• Increasing your activity level (such as starting a new exercise program or increasing the amount of exercise that you were already doing)
• Doing the same movements over and over (such as walking or running)

• Rest the leg until there is no heat or redness.
• Avoid activities that make your pain worse.
• Cold therapy (ICE)
• Arrange to see a physiotherapist.
• Take anti-inflammatory medicine such as ibuprofen (Advil).

If the problem lasts more than about three months, changes happen inside the tendon. If you have tendon problems that do not go away after a few months, it is important to talk to your healthcare team because long-term or chronic tendonitis is treated differently. Chronic tendon problems are treated with special exercises taught by a physiotherapist or other health care provider with experience treating tendon problems.

It is important to do the right kind of exercise, so you do not make the tendon problem worse.

• Increase in physical activity level, especially running and jumping
• Tight calf muscles
• Diabetes
• Obesity
• Steroid medications
• Trauma

• Avoid activities that make your pain worse
• Rest and cold therapy (ice)
• Physiotherapy
• Take anti-inflammatory medicine such as ibuprofen (Advil)
• Immobilization (sometimes needed)
• Calf and Achilles stretching

The non-operative treatment is successful in most cases and surgery is rarely indicated.

Some people will develop ankle arthritis after an injury like a bad ankle fracture or if the ankle is injured many times. Ankle arthritis can develop because of the way a person’s bones and joints line up. Other possible causes of ankle arthritis include inflammatory arthritis such as rheumatoid arthritis, crystal arthritis such as gout, or as a result of a serious joint infection.

There are many ways to help your ankle arthritis. The goal is to improve the way you move and decrease your pain.

Reduce the amount of weight on the ankle by:

• maintaining a healthy weight. (You might need to lose weight.)
• using a cane, crutches, or a walker
• sitting to do activities instead of standing

Reduce movement of the ankle joint by:

• wearing an ankle brace
• wearing rocker-bottom shoes. Rocker bottom shoes are shoes that have a slightly rounded curve in the sole of the shoe. This curve can help your foot to move more normally if you have stiff or painful joints

Take medicine, it might help. But talk to your doctor before you start taking anything new. Some of the kinds of medicine used to treat ankle arthritis include:

• acetaminophen, such as Tylenol Arthritis Formula
• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), such as ibuprofen (Advil)
• injections into the joint, such as cortisone, and hyaluronic acid

Surgery might be suggested if the options listed above do not help your ankle arthritis pain. 

The type of surgery will depend on the amount of arthritis in the ankle. Your surgeon might suggest:

1. a) ‘cleaning out’ (debriding) the ankle joint or if the arthritis is severe:
2. b) joining the ankle bones together (an Ankle arthrodesis or Ankle fusion) – see Surgeries – Ankle arthrodesis
3. c) Total ankle replacement – a surgical procedure in which parts of an arthritic or damaged joint are removed and replaced with a metal, plastic, or ceramic device called a prosthesis – see Surgeries – Total ankle replacement

• Use an arch support in your shoe, either an arch support you buy in a pharmacy or shoe store, or an orthotic made specifically for your feet.
• Work with a physiotherapist to learn how to do exercises that make the muscles and tendons in your foot and lower leg strong and flexible.
• Talk to your care team about getting a brace for your ankle.

Surgery might be suggested if the options listed above do not help your pain. 

Surgery is done to fix the position of the foot and possibly repair the injured tendons. It’s important to remember that you will be non-weight bearing for a few weeks and that the recovery process may be lengthy.

• Limit motion of the big toe joint – change in footwear (stiff-soled shoe), orthotics
• Ice therapy
• Over-the-counter anti-inflammatory medicine
• Corticosteroid or hyaluronic acid injections may be used, however with short-term relief

If pain persists after the conservative treatment, surgery will be considered. One of the most used techniques is joint arthrodesis (joint fusion) – see Surgeries – Hallux rigidus (Stiff big toe).

• Wear comfort shoes with a soft wide-toe box (the part that covers your toes) and avoid tight or sharply pointed shoes.

• Talk to a shoe repair store about stretching the inside border of the shoe. 
• Use bunion pads to protect the area from pressure and rubbing. 
• Wear toe spacers between the big toe and the second toe. 
• Talk to your healthcare team about orthotics or bunion splints.

Bunion surgery might be considered for people whose bunion pain does not improve after trying the options listed above – see Surgeries – Hallux valgus (Bunion).

The names ‘claw toes’ and ‘hammer toes’ are often used to mean the same thing. The main difference between these two problems is the position of the joint at the base of the toes.

Most problems caused by claw toes can be treated with the right footwear and by protecting the bony areas from too much pressure and irritation.

