Treating orthopaedic foot and ankle conditions

From standing and walking to running and dancing, your feet and ankles bear your body weight.

The ankle has the smallest surface area of the body's three major weight-bearing joints — the knees, hips, and ankles. The ankle also has the greatest amount of force placed on it. Experts estimate the force on your ankle when walking to be two and a half times your body weight. The amount of that force increases with impact when you're running or exercising.

With so much pressure put on such a small part of the body, it's no surprise that the feet and ankles are prone to painful injuries like sprains, fractures, and dislocations. The degenerative effects of arthritis, infections, and even structural characteristics like high arches or flat feet can take a toll on your feet and ankles. If you've had a foot or ankle injury, or if you're experiencing pain, weakness, or instability, orthopaedic foot and ankle specialists at Bothwell Medical Rooms can help.

Causes of foot and ankle pain

BMR foot

Among the most notable causes of acute and chronic foot and ankle pain, instability and weakness are:

  • Fractures and dislocations
  • Arthritis
  • Bursitis (inflammation around the joint)
  • Tendonitis (inflammation of the tendons)
  • Sprains and strains (when the ligaments stretch or tear, usually caused by rolling or twisting the ankle)
  • Overuse (repetitive stress to the foot or ankle)
  • Diabetic foot problems (neuropathic ulcers and fractures — open wounds, usually caused by diabetes, on the bottom of the foot)

Along with health and hereditary factors, these can lead to many different foot and ankle conditions, including:

Achilles tendonitis when the tendon that connects the calf and the heel ruptures from injury, overuse or degeneration. Plantar fasciitis, heel pain resulting from chronic inflammation.

Hallux valgus (bunion), which results when the joints in the ball of the foot become enlarged and are repositioned, leading to deformity of the forefoot and toes.

Lesser toe deformities, pain and/or poor flexibility in the smaller four toes. These deformities can be caused by muscle, tendon or ligament imbalance that leads to hammertoe or mallet toe, among others. Lesser toe deformities also can be the result of the structure of your foot, injury, disease or even the types of shoes you wear.

Flat foot problems when the arch of the foot makes complete contact with the ground when standing or walking.

Peripheral neuropathy involving pain, weakness or numbness in the foot caused by damage to the peripheral nerves located outside the brain or spinal cord. Damage can result from an injury, infection, genetics, or toxin exposure.

Post-traumatic/surgical conditions when a traumatic event or surgery results in:

  • Deformity to the foot or ankle
  • Tendon ruptures
  • Dislocations
  • Abnormal positioning
  • Infection
  • Post-polio syndrome when polio survivors experience weakening in muscles, including those in the feet and ankles, often years after recovering from polio.


Before outlining a treatment plan, your orthopaedic surgeon will assess your foot or ankle pain and diagnose your condition using a series of in-office exams or medical imaging tests such as:

  • X-rays
  • MRIs
  • CT scans
  • Ultrasound

To determine the best treatment plan for you, your orthopaedic surgeon may also collaborate with other healthcare providers, including:

  • Your GP
  • Physiotherapist
  • Once your doctor knows the exact cause of your pain and understands the functional limitations of your foot and/or ankle issue, you'll receive a personalized treatment plan that takes into account your unique needs and lifestyle.

Non-surgical treatments

In most cases, your orthopaedic surgeon will explore all non-surgical treatments before choosing to operate. Among the non-surgical treatments and therapies for foot and ankle conditions are:

  • Bracing, splinting or casting the foot/ankle.
  • Using supports like crutches or other assistive devices
  • Anti-inflammatory medication and/or steroid injections
  • Lifestyle or activity modifications

Surgical treatments

Surgery may be the best option for treating your foot or ankle pain, weakness or instability. The type of treatment chosen depends on many factors such as the type, location and extent of your injury or condition. Among the surgical foot and ankle treatments are:

Achilles tendon repair: The Achilles tendon connects the calf muscle and the heel bone. If it ruptures as a result of an injury, overuse or degeneration, an orthopaedic surgeon will surgically repair the tendon to reconnect the calf muscle and heel bone.

Total ankle replacement: A type of joint replacement surgery, total ankle replacement involves replacing damaged parts of the three bones that make up the ankle joint with specialized metal and plastic implant devices.

The procedure provides pain relief while maintaining or restoring joint function, allowing you to walk normally. The new joint prevents stress and strain on other joints, muscles, ligaments and tendons.

Foot and ankle reconstruction: To restore foot and/or ankle function, your surgeon may repair or transfer tendons, implant a prosthetic joint, remove a tumor or manipulate the bone by cutting, grafting or fusing.

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