Foot

Foot, Ankle & Heel Pain FAQs

Find the most useful PhysioWorks information for foot, ankle, heel, Achilles or shin pain based on where your symptoms occur and how they started.

Physiotherapist assessing a patient’s foot and ankle while standing
A foot and ankle assessment considers where symptoms occur, how they started and how the area responds to standing and movement.

Where should you start?

Begin with the pathway that best matches your main symptom location. These links provide general guidance and cannot confirm a diagnosis.

Pain under the heel or arch

Start with plantar fasciitis information if pain is strongest under the heel, through the arch or during your first steps after rest.

Pain behind the heel

Read about Achilles tendinopathy if pain sits through the tendon at the back of the heel and worsens with running, hills or jumping.

General ankle pain or swelling

Use the ankle pain guide if symptoms are broad, developed gradually or do not clearly match a recent ligament injury.

Pain through the foot or forefoot

Visit the foot pain hub for symptoms through the toes, forefoot, midfoot or arch, particularly when standing or walking aggravates pain.

Shin pain during exercise

Read about shin splints if pain develops along the shin during or after running, jumping or a recent increase in training.

Heel pain in a child

Start with Sever’s disease information when an active child or teenager develops heel pain during running, jumping or sport.

What causes foot, ankle and heel pain?

Foot, ankle and heel pain may develop after a sudden injury or build gradually as tissues become overloaded. Common contributing factors include an ankle twist, a rapid increase in activity, reduced strength, limited movement, repeated impact, footwear changes, growth-related stress and poor balance.

Sometimes one obvious incident causes the symptoms. In other cases, walking, running, hills, jumping or sport gradually places more demand on a structure than it can currently tolerate.

Common examples include a sprained ankle, plantar fasciitis, Achilles tendinopathy and shin splints.

Healthdirect also provides general information about foot care and common foot problems.

Which foot pain guides are most useful?

Start with the foot section when pain sits in the arch, forefoot, midfoot or toes, or when standing and walking provoke symptoms more than ankle twisting does.

Foot pain treatment

Learn how assessment, activity changes, exercise and other treatment options may assist.

Plantar fasciitis

Explore common features of pain beneath the heel and through the plantar fascia.

Barefoot running

Consider potential benefits, limitations and loading issues before changing running footwear.

Which ankle injury guides should you read?

The ankle section is most useful when you have swelling, bruising, a recent twist, pain with weight-bearing or repeated episodes of the ankle giving way.

Sprained ankle recovery

Review assessment, rehabilitation and return-to-activity considerations after an ankle sprain.

Ankle strapping

See how ankle taping may provide short-term support during selected activities or recovery stages.

What details help narrow the cause?

Location matters

Pain under the heel, behind the heel, through the forefoot or around the ankle may point towards different structures.

How it started matters

A sudden twist, fall or impact requires a different assessment pathway from pain that gradually builds with activity.

Function matters

Difficulty weight-bearing, marked swelling, repeated instability or declining walking ability deserves closer assessment.

Where should you start for heel, Achilles or shin pain?

Heel, Achilles and shin symptoms often relate to repeated loading during walking, running, hills, sprinting or jumping. The exact location and behaviour of the pain can help guide your next reading.

Shin splints

Review activity-related shin pain, common contributing factors and rehabilitation options.

What about children, balance and recurrent ankle rolling?

Children and teenagers may require a different pathway because growth-related heel and leg pain are common. Balance retraining can also be important when an old ankle injury continues to affect confidence or stability.

Sever’s disease

Read about growth-related heel pain commonly seen in active children and teenagers.

Kids’ leg pain

Explore common activity-related leg complaints that can affect children during sport and growth.

Growing pains

Learn about typical growing-pain patterns and symptoms that may need further assessment.

When should you seek prompt medical assessment?

Arrange a physiotherapy or medical assessment when symptoms persist, repeatedly return, affect normal walking or prevent work, exercise or sport.

Common foot, ankle and heel pain FAQs

Is foot, ankle or heel pain always caused by an injury?

No. Symptoms can develop through overload, stiffness, tendon irritation, unsuitable footwear, training errors, balance problems, growth-related issues or an old injury that never fully recovered. Sometimes repeated stress matters more than one traumatic event.

What causes heel pain during the first steps of the morning?

First-step heel pain commonly occurs with plantar fascia irritation. Achilles tendon problems and other heel structures can also contribute. Symptoms may feel stronger after rest because tissues have temporarily stiffened before loading resumes.

How do you know if an ankle sprain needs treatment?

An ankle sprain may need assessment when swelling, bruising or pain limits weight-bearing, or when confidence and stability do not return. Guided rehabilitation is particularly useful when symptoms persist or the ankle repeatedly gives way.

Can children get heel pain?

Yes. Active children can develop growth-related heel pain, including Sever’s disease. Symptoms commonly appear during running, jumping or sport and may improve with appropriate load modification and rehabilitation.

Can physiotherapy help foot, ankle and heel pain?

Physiotherapy may help identify likely contributing structures, improve movement and strength, guide activity progression and support a return to walking, work or sport. Treatment may also include footwear advice, taping, balance retraining and progressive exercise.

What should you do if the pain keeps returning?

Recurring symptoms may mean that strength, load tolerance, balance or movement control has not fully recovered. Repeated ankle sprains, persistent heel pain or ongoing Achilles symptoms should be assessed more closely.

What should you do next?

If your symptoms are broad or unclear, start with the main foot pain, ankle pain or heel pain guide. Then select the condition page that most closely matches your symptoms.

Book an assessment when pain persists, worsens, repeatedly returns or affects walking, work, exercise or sport. Your physiotherapist can assess the area, explain likely contributing factors and recommend an individual management plan.

Helpful supports and self-management options

Choose your clinic and appointment pathway

Select a PhysioWorks clinic to continue to live booking, an appointment request or reception assistance.

Ankle Products

These ankle products are commonly used by our physiotherapists to improve ankle pain, strength, balance, proprioception, endurance and flexibility, plus assist home exercise programs.

View all ankle products

Follow PhysioWorks

Get physiotherapy tips, exercise videos, recovery advice and blog updates.

