Causes of Foot and Ankle Pain When Walking

Causes Foot of Ankle Pain When Walking

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Medically reviewed by Misty Seidenburg

Our feet take us where we need to go as they bear our weight. After more than usual activity or wearing uncomfortable shoes, a bit of discomfort is expected. However, frequent or worsening pain while walking should be evaluated. If walking is painful, diagnosing and treating your condition is important to prevent further problems and help you become active, mobile, and pain-free again. Learn about the potential  causes of foot and ankle pain when walking and how to treat them.

Conditions That Cause Foot and Ankle Pain With Walking

Ankle pain and foot pain while walking can result from a single accident, like a fall or sports injury, or develop gradually over time from overuse. It can also be associated with systemic conditions that affect the body’s bones, muscles, nerves, or connective tissues.

Bunion

A bunion is a bony bump that forms on the joint at the base of the big toe. It occurs when bones at the front of the foot shift out of place, forcing the affected joint to stick out. You can be born with this condition or develop one from wearing constrictive shoes, or you may have a condition like arthritis that affects the joints. While not all bunions cause pain, sometimes, force at the joint can become painful. Pain near the bunion often worsens with walking, standing, or running.

Arthritis

Some forms of arthritis cause stiffness and pain in the bones, muscles, and joints of the feet. Osteoarthritis, in particular, affects the big toe, and rheumatoid arthritis generally affects several joints in both feet, causing the toe to stiffen and bend abnormally, making walking difficult.

Gout

Gout is another form of arthritis characterized by sudden, painful flare-ups in the big toe and lower leg. Flare-ups occur when high levels of urate accumulate in the body over time. This urate forms needle-like crystals around the joint. Gout pain makes walking and bearing weight difficult.

Bursitis

Bursae are fluid-filled sacs that cushion between bones, tendons, ligaments, and skin. The retrocalcaneal bursa is located at the back of the ankle under the Achilles tendon, which connects the calf muscles to the heel bone. Repetitive use of the ankle from too much walking, running, or jumping can inflame and irritate this bursa, causing back-of-ankle pain while walking.

Achilles Tendinopathy

Heel bursitis is often mistaken for Achilles tendinopathy because they both cause heel pain when walking or running. However, Achilles tendinopathy affects the Achilles tendon that connects the back of the leg to the heel and allows you to place your foot down. Pain can occur directly at the heel or a bit higher along the tendon. Overuse is a leading cause of Achilles tendinopathy, often seen in walkers, runners, and athletes.

Stress Fracture

A stress fracture is a small crack in a bone. As the name suggests, these injuries happen due to excess stress on your bones, often through repetitive motion. Stress fractures typically involve the bones of the lower body, including the foot and heel. Pain that worsens during physical activity may indicate a stress response to the bone.

Sprain or Strain

Ligaments are fibrous bands of tissue that attach bone to bone.  A sprain is a ligament stretch or tear. Strains are similar injuries, but they involve stretching or tearing of the muscles or tendons, which connect muscles to bones.

Sprains and strains often happen when the body turns or twists or is hit unexpectedly, forcing the body into an uncontrolled position. If you have a sprained ankle or foot, it may be painful or difficult to bear weight on your foot. Pain on the top of the foot when walking may indicate a sprain or strain.

Plantar Fasciitis

Plantar fasciitis is inflammation of the thick band of tissue that runs along the bottom of the foot, the plantar fascia. Stabbing heel pain, especially within the first few steps after being sedentary, is the most common symptom of plantar fasciitis. Risk factors for plantar fasciitis include prolonged standing, unsupportive shoes, and flat feet or high arches.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome (TTS) is irritation to the tibial nerve that runs through a passage of bones and ligaments in the ankle called the tarsal tunnel. Pain, weakness, and tingling in the feet are signs of TTS and can interfere with walking and other daily activities. Anatomical issues, acute injuries, and systemic conditions like diabetes or arthritis can all cause TTS.

Metatarsalgia

If you experience sharp, burning, or aching pain in the ball of your foot when walking or standing, you may have metatarsalgia. This is caused by excess pressure on the metatarsals, the long bones in the front of the feet, due to poorly fitting shoes or repetitive running and jumping without rest.

Turf Toe

Turf toe also causes significant toe pain when walking. It involves pain in the big toe joint that develops when your toes remain on the ground while the heel lifts. Over time, this motion can overstretch or tear the soft tissues and ligaments in the big toe. Turf toe is common among athletes who play sports like soccer and football which require frequent pushing off the toes on turf, which can be less forgiving than grass.

Heel Spur

Sudden, sharp heel pain when walking, especially in bare feet or less supportive shoes, may also indicate a heel spur. A heel spur, or osteophyte, is a bony growth on the heel bone that contains a small spike or hook facing the foot’s arch. This growth is formed of calcium deposits that collect over long periods, often in response to prolonged soft tissue damage at the bottom of the heel.

Morton’s Neuroma

This is a thickening of the tissue surrounding a nerve near the toes, causing sharp, burning pain in the ball of the foot. Some people describe it as feeling like standing on a small pebble in their shoes. Narrow, tight shoes, including high heels, are linked to Morton’s neuroma. Rest and more comfortable footwear can help improve symptoms.

