Foot, heel and ankle issues

Overview

Foot, heel, and ankle issues encompass a wide range of painful and limiting conditions affecting the complex structures that support body weight, enable mobility, and absorb impact during daily activities. The foot contains 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments working together to provide stability, flexibility, balance, and propulsion. Common problems include plantar fasciitis (heel pain from inflammation of the plantar fascia), Achilles tendinitis, ankle sprains, stress fractures, bunions, neuromas, arthritis, and biomechanical issues such as flat feet or high arches.

These conditions arise from various factors, including overuse and repetitive stress from walking, running, or standing; improper footwear lacking support or causing compression; biomechanical abnormalities affecting foot and ankle alignment; acute injuries from sprains or impact; degenerative changes with ageing; excess body weight increasing stress on lower extremity structures; and systemic conditions like diabetes or arthritis affecting foot health. Foot and ankle problems significantly impact quality of life by limiting mobility, reducing activity levels, affecting balance and fall risk, causing chronic pain, and restricting participation in work, exercise, and recreational activities.

While conventional treatment includes rest, ice, compression, elevation (RICE), orthotics, medications, physical therapy, and in some cases surgery, Traditional, Complementary, and Integrative Health (TCIH) modalities offer valuable approaches addressing pain, improving biomechanics, enhancing circulation, supporting healing, and preventing recurrence through hands-on therapies, specialized treatments, and whole-body approaches that recognize the interconnected nature of foot, ankle, leg, and whole-body alignment and function.

Common Causes and Contributing Factors

• Biomechanical abnormalities - Flat feet (overpronation), high arches (supination), leg length discrepancies, or abnormal gait patterns creating uneven stress distribution^[1]
• Overuse and repetitive stress - Excessive walking, running, standing, or high-impact activities without adequate rest or conditioning, causing tissue breakdown
• Improper footwear - Shoes lacking arch support, cushioning, or stability; high heels altering biomechanics; worn-out shoes no longer providing protection; or ill-fitting shoes causing compression
• Acute injuries - Ankle sprains, fractures, or direct trauma damaging bones, ligaments, tendons, or soft tissues
• Excess body weight - Additional weight increases stress and impact on feet, ankles, and related structures with each step
• Ageing and degeneration - Natural age-related changes, including arthritis, reduced tissue elasticity, thinning fat pads, and degenerative changes
• Tight or weak muscles - Calf tightness, weak intrinsic foot muscles, or imbalanced lower leg strength affecting foot and ankle mechanics
• Systemic conditions - Diabetes causing neuropathy and circulation problems; rheumatoid arthritis causing joint inflammation; gout creating acute pain episodes
• Previous injuries - History of ankle sprains, fractures, or foot injuries creating chronic instability, weakness, or altered mechanics
• Occupational factors - Jobs requiring prolonged standing, walking on hard surfaces, or wearing restrictive safety footwear

Signs and Symptoms

• Heel pain - Sharp or aching pain in the heel, particularly with first steps in the morning or after rest, classically indicating plantar fasciitis
• Ankle pain and swelling - Pain, swelling, bruising, or instability following injury or from chronic conditions like tendinitis or arthritis
• Arch pain - Discomfort along the bottom of the foot, potentially from plantar fasciitis, strain, or structural issues
• Achilles pain - Pain along the back of the heel and lower calf, particularly with activity or after rest, indicating Achilles tendinitis
• Forefoot pain - Burning, numbness, or sharp pain in the ball of the foot, potentially from neuromas, metatarsalgia, or stress fractures
• Stiffness and reduced mobility - Limited ankle or foot range of motion, particularly in the morning or after sitting
• Visible deformities - Bunions, hammer toes, or other structural changes causing pain and footwear difficulties
• Instability or weakness - Feeling of ankle "giving way," especially after previous sprains, or difficulty with balance
• Gait changes - Limping, altered walking pattern, or compensatory movements due to pain or dysfunction
• Skin changes - Calluses, corns, wounds (particularly concerning with diabetes), or colour changes indicating circulation problems

Holistic and TCIH Approaches

Holistic and Traditional, Complementary and Integrative Healthcare (TCIH) care addresses foot, heel, and ankle issues through specialised treatments that reduce pain, correct biomechanical problems, support healing, improve function, and prevent recurrence through comprehensive, hands-on approaches.

