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Sporthopedia · Patient Information

Understanding Your Foot & Ankle

Clear information about ankle sprains, Achilles tendon, and foot conditions — written for patients.

How Do the Foot & Ankle Work?

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Structure

26 Bones, 33 Joints

The foot contains 26 bones and 33 joints — forming a complex arch system that absorbs shock, adapts to uneven surfaces, and propels the body forward with each step.

Achilles Tendon

The Body's Strongest Tendon

The Achilles tendon connects the calf muscles to the heel bone and transmits enormous forces during running and jumping. Despite its strength, it is the most commonly ruptured tendon in the body.

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Ankle Ligaments

Stability on Every Step

Three lateral ligaments (ATFL, CFL, PTFL) and the medial deltoid complex stabilize the ankle. The ATFL is the most commonly sprained ligament in the entire body.

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Plantar Fascia

The Arch Support

A thick band of tissue running along the bottom of the foot, supporting the arch and absorbing impact. Inflammation of this tissue (plantar fasciitis) is the most common cause of heel pain.

What Could Be Wrong?

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Ankle Sprain

The most common sports injury — lateral ankle sprain occurs when the foot rolls inward, stretching or tearing the ligaments. Most heal with RICE and physiotherapy; recurrent sprains may need surgical stabilization.

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Achilles Tendon Rupture

A sudden "pop" with severe calf pain during a push-off movement. More common in recreational athletes aged 30–50. Treatment is surgical repair or non-surgical casting — both with structured rehabilitation.

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Plantar Fasciitis

Sharp heel pain — especially with the first steps in the morning. Caused by repetitive stress on the plantar fascia. Very common in runners, teachers, and those who stand all day.

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Ankle Osteoarthritis

Often post-traumatic (following ankle fractures or severe sprains), ankle arthritis causes pain, stiffness, and swelling. Treatment ranges from physiotherapy and bracing to ankle fusion or replacement.

What Happens Next?

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Diagnosis

MRI is best for tendons, ligaments, and cartilage. X-rays assess fractures, alignment, and arthritis. Ultrasound is excellent for real-time tendon and ligament assessment. Weight-bearing X-rays are essential for foot deformity assessment.

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Conservative Treatment

Physiotherapy, orthotic insoles, appropriate footwear, activity modification, and targeted strengthening resolve most foot and ankle conditions. Shockwave therapy is effective for chronic plantar fasciitis and tendinopathy.

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Minimally Invasive & Arthroscopic Surgery

Ankle arthroscopy can clean arthritic joints, repair cartilage, and treat impingement. Endoscopic plantar fasciotomy and Achilles tendon procedures can be performed through very small incisions.

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Reconstruction & Fusion

Achilles tendon repair, lateral ligament reconstruction (Broström procedure), and ankle fusion are performed for more significant pathology. Ankle replacement is an option for end-stage arthritis in selected patients.

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Rehabilitation

Return to sport after ankle sprain: 2–6 weeks. After Achilles repair: 6–9 months. After ankle fusion: 3–6 months non-weight bearing, then gradual return. Proprioception training is essential to prevent recurrent sprains.

Your Questions, Answered

Both are valid options. Modern evidence shows that functional rehabilitation with a boot (non-surgical) achieves similar re-rupture rates to surgery in most patients. Surgery may be preferred in high-level athletes or when the tendon ends are widely separated. Your surgeon will advise the best approach for you.

Proprioception exercises (balance training), ankle strengthening, and — if needed — an ankle brace during sport are highly effective. Up to 40% of ankle sprains develop chronic instability, so proper rehabilitation after the first sprain is critical.

Most cases resolve with calf stretching, plantar fascia stretching, orthotic insoles, and load management. Night splints help morning stiffness. Shockwave therapy is effective for chronic cases. Surgery is rarely needed and only considered after 12 months of failed conservative treatment.

The peroneus longus is a muscle in the outer lower leg whose tendon can be harvested as a graft source for ACL reconstruction. Sporthopedia is conducting international research on its outcomes. Importantly, its harvest may affect ankle eversion strength — which is why our research carefully monitors donor-site complications.

Questions about your foot or ankle?

Connect with a Sporthopedia participating surgeon or learn about our foot and ankle research studies.

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