Diagram showing Achilles tendinopathy with inflamed mid-portion and insertional areas of the Achilles tendon at the heel.

Ankle, Foot, and Ligament injuries; Understanding ad Treatment

Injuries to the ankle, foot, and ligaments can significantly impact your mobility and quality of life. At Healthy Movements Physiotherapy, we’re here to help you understand these injuries and provide the care you need for a full recovery.

ATFL: Anterior-talofibular ligament is the most commonly sprained ankle ligament, and occurs when someone rolls their ankle inward. The fibers of the ligament are stretched beyond their limit, and some fibers tear.

Common Ankle, Foot, and Ligament Injuries

Depending on the amount of fibers torn gives you the grading of the tear from:

Ankle Sprains:

  • ATFL (Anterior Talofibular Ligament):

    • This is the most commonly sprained ankle ligament, often occurring when you roll your ankle inward. The severity of the sprain depends on how many fibers are torn.
    • Grade 1 – Mild: Slight tearing of the ligament fibers.
      • Recovery: 1-2 weeks.
    • Grade 2 – Moderate: Partial tear of the ligament fibers.
      • Recovery: 2-4 weeks.
    • Grade 3 – Severe: Complete tear of the ligament.
      • Recovery: 6+ weeks.
Diagram showing an Anterior Talofibular Ligament (ATFL) injury with inflammation and location of the torn ligament in the lateral aspect of the ankle.
-ATFL injuries are the most common type of ankle sprain, typically caused by twisting the foot inward. -Pain, swelling, and instability on the outside of the ankle are key symptoms.

  • Other Ankle Ligaments:

    • Calcaneofibular Ligament: Often injured along with the ATFL.
Diagram showing a Calcaneofibular Ligament (CFL) injury with inflamed ligament on the lateral side of the ankle, between the fibula and calcaneus.
-CFL injuries typically occur with ankle inversion sprains, often alongside ATFL injuries. -Symptoms include swelling, tenderness below the fibula, and ankle instability during movement.

 

    • Posterior Talofibular Ligament (PTFL): Injured in severe cases, often alongside dislocation.
Diagram showing a Posterior Talofibular Ligament (PTFL) injury with inflamed ligament located at the back of the ankle between the fibula and talus.
-PTFL injuries are less common and typically result from severe ankle trauma or dislocations. -Pain at the back of the ankle and instability during weight-bearing may indicate a PTFL tear.

 

    • Deltoid Ligament Complex: Located on the inner side of the foot, injured by forceful outward rotation.
Diagram showing Deltoid Ligament Complex injury with affected medial ankle ligaments connecting the tibia to bones of the foot.

 

    • High Ankle Sprain: Occurs when the ligaments above the ankle are torn or damaged, usually with a twisting or rotational injury and dorsiflexion of the ankle. These ligaments are called:
      • Anterior-inferior tibiofibular Ligament (AITFL)
      • Posterior-inferior tibiofibular ligament (PITFL)
      • Inter-osseous membrane

Fractures:

If you have fractured your ankle, you have sustained a broken bone in one or more of the bones in the ankle. This usually requires a 6-week period of non-weight bearing, and your leg is usually in a boot or a cast.

Common ankle fractures;

  • Lateral Malleolus Fracture: Most common, affecting the outside bony bump of the ankle.
  • Bimalleolar Fracture: Breaks both inside and outside bony bumps of the ankle.
    Diagram of a bimalleolar fracture showing breaks in both the medial and lateral malleoli of the ankle joint.
    A bimalleolar fracture involves fractures of both the tibia (medial malleolus) and fibula (lateral malleolus).
    It typically results from high-impact ankle trauma and often requires surgical stabilization.
  • Trimalleolar Fracture: Involves the inside and outer bony bumps and the back part of the tibia.
    Diagram of a trimalleolar fracture showing fractures of the medial malleolus, lateral malleolus, and posterior malleolus of the ankle.
    A trimalleolar fracture involves breaks in the medial, lateral, and posterior malleoli, leading to significant ankle instability.
    This serious injury often requires surgical fixation followed by intensive physiotherapy.
  • Pilon Fracture (Plafond Fracture): A break through the weight-bearing roof of the ankle, often from a fall.

Tendinopathies:

Diagram showing Achilles tendinopathy with inflamed mid-portion and insertional areas of the Achilles tendon at the heel.
– Achilles tendinopathy causes pain and stiffness in the lower calf and heel, particularly during walking or running.
– This diagram highlights both mid-portion and insertional Achilles tendinopathy.
– The Achilles tendon connects the calf muscles to the heel bone and is vital for movement.
– Physiotherapy focuses on strengthening, load management, and restoring ankle function.

A tendinopathy was traditionally considered as an inflammation of a muscle tendon, however, it is now considered to be a degenerative process. There can also be an element of inflammation in the process. Tendons in the lower leg which develop tendinopathies are:

  • Peroneal Tendons: Injured through overuse or trauma, stabilising the outer ankle.
  • Achilles Tendon: Often affected by overtraining, poor flexibility, or improper training surfaces.
  • Tibialis Posterior: Stabilises the medial foot arch; injury can cause painful flat-footed deformity.
  • Flexor Hallucis Longus: Common among ballet dancers, causing pain in the back and inner aspect of the ankle.

How We Can Help

At Healthy Movements Physiotherapy, we offer a comprehensive approach to treating ankle, foot, and ligament injuries:

  • Tailored to your specific injury and recovery needs.
  • Techniques like soft tissue massage and joint mobilisations to reduce pain and improve comfort.
  • Specific exercises to restore range of motion, strength, and stability.
  • Practical tips on managing your injury and improving your overall foot and ankle health.

Why Choose Healthy Movements Physiotherapy?

patient doing physiotherapy

Experienced in Foot & Ankle Conditions:

We specialise in treating complex foot pain and tendon injuries, including mid-portion and insertional Achilles tendinopathy.

Biomechanical Assessments:

We identify underlying causes such as poor foot mechanics or calf tightness that contribute to tendon overload.

Trusted by the Community:

With a reputation built on trust, care and results, locals turn to Healthy Movements Physiotherapy for lasting outcomes. See our 5 star reviews!

Specialised Expertise in Workplace Injuries:

We have extensive experience in dealing with workers' compensation cases, offering ergonomic advice and strategies to prevent future Foot & Ankle injuries, making us a trusted partner in your rehabilitation journey.
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Top 5 FAQs About Achilles Tendinopathy & Foot Pain

Achilles tendinopathy is often caused by overuse, poor foot biomechanics, tight calf muscles, or sudden changes in training intensity.

Common signs include stiffness in the Achilles tendon, pain when walking or running, and tenderness when pressing the back of your heel.

Yes. Physiotherapy is the first-line treatment, focusing on load management, strength-building, and addressing movement patterns.

Recovery time varies but often takes 6–12 weeks, depending on the severity and how early treatment begins.

Not always. We’ll guide you on safe modifications to stay active while allowing your tendon to heal effectively.

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