• Podiatry provides specialized medical care focused exclusively on foot and ankle health through comprehensive assessment including gait analysis, biomechanical evaluation, and diagnostic imaging when needed; custom orthotics (shoe inserts) correcting biomechanical abnormalities and redistributing pressure; footwear recommendations ensuring proper fit, support, and appropriateness for activities; treatment of structural problems such as bunions, hammer toes, or ingrown toenails; management of diabetic foot care including neuropathy and ulcer prevention and minor surgical procedures when conservative treatment is insufficient. Podiatrists are essential for accurate diagnosis, orthotic prescription, and management of complex foot and ankle conditions requiring specialised expertise^[1,4,5].
• Photobiomodulation Therapy utilises specific wavelengths of light (typically red and near-infrared) to stimulate cellular healing and reduce inflammation in foot, heel, and ankle conditions. Photobiomodulation practitioners conduct thorough assessments of painful or injured tissues, identifying areas of inflammation, impaired healing, or chronic dysfunction; apply precise light wavelengths to penetrate tissues and stimulate mitochondrial energy production; modulate cellular processes that reduce pain, decrease swelling, and accelerate tissue repair; enhance blood flow and oxygen delivery to compromised tissues promoting faster recovery; and address both acute injuries and chronic conditions while supporting the body's natural healing mechanisms. Photobiomodulation therapy is particularly effective for plantar fasciitis, Achilles tendinopathy, ankle sprains, neuropathic pain, and post-surgical recovery, providing non-invasive pain relief and tissue regeneration that complements rehabilitation and restores optimal function^[8].
• Reflexology applies therapeutic pressure to specific reflex points on the feet (and hands) corresponding to organs and body systems throughout the body. Beyond its systemic effects, reflexology directly benefits foot health by improving local circulation to foot structures supporting healing and reducing inflammation; reducing pain through endorphin release and nervous system regulation; releasing tension in foot muscles and connective tissues; improving lymphatic drainage, reducing swelling; and promoting deep relaxation, reducing stress that can exacerbate pain perception. Reflexology has demonstrated effectiveness in improving diabetic peripheral neuropathy, ankle brachial index, and overall foot health in patients with diabetes. While not replacing medical podiatry care for structural problems, reflexology provides supportive treatment enhancing foot health, reducing pain, and promoting overall well-being through this accessible, gentle therapy^[4].
• Physiotherapy or Physical Therapy offers evidence-based assessment and treatment for foot and ankle conditions through detailed evaluation of biomechanics, strength, flexibility, and movement patterns; manual therapy techniques including joint mobilization to improve ankle mobility and soft tissue release for tight muscles or fascia; therapeutic exercises strengthening intrinsic foot muscles, ankle stabilizers, and calf muscles; stretching protocols addressing tight plantar fascia, Achilles tendon, and calf muscles; proprioceptive and balance training particularly important after ankle sprains; gait retraining correcting dysfunctional walking patterns; taping techniques providing support during healing; and education on activity modification, proper footwear, and home exercise programs. Physical therapy is particularly valuable for rehabilitation after injury, chronic conditions requiring functional improvement, and prevention of recurrence^[1,2,6,9,10].
• Osteopathy addresses foot and ankle problems through a whole-body approach, recognising that dysfunction in feet and ankles often relates to or creates compensatory patterns throughout the kinetic chain. Osteopathic treatment includes assessment of structural alignment from feet through legs, pelvis, spine, and upper body; manual techniques including joint articulation, soft tissue release, and myofascial techniques addressing restrictions in feet, ankles, and related areas; craniosacral techniques supporting overall nervous system regulation; treatment of compensatory patterns in knees, hips, or lower back resulting from or contributing to foot/ankle problems; and visceral manipulation when internal organ positioning affects lower extremity mechanics. This comprehensive approach addresses not just local symptoms but underlying structural and functional imbalances^[2,6].
• Remedial Massage employs therapeutic massage techniques specifically targeting muscles, tendons, fascia, and soft tissues of the feet, ankles, and lower legs. Treatment addresses tight calf muscles contributing to Achilles tension or plantar fasciitis; releases plantar fascia restrictions through specific techniques; improves circulation supporting healing and reducing inflammation; reduces muscle tension and trigger points referring pain to feet or ankles; breaks down scar tissue from previous injuries; and provides overall relaxation and pain relief. Remedial massage therapists use various techniques including deep tissue massage, myofascial release, trigger point therapy, and stretching, tailored to individual conditions and tolerance^[2,6].
• Myotherapy focuses specifically on the treatment of myofascial pain and dysfunction affecting muscles and fascia. For foot and ankle conditions, myotherapy addresses trigger points in calf muscles, plantar foot muscles, or peroneals referring pain to feet or ankles; releases fascial restrictions limiting mobility and creating pain; corrects muscle imbalances between tight, overactive muscles and weak, inhibited ones; improves biomechanics through muscle balancing and movement reeducation; provides dry needling (similar to acupuncture but targeting trigger points specifically) for persistent muscle tension; and develops corrective exercise programs addressing underlying muscular dysfunction. Myotherapists provide specialised soft tissue treatment complementing other therapies and addressing muscular contributions to foot and ankle problems^[2].