References

  1. Martin RL, Davenport TE, Paulseth S, et al. Ankle stability and movement coordination impairments: lateral ankle ligament sprains revision 2021. J Orthop Sports Phys Ther. 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302
  2. Koc TA Jr, Bise CG, Neville C, Carreira D, Martin RL. Heel pain—plantar fasciitis: revision 2023. J Orthop Sports Phys Ther. 2023;53(12):CPG1-CPG39. doi:10.2519/jospt.2023.0303
  3. Pillay J, Riva JJ, Squires JE, et al. Falls prevention interventions for community-dwelling older adults: systematic review and meta-analysis of benefits, harms, and patient values and preferences. Syst Rev. 2024;13(1):289. doi:10.1186/s13643-024-02681-3

Common Causes of Foot Pain

Article by John Miller & Erin Runge

Foot pain can come from joints, tendons, nerves, bones, or loading problems.

Common causes of foot pain include overuse injuries, tendon problems, nerve irritation, arthritis, and changes in foot biomechanics. Foot pain can affect walking, running, work, and daily comfort, so identifying the likely source early helps guide the right treatment and next steps.

Many cases relate to local structures in the foot, while others link to nearby regions such as the ankle, calf, or lower back. If you are unsure where your symptoms fit, start with our foot pain hub and related pages on heel pain, ankle pain, and calf pain.

Physiotherapist assessing foot pain through arch and ankle movement testing

Foot pain often starts during simple daily movements such as standing or walking.

Early foot pain may feel like stiffness, aching, sharp loading pain, or discomfort when you first get moving after rest.

Common signs linked to foot pain

  • Pain with walking, running, or standing
  • Morning stiffness or first-step pain
  • Swelling, bruising, or local tenderness
  • Burning, tingling, or numbness
  • Pain that worsens with load or certain shoes

What are the common causes of foot pain?

The common causes of foot pain include soft tissue irritation, tendon overload, nerve irritation, joint degeneration, poor loading tolerance, and traumatic injury. The exact cause often depends on where the pain sits, what activities aggravate it, and whether symptoms began gradually or after a specific incident.

Some causes affect the heel or arch, while others affect the forefoot, midfoot, toes, or ankle region. Below are some of the more common contributors.

Foot injuries

Tendon injuries

Bone and growth-related causes

Ligament and traumatic ankle injuries

Degenerative and inflammatory causes

Biomechanical and nerve-related causes

Systemic contributors

Physiotherapist assessing foot pain through arch and ankle movement testing

A physiotherapy assessment helps identify the most likely source of foot pain.

Assessment may include walking analysis, foot loading tests, joint movement checks, strength testing, and footwear review.

What do these causes of foot pain mean for you?

Foot pain can range from mild irritation to a more persistent problem that affects walking, work, exercise, or sport. Short-term symptoms sometimes settle with load reduction, footwear changes, and simple care, but ongoing or worsening pain often suggests a more specific issue that needs targeted treatment.

The exact location of your symptoms matters. Heel pain may point towards plantar fasciopathy, pain behind the ankle may relate to Achilles tendinopathy, and forefoot pain may fit conditions such as metatarsalgia or Morton’s neuroma.

When should you be concerned about foot pain?

You should be more concerned about foot pain if it lasts more than one to two weeks, becomes sharper with walking, causes swelling, or limits your ability to bear weight. These patterns can indicate a more persistent tendon, joint, nerve, or bone issue.

Signs you should get foot pain checked

  • Pain lasting longer than 1–2 weeks
  • Sharp or worsening pain when walking
  • Swelling, bruising, or marked tenderness
  • Difficulty standing or weight-bearing
  • Numbness, tingling, or burning pain
  • Pain stopping sport, work, or daily activity

Not sure what is causing your foot pain? A physiotherapy assessment can help identify the likely source of symptoms and guide the right treatment plan.

How is the cause of foot pain diagnosed?

The cause of foot pain is usually diagnosed through a combination of symptom history, foot and ankle examination, walking assessment, and loading tests. Imaging is not always needed, but it can help when a fracture, significant joint injury, or stubborn symptoms are suspected.

A physiotherapist may also assess nearby regions such as the calf, ankle, knee, and lower back because symptoms sometimes refer into the foot. General information on allied health assessment is also available through Healthdirect’s physiotherapy overview.

How can physiotherapy help foot pain?

Physiotherapy for foot pain may help by identifying the structure involved, reducing aggravating loads, improving strength and mobility, and guiding your return to normal activity. Treatment often includes activity modification, manual therapy, footwear advice, taping, exercise, and gradual loading strategies.

For active people, related training factors also matter. If symptoms began with increased mileage or higher impact activity, pages on running injuries and lower-limb loading patterns may also help.

Foot and ankle manual therapy treatment by physiotherapist in clinic setting

Manual therapy for foot and ankle pain

Hands-on physiotherapy techniques may help reduce foot pain, improve joint movement, and support your recovery.

Related foot pain information

What should you do next for foot pain?

If your foot pain is not settling, is affecting walking, or keeps returning, getting the right diagnosis is the best next step. Early assessment can help you understand what is driving the pain and what treatment is most likely to help.

Your physiotherapist can guide you on activity modification, footwear, exercises, and when you may need further investigation.

Patient walking comfortably with physiotherapist guidance during recovery session

Confident, pain-free walking recovery

Targeted treatment can help restore comfortable walking, confidence, and activity.

Choose your clinic and appointment pathway

Select a PhysioWorks clinic to continue to live booking, an appointment request or reception assistance.

Ankle Products

These ankle products are commonly used by our physiotherapists to improve ankle pain, strength, balance, proprioception, endurance and flexibility, plus assist home exercise programs.

View all ankle products

Follow PhysioWorks

Get physiotherapy tips, exercise videos, recovery advice and blog updates.

Common foot pain FAQs

What is the most common cause of foot pain?

Common causes of foot pain include plantar fasciopathy, tendon overload, forefoot irritation, nerve irritation, arthritis, and footwear or loading problems. The most likely cause depends on the location of symptoms and what activities aggravate them.

Why does foot pain hurt more when walking?

Foot pain often worsens with walking because walking increases load through the heel, arch, forefoot, and ankle. If tissues are irritated or overloaded, each step can increase compression, tension, or impact stress.

Can foot pain come from the ankle or back?

Yes. Some foot pain comes from nearby structures such as the ankle, calf, or lower back. Nerve-related pain, altered walking mechanics, and referred symptoms can all contribute to foot discomfort.