Posterior Tibial Tendon Dysfunction (PTTD)

Posterior tibial tendon dysfunction is damage to the posterior tibial tendon on the inside of the ankle, which helps support the arch when walking or running. PTTD can cause inner foot pain when standing on the ball of the foot or pushing down with the front of the foot. Overuse and ankle sprains are associated with PTTD. Left untreated, this condition can lead to adult-acquired flatfoot deformity (AAFD) and later to arthritis of the ankle.

Assessing Your Pain

Pain is the body’s sign that something is wrong. If you’ve read through the list of foot and ankle injuries and conditions, you’ll see there are many types of foot and ankle pain. The location and type of pain you experience provide important clues about your injury or condition.

How does foot or ankle pain feel? Does it ache, throb, or burn? Is it dull or sharp? Does it come on suddenly, or does it seem to occur more gradually? Do you notice any other symptoms like stiffness or swelling? Does it improve if you change your shoes or take the weight off your feet by sitting or lying down?

Being attentive to your pain, where you feel it, and what movements or activities trigger or make it worse will help your provider and physical therapist determine the cause and treat it appropriately.

When To See A Doctor

Foot and ankle pain is often a sign of a musculoskeletal issue that can be treated at home and with physical therapy. However, ignoring possible signs of a more severe problem is never wise.

See a doctor if you have:

  • A fever
  • An open wound
  • Severe bleeding
  • Possible broken bones
  • Extreme pain during walking
  • A visible deformity in the foot
  • Pain that interferes with daily activities
  • Numbness, burning, or tingling
  • Redness, warmth, or tenderness to the touch
  • Swelling that does not improve around five days after your injury

Also, if you cannot walk or put any weight on your foot, it’s best to see your provider to determine the cause and prevent further complications.

Treating Foot and Ankle Pain When Walking

Nearly 9 in 10 people will experience foot pain at some point. Without proper treatment, pain can impact function and mobility. Here are some things you can do to ease symptoms and make walking more accessible and less painful.

Switch your activities.

Take a break from activities that make your foot or ankle hurt more. Focus on those that put less stress on your lower extremities while allowing you to stay active: swimming, rowing, yoga, and tai chi are great, low-impact forms of exercise.

Try a little P.E.A.C.E & L.O.V.E.

In recent years, the R.I.C.E. protocol for treating soft-tissue injuries has evolved into the P.E.A.C.E. & L.O.V.E. rehabilitation approach. This updated approach entirely avoids icing and anti-inflammatory medication, as they are shown to inhibit tissue recovery. P.E.A.C.E. & L.O.V.E. focuses on the longer continuum of an injury—from immediate care to management and healing.

Self-refer to physical therapy.

If foot and ankle pain does not improve with at-home care, physical therapy may be beneficial. Physical therapists use therapeutic exercise and stretching to increase range of motion, flexibility, and strength.

Physical therapy also helps relieve pain and stiffness and improve alignment using manual therapy such as soft tissue and joint mobilization and other hands-on therapies. Physical therapists teach patients how to adjust their daily routines to allow their injuries to heal and prevent further damage.

Preventing Foot and Ankle Pain and Injuries

If you are recovering from a foot or ankle injury or want to prevent them, try these practical tips to move and walk without pain.

Stretch before walking

Before walking or any lower-body workout, take a few moments to do some dynamic stretches to warm up the muscles and decrease stiffness. Dynamic stretches also raise body awareness, which will help you avoid falls and stay balanced and stable.

Consider preventative physical therapy

Physical therapy is not just for injured patients. It’s highly effective for injury prevention for walkers, runners, and people who enjoy other forms of exercise and recreation.

Physical therapy lowers the risk of injuries by:

  • Increasing range of motion
  • Improving core strength and stability
  • Correcting posture and alignment issues
  • Building muscle strength and endurance.
  • Teaching proper form and technique.

Rethink your footwear.

Shoes that are worn out, don’t fit properly, or don’t provide adequate support can increase your risk of pain and injuries. As a rule, replace your shoes every 350-450 miles. Consider getting fitted for walking or running shoes from a reputable footwear retailer. Shoe inserts or orthotics can also reduce pressure on the ankle during walking and are especially beneficial for people with arthritis, according to a study on the subject.

If you’re feeling a bit unsteady on your feet or have discomfort when you take a few steps, relief may be possible without surgery or medication. Find a physical therapy clinic near you to schedule an evaluation for foot pain or ankle pain.

 

 

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Medically reviewed by

Misty Seidenburg

Vice President of Clinical Programs

Dr. Misty Seidenburg has been a practicing physical therapist since 2006 after obtaining her Doctor of Physical Therapy Degree from Gannon University. Dr. Seidenburg completed an Orthopedic Residency in 2009 and subsequent Spine Fellowship in 2010 where she discovered a passion for educating clinicians. Since 2019, she has developed and refined several post-professional residency and fellowship programs and currently serves as the Vice President of Clinical Programs for Upstream Rehab Institute. She serves on several APTA committees to help advance the profession, is adjunct faculty at Messiah University, and is also a senior instructor and course developer for the Institute of Advanced Musculoskeletal Treatments with a special interest in exercise integration. Outside of work, she enjoys challenging herself with new adventures and is currently competing as an endurance athlete.

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