Self-Care and Lifestyle Practices

• Wear appropriate, supportive footwear - Choose shoes with adequate arch support, cushioning, proper fit, and appropriate for activities; replace worn shoes regularly
• Stretch regularly - Perform daily calf stretches, plantar fascia stretches, and ankle mobility exercises to maintain flexibility and reduce tension
• Strengthen foot muscles - Practice exercises like toe curls, marble pickups, or towel scrunches to strengthen intrinsic foot muscles supporting the arch and preventing problems
• Apply ice for acute pain - Use ice massage or ice packs for 15-20 minutes several times daily for acute injuries or inflammatory conditions
• Use contrast baths - Alternate warm and cold water soaks to improve circulation and reduce inflammation in chronic conditions
• Maintain a healthy weight - Achieve and maintain an appropriate body weight to reduce stress on feet, ankles, and lower extremities
• Gradual activity progression - Increase walking, running, or standing activities gradually (no more than 10% per week) to allow tissues to adapt
• Practice good foot hygiene - Keep feet clean and dry, trim nails properly, moisturise (but not between toes), and inspect feet regularly, especially with diabetes
• Avoid walking barefoot - Especially on hard surfaces or if you have biomechanical issues; use supportive indoor footwear or orthotics as recommended
• Roll feet on tennis ball - Gently roll the bottom of the feet on a tennis or lacrosse ball to massage the plantar fascia and reduce tension

When to Seek Professional Support

Conventional medical practitioners should be consulted for accurate diagnosis of foot and ankle conditions through clinical examination and imaging (X-rays, MRI, ultrasound); evaluation of systemic conditions affecting feet such as diabetes, arthritis, or circulation problems^[4,5] prescription of medications for pain or inflammation when appropriate; referral to specialists including podiatrists, orthopedic surgeons, or rheumatologists; and consideration of surgical interventions for conditions not responding to conservative care^[1]. Medical attention is important when experiencing severe pain, inability to bear weight, visible deformity, signs of infection (redness, warmth, fever), numbness or circulation changes, or symptoms persisting despite self-care. Immediate emergency care is needed for suspected fractures, severe ankle sprains with inability to walk, signs of serious infection, or sudden loss of sensation or circulation.

A verified SoulAdvisor practitioner can work collaboratively with medical providers to deliver comprehensive complementary care. This integrative approach recognises that foot and ankle problems often stem from biomechanical imbalances, muscle dysfunction, or broader systemic factors that require thorough assessment. Manual therapies—including physical therapy, osteopathy, massage, and myotherapy—can effectively address soft-tissue and joint restrictions, while emerging treatments such as photobiomodulation offer promising non-invasive support for healing. Acupuncture has also been shown to reduce pain in conditions like plantar fasciitis.

By combining accurate medical diagnosis and conventional treatment with TCIH approaches that support tissue repair, optimise biomechanics, relieve pain, and restore function, clients receive the most well-rounded care. This partnership helps achieve lasting improvement, prevent recurrence, and support a full return to comfortable movement and mobility