When should I worry about foot pain?

You should be more concerned if foot pain is worsening, lasts beyond one to two weeks, causes swelling, stops you weight-bearing, or affects daily activity. These signs suggest you should arrange an assessment.

Can physiotherapy help foot pain?

Yes. Physiotherapy may help foot pain by identifying the likely cause, reducing aggravating loads, improving strength and mobility, and guiding a gradual return to walking, work, exercise, or sport.

Do I need a scan for foot pain?

Not always. Many causes of foot pain can be identified clinically. However, scans may be useful when a fracture, significant joint problem, or persistent symptoms are suspected.

References

  1. Morrissey D, Cotchett M, Said J'Bari A, et al. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. Br J Sports Med. 2021;55(19):1106-1118. doi:10.1136/bjsports-2019-101970
  2. Barton CJ, Bonanno D, Menz HB. Development and evaluation of a tool for the assessment of footwear characteristics. J Foot Ankle Res. 2009;2:10. doi:10.1186/1757-1146-2-10
  3. Trojian T, Tucker AK. Plantar Fasciitis. Am Fam Physician. 2019;99(12):744-750.
  4. Aicale R, Tarantino D, Maffulli N. Overuse injuries in sport: a comprehensive overview. J Orthop Surg Res. 2018;13(1):309. doi:10.1186/s13018-018-1017-5

Foot And Ankle Pain: When To Worry

Foot and ankle pain weight-bearing arch assessment by physiotherapist
Assessing foot posture and arch control under load

Foot and ankle pain should worry you when it is severe, follows a clear injury, stops you walking normally, or does not improve with sensible early care. It may come from simple overload, a sprained ankle, tendon irritation, plantar fascia pain, arthritis, nerve irritation, or a more serious problem such as a fracture.

For broader background, start with our guides to foot pain and ankle pain. Act sooner if the area is hot, red, very swollen, unstable, painful over bone, painful at night, or keeps flaring with running, jumping, or long walks.

Quick Signs You Should Get Checked

  • You cannot walk four steps normally.
  • Your foot or ankle looks deformed or badly swollen.
  • You have sharp bony tenderness after a twist, fall, or landing injury.
  • The joint feels hot or red, or you also have a fever.
  • Pain keeps returning, worsens at night, or flares with impact loading.

What Does Foot and Ankle Pain Usually Mean?

Foot and ankle pain usually means one or more tissues are irritated, overloaded, injured, or inflamed. The likely cause depends on where the pain sits, how it started, and what makes it worse.

Side-of-ankle pain after a roll often points towards a ligament injury. Heel pain with first steps may fit heel pain patterns such as plantar fascia irritation or Achilles-related problems. Pain across the midfoot after a twist or heavy landing needs a closer look because a Lisfranc injury can be missed early.

Is This Foot or Ankle Pain Serious?

Usually monitor it at home if pain is mild, you can still walk, swelling is light, and symptoms improve over a few days.

Book a physiotherapy assessment soon if pain affects walking, keeps returning, follows a change in sport or training load, or is not improving as expected.

Seek urgent medical review if you cannot weight-bear, the area looks deformed, the joint is hot and red, or the pain followed a significant injury and feels severe.

When Should You Worry About Foot and Ankle Pain?

You should worry about foot and ankle pain if it is severe, limits walking, follows a significant injury, or does not settle as expected. You should also act sooner if the area is hot, red, increasingly swollen, unstable, or painful directly over bone rather than mainly through soft tissue.

Seek urgent medical review if you suspect a fracture, dislocation, infection, or Achilles rupture. Healthdirect ankle pain guidance can help Australians decide where to seek care if they are unsure, but severe injury, deformity, fever, or urgent medical symptoms need prompt medical attention.

Foot and Ankle Pain Severity Guide

Mild

Pain is noticeable but manageable. You can still walk, swelling is minor, and symptoms settle with reduced activity, good footwear, and simple self-care.

Moderate

Pain affects walking, stairs, exercise, or work tasks. Swelling, stiffness, or weakness lasts more than a few days. This level usually deserves a physiotherapy review.

Severe

Pain is sharp, intense, or worsening. You cannot weight-bear properly, the area is badly swollen or deformed, or symptoms suggest fracture, rupture, or infection. This level needs urgent medical assessment.

Common Causes of Foot and Ankle Pain

Common causes of foot and ankle pain include ligament sprains, tendon injuries, joint irritation, overload from walking or sport, arthritis, plantar fasciitis, and bone stress injuries. A clear injury often points towards a sprain or fracture. Gradually worsening pain can fit tendon overload or foot stress fracture patterns.

  • Lateral ankle sprain: common after rolling the ankle inwards.
  • High ankle sprain: often more painful with twisting, push-off, and walking. See high ankle sprain.
  • Stress fracture: pain builds with impact or training load. See stress fractures.
  • Ongoing ankle giving way: may suggest incomplete rehabilitation or chronic ankle instability.
  • Ball-of-foot pain: may fit metatarsalgia, Morton’s neuroma, joint irritation, or bone stress.

Sprain vs Fracture vs Stress Fracture

Sprain: often follows a twist or roll, causes swelling and bruising around the joint, and tends to hurt most with movement and walking.

Fracture: is more likely after a stronger injury, with marked bony tenderness, heavier swelling, and difficulty weight-bearing.

Stress fracture: often builds gradually, feels localised over bone, and worsens with repeated loading such as running, jumping, or long walks.

Do You Need an X-ray for Foot or Ankle Pain?

You may need an X-ray when a fracture is reasonably suspected after an acute injury. The Ottawa Ankle Rules help guide whether imaging is appropriate after a recent ankle or midfoot injury, rather than ordering scans for every sprain.

For ankle injuries, an X-ray is usually considered when there is pain in the malleolar zone plus one of the following:

  • bone tenderness along the back edge or tip of the lateral malleolus
  • bone tenderness along the back edge or tip of the medial malleolus
  • inability to bear weight for four steps both immediately and at assessment

For foot injuries, an X-ray is usually considered when there is midfoot pain plus one of the following:

  • bone tenderness at the base of the fifth metatarsal
  • bone tenderness at the navicular
  • inability to bear weight for four steps both immediately and at assessment

An X-ray is less reliable for early stress fractures, so persistent bony pain may need further review even if an initial X-ray is clear. Persistent load-related pain should not be ignored.

