Foot & Heel

Injuries to the foot can be acute (sudden onset) or chronic which come on gradually often through overuse. We have categorised foot pain injury heel pain, midfoot pain, forefoot pain including pain under the ball of the foot, toe injuries and skin conditions such as athletes foot and blisters. If you have suffered a recent foot injury then you should apply immediate first aid for foot pain. We also explain under which circumstances you should see a doctor.

Heel injuries can be sudden onset (acute) or can come on gradually over time. The most common causes of heel pain including pain under the heel are Plantar Fasciitis and Bruised Heel whilst pain at the back of the heel in children is often Sever's disease. Select from the injuries below or if you do not know what your injury is then visit our symptom checker, or click on any of the symptoms below to view injuries with that particular symptom.

Midfoot pain is concerned with the middle of the foot where the small tarsal bones are located. The most common cause of midfoot pain other than following a sprained ankle is a mid tarsal joint sprain. A stress fracture of the navicular bone is also common and should not be missed. Pain in the midfoot area for more than five days following injury then a Lisfranc joint sprain should be considered.

Forefoot pain often originates from the long metatarsal bones in the foot down and down towards the toes as welll as pain under the ball of the foot. The more common gradual onset injuries include metatarsal stress fracures, bunions and mortons neuroma. Sudden onset or acute injuries result from direct trauma or impact and inlcude fractures and ligament sprains.

Skin conditions of the foot are common in sports and most are easiliy avoidable. They include athletes foot, blisters, corns, calluses and verucca.

Toe injuries include ingrown toenail, black toenail, fractured or broken toe, dislocated toe, hallux rigidus and hammer toe.

Immediate first aid for foot injuries

The PRICE principles (protection, rest, ice, compression and elevation) are the gold standard set for treating acute foot and heel injuries. PRICE should be applied as early as possible and continued for at least the first 24-72 hours.

Protection of the damaged tissue is vital to prevent further damage and enable the healing process to start efficiently and effectively. There are a number of ways to protect the injured area all with the same aim of limiting further movement and use of the joint/muscle/ligament/tendon. One way this can be achieved is using a support or splint.

Rest - in the early stages, rest is one of the most important components of the P.R.I.C.E principle but is often neglected or ignored. It does not only refer to the prolonged period of time that the athlete will be out of action but also to the immediate period after the injury.

Ice therapy, also known as cryotherapy, is one of the most widely known and used treatment modalities for acute sports injuries. It is cheap, easy to use and requires very little time to or expertise to prepare.

The application of ice to an injury:

  • Decreases the amount of bleeding by closing down the blood vessels (called vasoconstriction).
  • Reduces pain (pain gate theory)
  • Reduces muscle spasm
  • Reduces the risk of cell death (also called necrosis) by decreasing the rate of metabolism

A cold therapy and compression wrap is a convenient way to apply cold therapy. Ice should not be appllied directly to the skin as it may cause ice burns.

Compression - is applied to minimise the amount of swelling that forms after an injury and should be applied for the first 24 to 72 hours from the onset of injury. The most effective method is by using a compression bandage which is an elasticated bandage that simply fits around the affected limb.

Elevation of the injured limb is the final principle of PRICE but is equally as important as the other 4. Elevation allows gravity to drain the fluid away from the injured site. This aids in decreasing the swelling which in turn may decrease the pain associated with the oedema (swelling).

Read more on PRICE principles

When should I see a doctor?

When should you see a doctor with your foot pain? Often people do not want to bother their GP or A & E department but if you have any of the following symptoms you should seek further medical assistance.

  • Severe pain, especially on walking
  • Severe swelling (oedema)
  • Altered sensation in the foot – such as a feeling of “pins and needles” (paresthesia) or a “loss of feeling” (anaesthesia) in the foot.
  • Unable to complete normal daily activities after the initial 72 hours.

Further medical assistance can be sought through either your local GP or a private clinician such as a podiatrist, physiotherapist, sports therapist, osteopath or chiropractor. If you have followed the P.R.I.C.E. principles (see below) and are still unable to walk after 72 hours or still have severe pain that is not subsiding after the first 72 hours you should visit your local A&E department for further assessment.

Secondly, if you have applied for P.R.I.C.E. principles and still have weakness that lasts a long time (more than 2 weeks) or have ongoing discomfort in your foot or heel, you are highly recommended to seek advice from a specialist expert - such as a podiatrist or physiotherapist, osteopath, or chiropractor - who can provide you with advice and an appropriate and effective recovery and rehabilitation program.