Foot and ankle problems are extremely common. A misstep off a kerb, a sudden twist during sport or an unexplained ache during a run can leave you wondering whether to rest, ice or see a specialist. Many injuries settle with simple measures, but some need early assessment to avoid long-term instability or persistent pain.
This article, based on insights from Professor Nima Heidari, consultant foot and ankle surgeon at OS Clinic, explains what may be happening, how we investigate problems and what you can expect from treatment.
The foot and ankle contain a network of bones, joints, ligaments and tendons that work together with every step. When one structure is injured or overloaded, movement and balance can change quickly.
An ankle sprain happens when the foot rolls inwards or outwards, stretching the ligaments that stabilise the joint. A typical sprain causes swelling, bruising and difficulty bearing weight. Most improve with rest and rehabilitation.
‘One in ten visits to a musculoskeletal specialist relate to ankle sprains. If you cannot bear load after the injury, that is a red flag.’
– Professor Nima Heidari
The Achilles tendon provides the power for running and jumping. A sudden push off, especially in sport, can cause an acute rupture. People often describe the sensation as being kicked in the back of the leg, followed by loss of strength.
Stress fractures, or silent fractures, are tiny cracks in the bone that happen when repetitive load exceeds the bone’s capacity to repair.
Professor Heidari likens bone to a ‘living scaffolding system’ constantly adapting to activity levels. Increasing training too quickly can overwhelm the repair process.
‘As you ramp up activity, the bone needs to strengthen. Too many small injuries that the body cannot repair lead to a stress injury.’
– Professor Nima Heidari
Stress fractures are particularly common in runners preparing for longer events.
Some problems develop gradually due to reduced muscle control, stiffness or alignment differences. The small intrinsic muscles of the foot – the tiny muscles that sit within the foot itself – support balance and subtle movements. Weakness in these muscles, or tight calf muscles, can increase strain on the Achilles tendon or make the ankle more prone to rolling.
Understanding your symptoms can help you decide whether to rest at home or arrange an assessment.
These usually improve over several days:
Professor Heidari explains that certain symptoms should never be ignored:
‘If you really think something is not right, get it checked. Early assessment can make a big difference.’
– Professor Nima Heidari
Seek urgent medical attention if you experience:
The assessment begins as soon as you walk into the clinic. We will observe how you stand and walk, looking for clues in alignment, posture and muscle bulk.
A detailed conversation helps understand how the problem started:
The consultant will examine both feet and ankles, checking:
OS Clinic uses imaging selectively to answer specific clinical questions.
Load‑bearing X‑rays show how the structures behave under pressure, which is helpful for ankle and midfoot injuries. Magnetic resonance imaging (MRI) evaluates ligaments, tendons, cartilage and bone bruising. Ultrasound may be used to assess tendon movement in real time.
These investigations help confirm the diagnosis and guide treatment planning.
For most sprains and strains, you can support recovery by:
‘Even a simple elasticated splint can make a big difference to comfort during the first few days.’
– Professor Nima Heidari
Rehabilitation is central to long-term recovery for almost all foot and ankle conditions. This includes:
‘Intrinsic foot exercises can include scrunching a towel with the toes, spreading the toes or picking up small objects. These help develop fine control and may reduce the risk of rolling the ankle again.’
– Professor Nima Heidari
A homemade solution is rarely effective. Proper splinting reduces pain and prevents further injury.
If a rupture is suspected, the foot should be placed in a pointed-down (equinus) position until specialist review. Treatment may involve:
Choice of treatment depends on the location of the rupture, your activity levels and clinical findings.
Stress injuries need reduced load and a structured return to activity. MRI often confirms the diagnosis. Treatment may include supportive footwear, temporary boot use and physiotherapy to address how you move.
Surgery is only recommended when structural damage cannot heal reliably without intervention.
Examples include:
All surgical decisions involve discussing risks, benefits and alternatives.
Recovery is influenced by injury severity, general health, alignment and muscle control.
Typical timelines include:
Setbacks can occur if activity increases too quickly. Some people experience persistent stiffness or instability. Your consultant will explain your individual recovery plan.
Most people return to their usual activities with the right rehabilitation. Sporting activities often require a staged return to running, jumping or pivoting. Working with physiotherapy helps rebuild confidence and control.
OS Clinic works closely with physiotherapists and other specialists to coordinate recovery and support long-term function.
If you’re concerned about a recent foot or ankle injury or symptoms that are not settling, book a consultation with our foot and ankle team at OS Clinic.
Prefer to speak first? Call +44 (0)20 7046 8000 to reach our patient liaison team.
1. How long should swelling last after an ankle sprain?
Mild to moderate swelling is normal for several days. It should steadily improve with rest, elevation and gentle movement. If swelling worsens after 48–72 hours or you cannot bear weight, you should be assessed. Swelling that lasts beyond two weeks may indicate a deeper ligament injury.
2. Can I walk on a suspected stress fracture?
It’s best to avoid it. Stress fractures can worsen with continued load. Pain that eases with rest and returns during activity is a typical sign. If you suspect a stress fracture, seek specialist review. MRI is the most reliable way to confirm the diagnosis.
3. Do high-top shoes or braces prevent ankle sprains?
Supportive footwear can reduce extreme movement but will not prevent all sprains. Good balance, calf strength and intrinsic foot control are more protective than footwear alone. A physiotherapist can guide an effective stability programme.
4. What is the difference between an Achilles rupture and Achilles tendinopathy?
A rupture happens suddenly, often during sport, and may feel like being kicked in the back of the leg. Strength loss is immediate. Tendinopathy develops gradually and causes stiffness or aching, especially in the morning.
Both need assessment, but a suspected rupture should be reviewed urgently.
5. Are flat feet relevant to ankle injuries?
Flat feet can influence how forces travel through the ankle, but many people with flat feet have no symptoms. What matters most is whether the foot moves well and is pain-free. A specialist can assess whether your foot shape is contributing to your symptoms.
6. Can alignment issues cause repeated sprains?
Yes. Differences in limb alignment, muscle bulk or gait can increase the likelihood of rolling the ankle. These factors are routinely checked during an orthopaedic assessment and may shape your rehabilitation plan.
7. What imaging is best for foot and ankle injuries?
Load-bearing X-rays assess bone alignment. MRI is best for ligaments, tendons and stress fractures. Ultrasound can help assess tendon movement. Your consultant will recommend the imaging that adds the most value to your diagnosis.
8. What is intrinsic foot strengthening, and does it work?
Intrinsic exercises target the small muscles that support the arch and stabilise the ankle. Towel scrunches, toe spreading and picking up small objects can build control and balance. When done regularly, these exercises support recovery and help reduce injury risk.
This article is for general information only and is not a substitute for professional medical advice. If you have sudden pain, cannot bear weight or develop a hot, swollen joint with fever, seek urgent medical attention.
Reviewer: Professor Nima Heidari, Orthopaedic and trauma surgeon
Last reviewed: [17 December 2025]