What Are the Red Flags for Foot and Ankle Pain?

Red flags include deformity, severe swelling, inability to walk, sudden calf or heel pain with a pop, a hot or feverish joint, or pain that is severe and worsening rather than gradually settling. These patterns can suggest fracture, dislocation, infection, Achilles rupture, or another more serious injury.

If you have swelling with redness and fever, or the ankle feels obviously unstable after trauma, arrange urgent medical assessment. If the pain developed gradually but is sharp, localised over bone, and worsens with impact, consider a bone stress injury rather than “just a strain”.

Can You Keep Walking on Foot and Ankle Pain?

Yes, sometimes. You can usually keep gentle walking if pain stays mild, your limp does not worsen, and symptoms settle after activity.

Reduce load if pain increases during the walk, changes your gait, or leaves you worse later that day.

Stop and get checked if you cannot walk four steps, the pain is sharp over bone, or the ankle feels unstable after injury.


Foot and ankle pain balance exercise with physiotherapist checking control

Rebuilding ankle and foot control

How Is Foot and Ankle Pain Treated?

Treatment depends on the cause, stage, and severity of the problem. Many people improve with a combination of load modification, manual therapy, exercise rehabilitation, taping or bracing, footwear advice, and a graded return to walking, work, or sport.

For example, ankle pain physiotherapy often includes mobility work, calf and lower-leg strengthening, balance training, and confidence rebuilding. Broader physiotherapy treatment may also include hands-on care, diagnosis clarification, and a structured plan for recovery.

Who Should You See for Foot or Ankle Pain?

A physiotherapist is a sensible first step for many foot and ankle pain presentations, especially if you are unsure whether the problem is a sprain, tendon issue, overload injury, or something more significant. A physiotherapist can assess the pattern, guide early management, and tell you when medical imaging or medical referral may be needed.

In some cases, you may also need a GP, sports doctor, podiatrist, or orthopaedic opinion. That is more likely when the pain is severe, the diagnosis is unclear, symptoms keep recurring, or a fracture, infection, or surgical problem is suspected.

Top 6 FAQs About Foot and Ankle Pain

Is foot and ankle pain always a sprain?

No. A sprain is common, especially after a twist, but foot and ankle pain can also come from tendon overload, joint irritation, arthritis, plantar fascia pain, nerve irritation, or a fracture. The history, pain location, swelling pattern, and ability to load the leg help narrow it down.

How do you know if foot and ankle pain could be a fracture?

A fracture becomes more likely if you have bony tenderness, marked swelling, a clear traumatic mechanism, difficulty weight-bearing, or pain that feels deeper and sharper than a typical soft-tissue sprain. The Ottawa Ankle Rules help guide when imaging is worth considering after an acute injury.

Can physiotherapy help foot and ankle pain?

Yes, physiotherapy may help many causes of foot and ankle pain by clarifying the diagnosis, reducing irritation, improving movement, rebuilding strength, and progressing you back to walking or sport. It is especially useful when symptoms linger, keep returning, or are linked to weakness, stiffness, balance, or overload.

When should you stop sport or exercise?

You should reduce or stop impact loading if pain alters your walking, worsens during the session, spikes afterwards, or leaves you limping the next day. That does not always mean complete rest. It usually means changing the type, amount, or intensity of loading until the area calms down.

Is swelling always a sign of serious injury?

No. Swelling is common after ankle sprains and other soft-tissue injuries. However, heavy swelling with deformity, inability to walk, intense pain, or a hot red joint is more concerning and should be assessed sooner. The context matters more than the swelling alone.

Should you get an MRI for foot and ankle pain?

Not always. MRI is usually reserved for cases where the diagnosis remains unclear, symptoms do not follow the expected recovery path, or a stress fracture, tendon tear, cartilage injury, or more complex foot problem is suspected. Many common sprains and overload issues can be assessed well without early MRI.

Foot and ankle pain walking gait retraining during recovery
Returning to smooth, comfortable walking

What to Do Next

If your foot and ankle pain is severe, keeps returning, or is not improving, book an assessment rather than guessing. Early review can help rule out more serious injury, explain what is driving your pain, and give you a plan that matches your work, walking, exercise, and sport goals.

If you are not sure where to start, see our symptoms search, foot pain, or ankle pain guides for the next best step.

Choose your clinic and appointment pathway

Select a PhysioWorks clinic to continue to live booking, an appointment request or reception assistance.

In some cases, temporary support such as braces, taping, or compression can help protect the area and improve confidence while you recover.

Ankle Products

These ankle products are commonly used by our physiotherapists to improve ankle pain, strength, balance, proprioception, endurance and flexibility, plus assist home exercise programs.

View all ankle products

Follow PhysioWorks

Get physiotherapy tips, exercise videos, recovery advice and blog updates.

References

  1. Gomes YE, Chau M, Banwell HA, Causby RS. Diagnostic accuracy of the Ottawa ankle rule to exclude fractures in acute ankle injuries in adults: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2022;23(1):885. doi:10.1186/s12891-022-05831-7
  2. Smith SE, Chang EY, Ha AS, et al. ACR Appropriateness Criteria® Acute Trauma to the Ankle. J Am Coll Radiol. 2020;17(11S):S355-S366. doi:10.1016/j.jacr.2020.09.014
  3. Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther. 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302
  4. Paavana T, Rammohan R, Hariharan K. Stress fractures of the foot - current evidence on management. J Clin Orthop Trauma. 2024;50:102381. doi:10.1016/j.jcot.2024.102381

What Are the Most Common Running Injuries?

Runner with knee pain pointing to knee during physiotherapy assessment in clinic

Running injuries most often affect the knee, shin, Achilles tendon, calf, foot and hip. Many develop gradually when a recent running demand exceeds the capacity of a muscle, tendon, joint or bone.

Common pattern

Pain builds during a run, appears afterwards or feels worse the next morning.

Important clue

Symptoms often follow a change in distance, speed, hills, frequency, surface or recovery.

Seek assessment

Book earlier when pain changes your stride, causes limping or becomes sharp and localised.

Which running injuries are most common?

Running-related injuries can affect muscles, tendons, joints, bones and other supporting tissues. Some start suddenly, such as an ankle sprain or calf strain. However, many build over several runs as repeated loading exceeds the tissue’s current capacity.

