to a sharper and more intense pain if care is not taken.
Tip: preventing the stress fracture from worsening means reducing the pressure on the fracture site. The best way to do this effectively is to book in with your physiotherapist or podiatrist - ideally a clinic that offers expertise like we do here at PhysioCentral. Your physiotherapist will assess what’s causing the excess pressure, and put the right measures in place to help you recover and prevent excess loading in the future.
To help further support your foot and ankle health and prevent injury, we recommend:
- Pace yourself: don’t go too hard, too fast. Overloading your feet and ankles is a common cause of preventable injuries. Start at a manageable baseline and gradually increase your intensity, limiting the weekly increment to no more than 10%. This gradual approach allows your body to adapt naturally and minimises the risk of injury.
- Address muscle imbalances in the feet and legs. Imbalances can disrupt normal muscle function, leading to problems. Your physio can help you identify areas of weakness or tightness, and then create a personalised plan for corrective stretching and strengthening.
- Keep your feet well supported with good shoes. Look for shoes with a strong heel counter, which stabilises your ankle and reduces excess side-to-side motion. Ensure they match the natural flexion of your toes, are the right width and length, and provide the necessary support for your foot type.
- Establish healthy exercise habits. This includes proper warm-up and stretching routines, effective cooling down, maintaining adequate nutrition and hydration, and using prescribed joint supports.
- Pay attention to your body. If you experience foot or ankle discomfort during exercise, take it seriously. Investigate the cause, which might be related to your technique, overloading certain muscle groups, or fatigue. Get a physio to help. Exercise should be challenging but not painful. If you have foot pain, see a podiatrist or physio before it escalates into a preventable injury.