• Reduce the amount of weight on the foot:
  • Maintain a healthy weight (You might need to lose weight).
  • Use a cane, crutches, or a walker.
  • Sit to do activities instead of standing.
• Change your footwear:
  • Wear stiff-soled rocker-bottom shoes with a wide toe box.
  • Talk to your care team about orthotics and shoe inserts (sometimes called ‘metatarsal pads’).
• Take medicine, it might help. But talk to your doctor before you start taking anything new. Some of the kinds of medicine used to treat metatarsalgia include:
  • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), such as ibuprofen (Advil).
  • injections into the joint, such as cortisone.

There are many ways to treat this condition, but it can take some time and effort to find what will work for you.

• Reduce the amount of weight on the foot:
  • Maintain a healthy weight (You might need to lose weight).
  • Use a cane or a walking aid.
  • Sit to do activities instead of standing.
• Changing your footwear:
  • Do not wear high-heeled shoes.
  • Talk to your care team about shoe inserts called ‘metatarsal pads’.
• Talk to your doctor about taking medicine for pain. The doctor might consider injections into the joint such as cortisone.

Surgery for Morton’s neuroma might be suggested for patients whose pain does not improve after trying the options listed above.

• Work with a physiotherapist to stretch your calf muscles and plantar fascia and strengthen your leg muscles.
• Change your footwear.
  • Wear stiff-soled shoes. 
  • Avoid sandals and flat shoes.
  • Over-the-counter orthotics.
• Do not walk barefoot until the pain is gone.
• You can apply ICE (cold therapy) many times a day for 20 min each time. Remember to put a thin towel between the skin and the ICE pack/bag.
• Take medicine, it might help. But talk to your doctor before you start taking anything new. Some medications used to treat Plantar fasciitis include: 
  • Over-the-counter anti-inflammatory drugs, such as ibuprofen (Advil) or naproxen.
  • Acetaminophen, such as Tylenol arthritis formula.
  • Injections, such as cortisone.
• Changing your activity. It would be a good idea to switch from walking and running to swimming or cycling while the symptoms last.
• Talk to your healthcare team about night splints.

Surgery is rarely needed but is an option in severe cases, after exhaustive non-operative treatment.

A rupture of the tendon is a tearing and separation of the tendon fibers so that the tendon can no longer perform its normal function. Achilles tendon tears are typically the result of a sudden increase in stress on the tendon or repetitive stress. Ruptures most often occur 2 to 3 inches above the heel bone.

Anyone can develop an Achilles tendon tear, but it occurs most frequently in people ages 30 to 50 and is more common in men than in women. A rupture usually occurs during sports activities that involve running and jumping, or trauma such as slips and falls.

Common symptoms include:

• The feeling of being kicked or hit with a hard object in the back of the ankle/leg
• A popping or snapping sensation (which is sometimes heard) in the back of the ankle/leg
• Pain and swelling at the back of the ankle/leg
• Difficulty walking and difficulty rising up on the toes

Treatment can be surgical or conservative (non-surgical).

Conservative treatment consists of placing the foot in a toes-downward position [equinus] and immobilizing (cast) the foot in this position until the tendon has healed. You will be non-weight bearing for several weeks.

The surgery involves making an incision in the back of your lower leg and stitching the torn tendon together. Surgical repair usually results in a quicker recovery and return to regular activities than non-operative treatment – see Surgeries – Achilles tendon rupture.

The surgeon will guide you in choosing the treatment that works for you based on your age, activity level, and medical history.

You will be non-weight bearing and wearing a cast/splint that will be switched for a walking boot on your first postoperative visit. You may be able to put weight on your affected leg after a few weeks. After proper rehabilitation, full recovery is expected within 8-12 months.

A fracture is a partial or complete break in a bone. Broken ankles involve the distal parts of the tibia and/or the fibula. An ankle fracture can be stable or unstable depending on the alignment of the bones and the stability of the ankle joint.

Ankle fractures are usually caused by a rotational injury. You may experience an ankle fracture from a twisting injury from a simple misstep or fall, or from direct trauma during a motorcycle accident, for example.

The treatment can be operative or conservative(non-operative). Non-operative treatment may be offered for a stable fracture. For an unstable fracture, surgical treatment will be indicated. Metal plates, screws, or nails may be needed for fracture fixation – see Surgeries – Ankle fracture.

Ankle sprains happen when the foot twists, rolls, or turns beyond normal motions. Usually occurs during activities involving running and jumping, and even stepping on an uneven surface while walking. The ligaments on the outside of the ankle are most commonly affected.

After initial orthopaedic evaluation, it can be treated with rest, ice (cold therapy), compression (elastic bandages) and elevation. Patients may benefit from a short period of immobilization in severe sprains.

Work with a physiotherapist to strengthen the muscles in your leg and improve your range of motion.

On some occasions, after the initial recovery process, the patient may develop ankle instability and surgery may be required.