The eight conditions below account for many of the knee, shin, calf, heel, foot and thigh symptoms reported by recreational runners.

Runner’s knee

Pain around or behind the kneecap. It commonly becomes noticeable during hills, stairs, squats or longer runs.

Shin splints

A broader area of exercise-related pain along the shin. Symptoms often follow a change in impact load or training volume.

Achilles tendinopathy

Pain and stiffness around the Achilles tendon. Morning stiffness and discomfort at the start of running are common features.

Plantar fasciopathy

Pain under the heel or arch. The first steps after rest may feel uncomfortable before symptoms ease with movement.

ITB syndrome

Pain around the outside of the knee. It may appear at a similar point during each run, particularly on hills.

Calf strain

A sudden or gradually worsening pain in the calf. Faster running, sprinting and hills can increase calf demand.

Hamstring injury

Pain at the back of the thigh or near the sitting bone. Symptoms may affect faster running, acceleration and longer strides.

Bone stress injury

Focal bone pain that may progress from running pain to discomfort with hopping, walking or normal daily activity.

Where do runners commonly feel pain?

Front or outside of the knee

Front-of-knee pain may relate to runner’s knee, also called patellofemoral pain. Symptoms often become noticeable during downhill running, stairs, squats or after sitting with the knee bent.

Pain on the outside of the knee may fit an iliotibial band presentation. However, several knee structures can cause pain in a similar area. The location alone does not confirm a diagnosis.

Along the shin

A broad area of tenderness along the inner shin often fits shin splints. By contrast, a small and sharply localised painful area raises more concern about a bone stress injury.

Shin pain warrants earlier assessment when hopping is painful, symptoms persist after exercise or discomfort begins affecting walking.

Behind the ankle or in the calf

Achilles tendinopathy commonly causes pain, stiffness or thickening around the tendon. Symptoms may feel worse during the first steps in the morning or when beginning a run.

A calf strain is more likely when pain starts suddenly during acceleration, hills or faster running. Significant weakness, swelling or difficulty pushing through the foot requires prompt assessment.

Under the heel or through the foot

Plantar fasciopathy often causes pain under the heel, particularly during the first few steps after getting out of bed or standing after rest.

Forefoot pain has several possible causes, including metatarsal overload, nerve irritation and bone stress. Persistent focal pain should not be managed simply by continuing to run through it.

At the hip, groin or back of the thigh

Hip and thigh symptoms may involve the gluteal tendons, hamstrings, hip joint or surrounding muscles. Proximal hamstring symptoms often sit close to the lower buttock and may become uncomfortable during faster running or prolonged sitting.

Groin pain has several possible sources. Assessment becomes more important when pain persists, affects walking or does not settle after a reasonable reduction in training.

Why do running injuries happen?

Running injuries rarely have one isolated cause. Instead, they usually reflect an interaction between recent training, previous injuries, recovery, health, tissue capacity and the demands of the runner’s chosen pace, terrain and distance.

Common contributing factors may include:

  • A longer individual run than your body has recently tolerated
  • Adding speed, hills and distance within the same training period
  • Returning quickly after illness, injury or a break from running
  • Insufficient recovery between demanding sessions
  • Reduced calf, thigh, hip or trunk capacity
  • A previous injury that has not regained full strength or running tolerance
  • A sudden change in shoes, running surface or training environment

What are the early signs of a running injury?

An early running injury does not always begin with severe pain. Mild changes in comfort, stiffness or movement can appear before running becomes significantly limited.

During running

Pain starts earlier, becomes stronger or makes you shorten your stride.

After running

Soreness lasts longer than expected or increases later in the day.

The next morning

Stiffness, tenderness or pain is worse than your usual post-training response.

Other warning signs include swelling, reduced push-off strength, repeated pain at the same running distance and declining confidence in the affected leg.

Can you keep running with an injury?

Some runners can continue with a temporarily reduced load. Others need to pause running while the injury is assessed. The safest choice depends on the suspected tissue, symptom severity and how the condition responds during and after exercise.

Consider reducing or stopping the run when:

  • Pain continues to increase as you run
  • Your stride changes or you begin to limp
  • Symptoms remain clearly worse the following morning
  • You have sharp or highly localised bone pain
  • You lose strength, balance or confidence in the leg
  • Running causes increasing swelling

A minor symptom that remains mild, does not alter movement and settles promptly may allow a modified run. However, repeatedly testing an injury with the same aggravating session can delay recovery.

How are running injuries assessed?

A physiotherapy assessment usually begins by clarifying where symptoms started, how they respond to running and what changed before the problem developed.

Your assessment may include:

  1. Reviewing your recent training

    Your physiotherapist may compare distance, pace, hills, speed sessions, surfaces, footwear, recovery and recent interruptions to training.

  2. Examining the painful area

    Palpation, movement testing and relevant clinical tests help identify which tissues may be contributing.

  3. Checking strength and movement capacity

    Testing may include calf raises, hopping, squats, step tasks, hip strength or other movements matched to your symptoms.

  4. Reviewing your running where useful

    A running assessment can examine relevant movement patterns and how they interact with your current injury and training demands.

Imaging is not required for every running injury. However, a medical referral or imaging may be appropriate when the assessment suggests a fracture, significant tendon injury or another condition needing further investigation.

Physiotherapist guiding step-up exercise for lower limb strength and rehabilitation in clinic

How can physiotherapy help a running injury?

Physiotherapy aims to identify the likely injury, reduce aggravating load and rebuild the capacity needed for running. Your plan should reflect the affected tissue, your current symptoms and the type of running you want to resume.

Management may include:

  • Temporary changes to running distance, pace, hills or frequency
  • Progressive calf, knee, hamstring, hip or trunk strengthening
  • Mobility work when a relevant restriction affects function
  • Advice about footwear, surfaces and training structure
  • Movement or running retraining when it has a clear clinical purpose
  • A staged return-to-run program
  • Testing before faster running, hills or longer distances resume

Passive treatment may help some symptoms in the short term. However, rebuilding load tolerance and gradually returning to running usually remain central to rehabilitation.

Runners with recurring symptoms may also benefit from a dedicated running injury risk and performance assessment.

How can you reduce your risk of another running injury?

