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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.

John Miller Physiotherapist Chelsea Gan Physiotherapist
Article by John Miller & Chelsea Gan
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.

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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.

Foot pain

Explore common foot conditions, symptoms and treatment pathways.

Ankle pain

Review ankle injuries and other common sources of pain or swelling.

Heel pain

Compare common causes of pain beneath, behind or around the heel.

Plantar fasciitis

Learn about plantar heel pain and common rehabilitation approaches.

Sprained ankle

Review ankle-sprain treatment, rehabilitation and return to activity.

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

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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

John Miller Physiotherapist Erin Runge Physiotherapist
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.

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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.

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

Not sure what to choose? Compare appointment types
View all clinic locations and phone numbers

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

John Miller Physiotherapist Chelsea Gan Physiotherapist
Article by John Miller & Chelsea Gan
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.

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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.

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

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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

Common Running Injuries

John Miller Physiotherapist Chelsea Gan Physiotherapist
Article by John Miller & Chelsea Gan
Runner with knee pain pointing to knee during physiotherapy assessment in clinic

Running-related knee pain assessed in clinic

Common running injuries usually develop when repeated running load exceeds tissue capacity.

Common running injuries most often affect the knee, shin, calf and Achilles, and foot. Common examples include shin splints, runner’s knee, Achilles tendinopathy, plantar fasciopathy, and stress fractures.

If your pain keeps returning, changes your stride, or stops you training normally, it is worth comparing this page with our broader running injuries guide and sports injuries hub. These pages help you work out whether the issue is more likely to be a training-load problem, a tendon or joint overload issue, or something that needs earlier assessment.

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Common signs of running overload

  • Pain that builds during or after a run
  • Morning stiffness in the Achilles, calf or foot
  • Localised shin or bone pain after load spikes
  • Knee pain with hills, stairs or downhill running
  • Symptoms that keep returning when mileage increases

What are common running injuries?

Common running injuries are overuse or impact-related problems affecting muscles, tendons, joints, bones, or supporting tissues during training. They usually build gradually rather than appearing from one single incident, although some runners also develop acute injuries such as a rolled ankle, muscle tear, or sudden calf pain.

Most runners experience pain in one of a few predictable regions. That is why the best page structure for common running injuries is not just one long list. It should help readers match their symptoms to the right body region and then move to the most relevant condition page.

Why do running injuries happen?

Most running injuries happen because your training load rises faster than your tissues can adapt. This can occur when volume, pace, hills, shoes, surface, recovery, or strength work change too quickly. In other words, the issue is often not running itself, but how much load your body is being asked to tolerate.

Common contributors include sudden weekly kilometre increases, too much speed work, back-to-back harder sessions, poor recovery, reduced calf or hip strength, limited running preparation, and returning too quickly after time off. A running analysis or sports physiotherapy assessment can help identify which factors are most relevant to you.

Most common running injuries by body region

The most common running injuries usually cluster around the tissues that absorb and transfer repeated force. The main hotspots are the knee, shin, calf-Achilles complex, foot, hip-groin region, and lower back. Start with the painful area, then use the links below to drill down to the most likely condition pages.

Assessment helps identify which tissues are overloaded and guide the right treatment approach.

Lower limb physiotherapy assessment with single-leg stance evaluating knee, shin and foot alignment

Assessing lower limb alignment during single-leg stance

Lower limb alignment and control play a key role in common running injuries, particularly affecting the knee, shin, calf and foot during repeated load.

Knee injuries

Knee pain is one of the most common complaints in runners, especially during mileage increases, hills, or downhill running. Front-of-knee pain often links with runner’s knee or patellofemoral pain syndrome, while outer knee pain may relate to ITB syndrome.

Shin injuries

Shin pain is common when impact load, hills, speed work, or total volume rise too fast. The most common diagnosis is shin splints, but more focal pain may suggest a stress fracture or another bone stress problem.

Calf and Achilles injuries

Calf and Achilles pain often flare when runners add hills, speed, sprinting, or faster training blocks. Morning stiffness is common with Achilles tendinopathy, while sudden sharp pain may point to a calf tear. Runners with persistent calf tightness, Achilles soreness, or reduced push-off power often benefit from earlier loading advice and progressive strengthening.

Foot and heel injuries

Foot pain often relates to repeated loading through the arch, heel, forefoot, or smaller stabilising tendons. Heel pain may reflect plantar fasciopathy, while metatarsal or localised forefoot pain may need assessment for a foot stress fracture. Foot symptoms that worsen with longer runs, harder surfaces, or reduced recovery often respond best when footwear, load, and strength are reviewed together.

Hip, thigh and groin injuries

Runners can also develop overload in the hip and pelvis, especially when strength, control, or recovery are lagging behind training demand. Common examples include hamstring strain, gluteal tendinopathy, groin strain, and higher-risk bone stress problems such as femoral stress fracture.

Back and trunk-related pain

Some runners develop lower back symptoms because fatigue, stiffness, or trunk load tolerance cannot keep pace with training. This may present as lower back pain, back muscle pain, or symptoms linked with reduced trunk control.

