Pain can be a problem for many seeking the pursuit of an active lifestyle. The main causes of injury that result in heel, foot, and ankle pain involve intense physical movement. If you are one of the many people who experience pain because of an accident or injury, there are different treatment options to help you get back to your old self. But first, you have to identify why certain movements can lead to injury. By learning the five common causes for ankle, heel, and foot pain, you can avoid the pitfalls of injury, while having options to treat existing pain.

The Five Common Causes of Ankle and Heel Pain are:

  • Achilles tendon pain
  • High ankle sprain
  • Peroneal tendonitis
  • Metatarsalgia
  • Plantar fasciitis

These terms may be unfamiliar to you but are important in recognizing what could be wrong with your foot or ankle. The human body has an intricate array of tendons and ligaments that connect bones and supply motion to joints. When exercising, these tendons, ligaments, and muscles could sprain or strain, resulting in severe pain. By educating yourself on these common injuries, you can get the help you need.

Achilles Tendon Pain

The hindfoot comprises of the ankle bone (talus) and the heel bone (calcaneus). When you make sudden movements and put a lot of weight on the ankle joint (talocrural joint), the impact can affect not just the ankle, but also the heel. Such force applied to these areas can result in pain in the ankle and also the tendon connecting the ankle to the heel bone, the Achilles tendon. The Achilles tendon serves as the bridge between the calf muscles and the heel bone. This large tendon is responsible for pushing off during walking and jumping. If achilles tendon pain is not well managed it may progress to a full tear. Physical therapy treatment keeps the tendon from tearing and involves a combination of tendon loading, dry needling, joint manipulation and activity modification.

High Ankle Sprain

When you run and change direction quickly, the ligaments of the syndesmosis help keep the fibula and tibia (lower leg bones) from spreading out too much. If enough turning and twisting motion is applied to these ligaments, you could end up with a high ankle sprain. After a high ankle sprain, it may be difficult to walk because the weight of the body causes the joint to gap. It is common to walk with the support of crutches for 1-2 weeks after injury to allow healing of the syndesmosis joint before restrengthening the joint. We teach corrective exercises to those with ankle sprains to promote balance and strength and regain mobility.

Peroneal Tendonitis

Peroneal tendonitis means inflammation of the peroneal tendons. The tendons are located to the sides of the foot behind the ankle bone. One of the two tendons attaches to the lateral side of the midfoot, while the other attaches close to the inside arch. Microtears lead to inflammation and tendon damage, causing tendonitis. The back and outside of the foot may swell and become painful leading to difficulty walking. Other symptoms include ankle instability and popping.

People develop peroneal tendonitis frequently from overuse. Runners and other athletes with repetitive foot or ankle motions have a higher chance of experiencing peroneal tendonitis. The main treatment in the first few days is the R.I.C.E. principle—rest, ice, compression, and elevation. If the pain persists longer than 1-2 weeks, then physical therapy and strengthening exercises improve the movement of the calf and foot. We use a combination of corrective exercise and joint manipulation to ease pain in the short term.


Metatarsalgia is a condition referring to painful inflammation of the ball of your foot. Metartarsalgia may develop if you participate in activities involving jumping and running. Other less common causes are tight or loose shoes and foot deformities. Generally not considered serious, the injury over time can negatively affect how you walk, climb stairs, and land from a jump. While at-home treatments and wearing proper footwear help, professional assistance can make a big difference in the long run.

If left untreated you may be at risk for further injury in other parts of the foot. We can enable recovery and healing of the area through direct targeting of myofascial trigger points and strengthening the muscles of the foot. By easing tense muscles, you can avoid further irritation and remain active.

Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain. It involves inflammation of the plantar fascia or thick band of tissue running across your foot’s bottom and connecting the heel bone to the toes. A frequent symptom of plantar fasciitis is heel pain. You may feel it when you first step out of bed in the morning. Initially, it’s a sharp pain that gradually turns into a nagging ache as the day continues.

The most effective treatment is a combination of joint manipulation and corrective exercisesDry needling is another service we offer that can assist in the natural healing of the muscles and plantar fascia itself.

Get Help For Your Ankle Or Foot Pain Today

ankle or foot pain can be debilitating, and, if left untreated, it may get worse instead of better. At Peak Physiotherapy and Performance we treat heel pain and achilles tendon pain in active adults and athletes every single day. Have you been struggling with pain and just don’t know where to go or what to do next? Get in touch with me for a Free Phone Consultation about your ankle/foot pain problem or contact us if you have any questions.

About the Author

Dr. Andrew Junak is a Doctor of Physical Therapy and Board-Certified Orthopedic Specialist. Dr. Junak received his Doctorate of Physical Therapy from Walsh University and completed his Orthopedic Specialist training at the Cleveland Clinic. He is the owner of Peak Physiotherapy and Performance, a physical therapy clinic in Canal Winchester, Ohio. He serves the local communities of Lancaster, Grove City, Pickerington, and Columbus. Dr. Junak is passionate about helping people solve their problems in order to get them back to doing the things they love.

Share this with friends!