No strategy can prevent every injury. Even so, sensible progression and adequate recovery can reduce avoidable overload.

  1. Build one demand at a time

    Avoid making large increases in distance, speed and hills simultaneously.

  2. Watch individual long-run changes

    Compare a planned longer run with the longest distance you have completed recently, not only your weekly total.

  3. Keep regular strength work

    Calf, thigh, hamstring, hip and trunk exercises can support the physical demands of running.

  4. Respond early to warning signs

    Modify training when pain escalates, changes your stride or remains worse the following morning.

  5. Return gradually after a break

    Fitness can return faster than the load tolerance of bones, tendons and muscles after time away.

When should a runner book an assessment?

Consider booking a physiotherapy assessment when:

  • Pain is changing your running technique
  • You cannot progress training without another flare-up
  • Symptoms are worsening from one session to the next
  • Morning pain or stiffness is becoming more noticeable
  • Pain is sharply localised over a bone
  • You have swelling, weakness or difficulty walking
  • You are unsure how much running is currently safe

Earlier assessment is especially useful when a stress fracture, significant calf injury or Achilles tendon injury is possible.

Common running injury FAQs

What is the most common running injury?

Knee pain, including runner’s knee or patellofemoral pain, is consistently among the most frequently reported running injuries. Shin splints, Achilles tendinopathy and plantar heel pain are also common.

Are most running injuries caused by overuse?

Many running injuries develop gradually through repeated loading rather than one traumatic event. However, “overuse” does not identify one cause. Training changes, recovery, previous injury, health and tissue capacity can all contribute.

What are the first signs of a running injury?

Early signs may include pain that begins sooner during a run, soreness that lasts longer afterwards, increasing morning stiffness or a subtle change in stride. Repeated symptoms at a similar distance also deserve attention.

Should I stop running when I have pain?

Stop or reduce running when pain escalates, changes your gait, causes swelling or remains clearly worse the following morning. Mild symptoms that settle promptly may allow modified activity, but the safe approach depends on the injury.

When is shin pain more serious?

Shin pain is more concerning when it is sharply localised, painful with hopping, present during walking or continuing after exercise. These features may indicate a bone stress injury and should be assessed promptly.

Can a running assessment prevent injuries?

A running assessment cannot guarantee injury prevention. It may identify useful changes to strength, training, recovery or movement when interpreted alongside your symptoms, injury history and running goals.

What causes knee pain when running?

Running-related knee pain may involve the patellofemoral joint, iliotibial band, patellar tendon or another structure. Training changes, reduced tissue capacity and a previous injury can contribute, so persistent pain should be assessed rather than diagnosed from location alone.

What should you do next?

Use the links above to compare your painful area with the most relevant condition guide. Meanwhile, reduce the running sessions that clearly aggravate your symptoms rather than repeatedly testing the same painful load.

Book an assessment when pain is changing your stride, limiting normal training or becoming more localised. A clear diagnosis and staged rehabilitation plan can help you return to running with appropriate progression.

Choose your clinic and appointment pathway

Select a PhysioWorks clinic to continue to live booking, an appointment request or reception assistance.

Follow PhysioWorks

Get physiotherapy tips, exercise videos, recovery advice and blog updates.

References

  1. Correia CK, Machado JM, Dominski FH, de Castro MP, Fontana HB, Ruschel C. Risk factors for running-related injuries: an umbrella systematic review. Journal of Sport and Health Science. 2024;13(6):743–757. doi:10.1016/j.jshs.2024.04.011.
  2. Frandsen JSB, Hulme A, Nielsen RO, et al. How much running is too much? Identifying high-risk running sessions in a 5200-person cohort study. British Journal of Sports Medicine. 2025;59(17):1203–1211.
  3. Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. Journal of Sport and Health Science. 2021;10(5):513–522. doi:10.1016/j.jshs.2021.04.001.

What Is the Most Effective Foot Pain Treatment?

The most effective foot pain treatment depends on the cause of the pain, the tissue involved and how much load your foot can currently tolerate.

Article by John Miller & Erin Runge
Physiotherapist supervising a balance and foot strengthening exercise
A foot pain rehabilitation plan may include balance, strength and gradual loading exercises matched to the diagnosis.

Pain beneath the heel may require a different approach from pain in the ball of the foot, a tendon problem, a joint injury or a foot stress fracture. Therefore, identifying the likely source of your symptoms is an important first step.

For information about common causes, symptoms and assessment, visit our main Foot Pain guide.

Why Does Foot Pain Treatment Vary?

The foot contains many bones, joints, muscles, tendons, ligaments and nerves. Several conditions may cause pain in a similar area even though they need different treatment plans.

Heel pain

Conditions such as plantar fasciitis may respond to education, taping, stretching, progressive loading and selected footwear changes.

Forefoot pain

Metatarsalgia and related conditions may require changes to footwear, activity, pressure distribution and foot strength.

Tendon pain

Tendon problems usually need progressive loading matched to the affected tendon and its current capacity.

Bone stress injury

A suspected stress reaction or fracture may require prompt assessment and temporary protection from impact loading.

Joint or ligament injury

Management may include protection, movement restoration, strengthening and a staged return to walking, work or sport.

Nerve-related pain

Burning, tingling, numbness or shooting pain may require assessment of the foot and other possible sources along the nerve pathway.

What May Be Included in a Foot Pain Treatment Plan?

Adjusting the aggravating load

You may need to temporarily reduce or change the activity that repeatedly aggravates your foot. This does not always mean complete rest. Instead, the aim is to find a level of walking, work, exercise or sport that your foot can tolerate without a sustained increase in symptoms.

More protective management may be required after significant trauma or when a bone stress injury is suspected. In selected cases, this may include a brace, supportive shoe or walking boot.

Progressive exercise

Exercise should match the painful structure and your functional goals. A rehabilitation program may include:

  • calf and foot muscle strengthening;
  • toe and arch control exercises;
  • balance and single-leg control;
  • ankle mobility when a relevant restriction is present;
  • graded walking or running exposure; and
  • work-specific or sport-specific rehabilitation.

Useful supporting information includes our guides to active foot posture correction exercises, strength training and closed kinetic chain exercises.

Footwear and pressure management

Suitable footwear may improve comfort by changing pressure, cushioning or stability. The right choice depends on the diagnosis, foot shape, activity and work demands.

