Calf, ankle and foot pain

The problem

I commonly see clients with lower leg and foot injuries whether that’s runners with calf pain or ball sports players with ankle ligament injuries.

As with other specific conditions that can be treated with manual therapy, it is important to first understand the history of your lower leg injury before a diagnosis can be made. This involves asking you: to describe your symptoms; when and how your symptoms started e.g. through an injury or slowly over time; which activities provoke pain or dysfunction and so on.

Understanding your pain

The history you give me guides me in making an appropriate physical examination of the area and surrounding tissue including joints above and below especially your toes, foot and ankle. The examination might include observation in standing and on the treatment couch, palpation of the area as well as special tests of the joints.

Common ankle problems I treat include

  • Achilles tendinopathy
  • Plantar fasciitis
  • Ankle ligament injury
  • Calf strains
  • Medial Tibial Stress Syndrome (MTSS)

I frequently encounter what are known as overuse injuries such as tendinopathies, MTSS and plantar fasciitis. Clients respond well to manual treatment for these conditions alongside improving their understanding of the causes of their condition which allow them to make informed adjustments to their daily activities and exercise habits as well as appropriate advice on rehabilitative exercises.

Injuries to the ligaments of the ankle are the most common acute sports injury I see. Usually injuries in this area occur to the lateral collateral ligaments, i.e. those around the outside of the ankle and the rear part of the foot. These injuries are extremely painful and debilitating in the short term. However, if not properly treated there is a high chance of recurrence of this type of injury throughout the sufferer’s life which can lead to foot and ankle instability as well as knee, hip and back problems.


The approach to treatment depends on whether the injury is acute, for instance as the result of a trauma such as a ligament sprain or whether it has developed over time. In all but recent, acute injuries to the ankle I will tend to utilise appropriate manual therapy techniques such as soft tissue massage, joint mobilisation and stretches to the appropriate tissue. Sometimes this means a focus on the area of pain and sometimes this means relieving surrounding tissue that may have become painful or restricted either because of adaptations you have made to accommodate your ankle problem or issues that are affecting the ankle directly. Indeed, for many of the chronic ankle conditions listed above which develop over time there is often a relationship between your ankle pain and pain / dysfunction and the hip or ankle.

Lower leg injuries respond well to appropriate loading especially through resistance training. During the treatment we can discuss if a graded exercise programme is appropriate for you and if so I can take you through the relevant exercises after the manual therapy treatment.