Why do runners get shin pain?

Runners usually get shin pain when impact load, hills, speed work, or training volume rise faster than the lower leg can adapt. The most common causes are shin splints and bone stress problems, so localised pain that worsens with hopping or lingers after exercise deserves earlier review.

If your pain is broad and exercise-related, shin splints may be more likely. If it is small, sharp, and very local, compare your symptoms with a stress fracture or foot stress fracture.

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

Step-up exercise to rebuild strength and control

Step-up exercises can help rebuild lower limb strength, balance and running control during rehabilitation.

How Can Physiotherapy Help Common Running Injuries?

Physiotherapy for common running injuries usually focuses on settling irritation, improving tissue capacity, and grading your return to running. Treatment may include load modification, strength work, calf and hip conditioning, mobility where needed, footwear or training advice, and progressive return-to-run planning.

For some runners, the key issue is simply doing too much too soon. For others, the problem is repeated exposure to hills, speed work, poor recovery, or reduced control through the calf, hip, or trunk. A good plan matches the tissue involved and the demands of your running. This is also where running analysis can add value.

What to watch during training

  • Sharp increases in weekly kilometres
  • Adding speed and hills at the same time
  • Ignoring pain that changes your stride
  • Morning stiffness that is worsening, not easing
  • Localised bone pain that lingers after running

When runners should book an assessment

  • Pain changes your running style or causes limping
  • Symptoms keep returning with mileage increases
  • Morning stiffness is worsening rather than easing
  • Bone pain feels sharp, focal, or lingers after exercise

When should you worry about common running injuries?

You should worry about common running injuries when pain becomes localised, changes your running pattern, causes swelling or limping, wakes you at night, or keeps returning despite rest and modified training. These features increase the chance that you need a clearer diagnosis and a more structured rehabilitation plan.

Seek earlier assessment if you suspect a stress fracture, have calf pain that feels sudden or severe, develop marked swelling, or cannot run without compensating. Even when the injury is not serious, earlier guidance often shortens the downtime and reduces the chance of a repeat flare-up.

How can you reduce the risk of common running injuries?

You can reduce the risk of common running injuries by progressing load gradually, spacing harder sessions sensibly, building calf and hip strength, and monitoring how your body responds to each training block. Prevention is less about one magic exercise and more about managing overall running stress well.

Many runners do well when they combine graded mileage progression with simple strength work, recovery planning, and early response to warning signs. If you are unsure whether your issue is training-related, our pages on running injuries, running analysis, and sports physiotherapy are good next steps.

Common running injuries FAQs

What is the most common running injury?

The most common running injury varies between studies, but knee pain presentations such as runner’s knee and patellofemoral pain are consistently common. Shin splints, Achilles tendon pain, plantar fasciopathy, and stress-related bone pain also appear regularly in both recreational and more experienced runners.

Are most running injuries overuse injuries?

Yes. Most running injuries are overuse-related rather than caused by one dramatic event. They usually develop when repeated impact and training stress outpace the body’s ability to recover and adapt, especially during volume increases, hill work, speed blocks, or a quick return after time off.

What are the first signs of a running injury?

Early signs often include stiffness at the start of a run, pain that builds during or after running, local soreness the next morning, or symptoms that flare every time training volume increases. A small change in stride or confidence can also be an early warning sign worth taking seriously.

Should I stop running if I have pain?

Not always, but you should modify your running if pain is worsening, changing your gait, or not settling by the next day. Some minor symptoms can be managed with load reduction, while sharper, localised, or escalating pain needs earlier assessment to rule out more significant overload problems.

When is shin pain more serious for runners?

Shin pain is more serious when it becomes very localised, hurts with hopping, lingers after exercise, or progresses from exercise pain to walking pain. That pattern can suggest a bone stress injury rather than shin splints and should usually be assessed sooner rather than later.

Can running analysis help prevent injuries?

Running analysis may help when it leads to practical changes in training, strength work, recovery, or technique. It is most useful when combined with a broader physiotherapy assessment, because common running injuries rarely come from one isolated movement issue alone.

What causes knee pain when running?

Knee pain when running is commonly caused by load-related irritation of the patellofemoral joint, ITB, or patellar tendon. It often develops when training increases too quickly or recovery is insufficient.

What to do next

If you think one of these common running injuries matches your symptoms, start by using the body-region links above to narrow the most likely diagnosis. Then compare it with our detailed running injuries guide or book a sports physiotherapy assessment if the problem is limiting your training.

Earlier assessment can help clarify whether you are dealing with tendon overload, joint irritation, muscle strain, or a bone stress issue. That usually leads to a safer return-to-run plan and fewer repeat flare-ups.

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References

  1. Correia CK, Machado JM, Dominski F, de Castro MP. Risk factors for running-related injuries: An umbrella systematic review. J Sport Health Sci. 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 for lower extremity overuse injury in recreational runners. Br J Sports Med. 2025;59(17):1203-1211.
  3. Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. J Sport Health Sci. 2021;10(5):513-522. doi:10.1016/j.jshs.2021.04.001

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.

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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.

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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

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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.
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