Selected people may also benefit from temporary padding, heel cups, taping or foot orthoses. These supports should address a specific problem rather than substitute for rehabilitation when strength and load tolerance also need attention.

Movement and activity assessment

A physiotherapist may assess walking, balance, calf capacity, foot control and the activities that reproduce your symptoms. Runners may benefit from a targeted running analysis, while other presentations may need a broader gait analysis.

Short-term symptom support

Taping, activity modification, manual therapy or soft-tissue treatment may help some people move more comfortably during rehabilitation. However, passive treatment alone usually does not rebuild the strength and capacity required for lasting activity tolerance.

How Much Pain Is Acceptable During Rehabilitation?

A small and temporary increase in symptoms may be acceptable during some rehabilitation programs. However, the appropriate response depends on the diagnosis.

Exercise or activity should be reviewed when pain becomes sharp, causes limping, continues to rise after the activity or remains clearly worse later that day or the following morning. Suspected fractures and acute traumatic injuries require more cautious loading than many gradual-onset tendon or plantar heel conditions.

When Should Foot Pain Be Assessed?

Consider an assessment when pain:

  • persists or repeatedly returns;
  • limits walking, standing, work, exercise or sport;
  • started after a sudden increase in running, jumping or other weight-bearing activity;
  • causes you to limp or avoid loading the foot;
  • includes burning, tingling, numbness or weakness; or
  • has not improved with sensible short-term activity changes.

Will You Need a Scan?

Many foot problems can initially be assessed from the history and physical examination. Imaging may be considered when the findings suggest a fracture, bone stress injury, significant joint injury, persistent unexplained pain or another condition that could change management.

A scan should answer a clinical question. Imaging findings also need to be interpreted alongside your symptoms and examination rather than treated in isolation.

What Should You Do Next?

Start by reducing the activities that clearly aggravate the pain while maintaining comfortable movement where appropriate. Check whether your footwear is worn, poorly fitted or unsuitable for the activity.

Persistent or limiting symptoms benefit from a diagnosis-led plan. A physiotherapist can assess the painful region, explain likely contributing factors and build a staged program for walking, work, exercise or sport.

Choose your clinic and appointment pathway

Select a PhysioWorks clinic to continue to live booking, an appointment request or reception assistance.

Feet Products

These feet products are commonly used by our physiotherapists to improve support, comfort, strength, balance, flexibility, and home exercise programs.

View all feet products

Follow PhysioWorks

Get physiotherapy tips, exercise videos, recovery advice and blog updates.

References

  1. Koc TA Jr, et al. Heel Pain—Plantar Fasciitis: Revision 2023. Journal of Orthopaedic & Sports Physical Therapy. 2023;53(12):CPG1–CPG39. View the plantar heel pain clinical practice guideline.
  2. Morrissey D, et al. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. British Journal of Sports Medicine. 2021;55(19):1106–1118. View the plantar heel pain best-practice guide.
  3. Ruiz-Ramos M, et al. Effectiveness of bespoke or customised orthotic treatment in plantar pressure reduction of the central metatarsal heads: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2024. View the metatarsalgia orthoses review.

Foot Pain Treatment FAQs

What is the most effective foot pain treatment?

The most effective treatment matches the diagnosis and commonly combines appropriate activity changes, progressive exercise, footwear advice and gradual reloading. Taping, braces, orthoses or hands-on treatment may help selected conditions.

Can foot pain improve without treatment?

Mild foot pain may improve after reducing an aggravating activity and wearing suitable footwear. Assessment is recommended when pain persists, returns, worsens or limits normal activity.

How long does foot pain take to improve?

Recovery may take days, weeks or several months depending on the diagnosis, severity, symptom duration and required activity level. Bone, tendon and long-standing overload problems often recover more slowly than a minor irritation.

Should you rest a painful foot completely?

Complete rest is not required for every foot problem. Many conditions respond better to temporary load reduction followed by gradual activity and exercise. A fracture or significant acute injury may need greater protection.

Are orthotics necessary for foot pain?

No. Orthotics may help selected people by changing pressure or improving comfort, but they are not required for every condition. Footwear, exercise and load management may be equally or more important.

When should foot pain be assessed urgently?

Seek prompt care after major trauma, if you cannot bear weight, or when there is marked swelling, redness, heat, discolouration, an open wound, fever, rapidly increasing pain, significant numbness or weakness.

Shoe Size Conversion Chart

Shoe size conversion chart for men and women showing US, UK, Australian and European sizes with stylish shoes at the top corners.

Use this shoe size conversion chart as a starting point before checking fit.

This shoe size conversion chart helps you compare Australian, US, UK, European and centimetre shoe sizes. It is useful when you buy shoes online, travel overseas, or compare brands that use different sizing systems.

Shoe sizing is a guide only. A better fitting shoe should feel comfortable through the heel, midfoot and toe box. Correct footwear can also help reduce unwanted pressure on your feet, ankles, knees and lower back.

Quick Fit Checklist

  • Leave a thumb-width of space in front of your longest toe.
  • Check that your heel feels secure and does not slip.
  • Make sure the toe box is wide enough for your foot shape.
  • Try shoes later in the day when feet may be slightly larger.
  • Use brand-specific sizing charts when available.

What Do You Need Help With?

How Do You Use a Shoe Size Conversion Chart?

Use a shoe size conversion chart by finding your usual size in one system, then following the row across to compare other systems. For example, an Australian men’s size 8 usually aligns closely with a UK 8, US men’s 9 and European 42.

However, sizing varies between brands, shoe styles and foot shapes. Running shoes, work shoes, school shoes and fashion shoes may all fit differently. If pain persists despite changing shoes, a physiotherapist may assess your walking pattern, foot posture and load tolerance.

Common Shoe Sizing Mistakes

  • Choosing size based only on the number, not fit.
  • Ignoring width and toe box shape.
  • Buying shoes early in the day when feet may be smaller.
  • Assuming all brands fit the same.
  • Not accounting for foot swelling during sport or long walks.

International Shoe Size Conversion Chart

The table below compares common adult shoe sizes. On mobile, scroll sideways to view the full chart.

Sizing system Size 1 Size 2 Size 3 Size 4 Size 5 Size 6 Size 7 Size 8 Size 9
Australian Men’s 4 5 6 7 8 9 10 11 12
Australian / US Women’s 6 7 8 9 10 11 12 13 14
US Men’s 5 6 7 8 9 10 11 12 13
European 37 38 39.5 40.5 42 43 44.5 46 47
UK 4 5 6 7 8 9 10 11 12
Foot length in cm 22.8 23.7 25.1 25.4 26.3 27.1 28.0 28.8 29.6

Tip: Scroll sideways on mobile to view all sizes.

Important: conversion charts provide an estimate only. Shoe width, arch shape, toe box space and heel hold often matter as much as the number printed inside the shoe.

Do Different Shoes Fit Differently?

Yes. Shoe fit varies depending on purpose, brand and design. A size that feels right in one shoe may feel too narrow, loose or short in another.

  • Running shoes: often need extra toe room for swelling and repeated impact.
  • Work shoes: usually need support, durability and a secure heel fit.
  • Dress shoes: may feel narrower or firmer through the forefoot.
  • Sports shoes: should match the movement demands of the sport.
  • School shoes: need enough room for growth without slipping.

Why Does Correct Shoe Size Matter?

Correct shoe size matters because tight, loose or poorly shaped shoes can increase pressure on the foot and alter how you move. This may contribute to blisters, toe pain, bunions, plantar fasciitis, heel pain or lower limb discomfort.

Incorrect shoe size can contribute to specific symptoms such as:

Research on occupational footwear also links inappropriate footwear with pain in the foot, ankle, knee, hip and lower back. For general footwear advice, Better Health Channel notes that correctly fitted, supportive shoes can help protect foot health and comfort.

How Should Shoes Fit?

A well-fitting shoe should feel secure at the heel, comfortable across the midfoot and roomy enough around the toes. Your toes should not feel squeezed, and the shoe should match the activity you plan to use it for.

  • Toe room: leave space for your longest toe, not just your big toe.
  • Width: avoid shoes that press across the forefoot.
  • Heel fit: avoid excessive slipping at the back of the shoe.
  • Support: choose support based on your foot shape, activity and symptoms.
  • Activity match: running, walking, work and dress shoes have different demands.

If you run regularly, also see our guide to choosing running shoes and our article on running pain versus running injuries.

When Should You Seek Help for Shoe-Related Foot Pain?

Seek help if foot, ankle, knee or back pain continues after changing shoes, reducing load or checking your size. Persistent symptoms may relate to footwear, strength, mobility, walking pattern, training load or an underlying foot condition.

A physiotherapist can assess your movement, discuss footwear choices and guide a plan for pain, activity and exercise. This may include advice about orthotics, calf strength, foot posture, load management or footwear changes.

Still Not Sure About Your Shoe Size?

If your shoes feel uncomfortable or your pain continues, a physiotherapist can assess your foot shape, walking pattern and footwear to guide the right choice.

What To Do Next

If your shoes fit well but pain continues, book a physiotherapy assessment. We can check whether your symptoms are coming from your foot, ankle, knee, hip or lower back, then guide your next steps.

Choose your clinic and appointment pathway

Select a PhysioWorks clinic to continue to live booking, an appointment request or reception assistance.

Feet Products

These feet products are commonly used by our physiotherapists to improve support, comfort, strength, balance, flexibility, and home exercise programs.

View all feet products

Follow PhysioWorks

Get physiotherapy tips, exercise videos, recovery advice and blog updates.

FAQs About Shoe Size Conversion

How do I convert US shoe size to UK?

For many adult shoes, subtract 1 from a US men’s size to estimate the UK size. For women’s shoes, the difference is often about 2 sizes. However, always check the brand’s own sizing chart because sizing can vary.

Are Australian shoe sizes the same as UK sizes?

Australian men’s shoe sizes are often close to UK men’s sizes. Australian women’s sizing often follows US women’s sizing. Use the shoe size conversion chart as a guide, then confirm comfort by checking length, width and heel fit.

What does EU shoe size mean in Australia?

EU shoe size refers to the European sizing system. To compare it with Australian sizing, find the EU size in the conversion chart and follow the same row across to the Australian men’s or women’s size.

How do I measure my feet for shoes?

Place your foot on paper, trace around it, then measure from the heel to the longest toe. Measure both feet and use the longer foot as your guide. Also check width, as length alone may not give a comfortable fit.

Can the wrong shoe size cause foot pain?

Yes. Shoes that are too tight, loose, narrow or poorly shaped may contribute to pressure areas, blisters, heel pain, bunions or changes in walking pattern. Persistent pain should be assessed rather than managed by shoe changes alone.

Should running shoes be a bigger size?

Many runners choose slightly more toe room because feet can swell during longer runs. The shoe should still feel secure around the heel and midfoot. Avoid excessive movement inside the shoe, as this may increase rubbing or instability.

Related Articles

  1. Choosing the Right Running Shoes - Compare footwear choices for running comfort and injury prevention.
  2. Running Pain Versus Running Injuries - Learn when running discomfort may need assessment.
  3. Foot Pain Conditions - Review common foot problems and treatment pathways.
  4. Plantar Fasciitis - Read about common causes of heel and arch pain.
  5. Bunions - Learn how bunions can affect footwear comfort.
  6. Orthotics - See when shoe inserts may support foot comfort.
  7. Heel Pain Causes - Review common reasons for heel pain.
  8. Achilles Tendinopathy - Learn how footwear and load may affect Achilles pain.
  9. Diabetes and Foot Health - Read about foot care considerations for people with diabetes.
  10. Active Foot Posture Exercises - Build better foot control and strength.

References

  1. Pereira-Barriga MC, Borrero-Hernández JM, García-Sanz-Calcedo J, et al. A review of the injuries caused by occupational footwear. Occupational Medicine. 2024;74(3):218-225.
  2. Orr RM, Maupin D, Palmer R, Canetti EFD, Simas V, Schram B. The impact of footwear on occupational task performance and musculoskeletal injury risk: a scoping review to inform tactical footwear. International Journal of Environmental Research and Public Health. 2022;19(17):10703.
  3. Better Health Channel. Choosing the right shoe. Victorian Government.
  4. Better Health Channel. Footwear for healthy feet. Victorian Government.
  5. Healthdirect Australia. Foot care. Australian Government-funded health information service.
You've just added this product to the cart: