Ankle and Foot Pain: Sprains, Plantar Fasciitis, and How PT Helps

By Dr. Matt Johnson, PT, DPT, OCS, CMPT, TPI-CERT, FAAOMPT – Updated 6 October 2026

Your feet and ankles carry you through every step of the day, so pain there has an outsized effect on your life, from that sharp first step out of bed in the morning to an ankle that still feels wobbly weeks after a twist. Foot and ankle pain is common, and the good news is that most of it responds well to the right care. This guide covers two of the most frequent culprits, plantar fasciitis and ankle sprains, along with other common causes, what actually helps, and how physical therapy can get you back on your feet without drugs or surgery.

Common causes of foot and ankle pain

Foot and ankle pain has many sources. A few of the most common we see:

Plantar fasciitis (heel pain). This is the most common cause of pain on the bottom of the heel. It happens when the thick band of tissue that supports the arch of your foot becomes irritated. The hallmark is sharp heel pain with your first steps in the morning or after sitting, which often eases as you warm up. As the AAOS OrthoInfo guide to plantar fasciitis explains, it is often linked to tight calves, high or flat arches, and a recent increase in activity, and it usually responds to conservative care.

Ankle sprains. A sprain happens when the ligaments that stabilize the ankle stretch or tear, usually from rolling the ankle. As the AAOS OrthoInfo guide to sprained ankles notes, most sprains heal with proper care, but without good rehabilitation a sprain can leave the ankle weak and prone to repeat injuries and long-term instability.

Achilles and tendon problems. The Achilles and other tendons around the foot and ankle can become irritated with overuse, causing pain and stiffness, often at the back of the heel or along the arch.

Overuse and footwear issues. A jump in walking or running, hard surfaces, and unsupportive shoes can all overload the foot and ankle.

The ankle sprain that never fully healed

One of the most important things we tell patients is that a sprained ankle is not “just a sprain.” It is one of the most under-rehabbed injuries we see. People often rest until the swelling goes down, then return to activity, only to find the ankle keeps giving way or re-spraining. The reason is that a sprain does not only stretch a ligament; it disrupts the ankle’s balance and control system. Without rebuilding strength and balance, the ankle stays vulnerable. This is exactly why proper rehab matters, and why finishing the job after a sprain prevents years of recurring problems.

Pain is where you feel it, not always where it starts

A theme we return to with patients: the sore spot is not always the source. In the foot and ankle, tight calves can drive heel pain, weak hips can change how your foot strikes the ground, and poor ankle control can overload the arch. That is why a good assessment looks up the chain at the calf, knee, and hip, not just the painful spot. Treating only the heel or the ankle, without addressing what is loading it, is why some foot pain keeps coming back.

The Chicago angle

Foot and ankle pain often tracks with the seasons and the city. Spring brings a surge of people returning to running along the lakefront or ramping up for the marathon, a classic setup for heel pain and tendon overload. Hard city sidewalks add repetitive impact. Winter brings icy footing and awkward slips that roll ankles. Long days on your feet at work, in unsupportive shoes, quietly load the arch. Recognizing the recent change that triggered your pain is part of fixing it.

What actually helps

Calm it down, then build it up. Early on, reducing the aggravating load and easing pain sets the stage. But lasting relief comes from rebuilding strength, mobility, and balance, not from rest alone.

Stretch the calf and support the arch. For plantar fasciitis, calf and plantar fascia stretching, along with supportive footwear, often brings meaningful relief.

Rebuild balance and control after a sprain. Balance and strengthening work restores the ankle’s stability so it stops giving way.

Address the whole chain. Improving hip and calf strength and how your foot strikes the ground takes stress off the painful area.

How physical therapy helps at Muscle & Joint

At Muscle & Joint Physical Therapy, we assess how your foot, ankle, and the whole leg move and load, figure out what is driving your pain, and build a plan to calm it and rebuild strong, stable movement. As an independent, employee-owned clinic, we take the time to explain what we find in plain language. Learn more on our ankle and foot pain physical therapy in Chicago page.

Depending on what we uncover, your care may include hands-on manual therapy to restore motion, targeted strengthening and balance work for the foot, ankle, and hip, and guidance on footwear and a smart return to walking or running. For runners, our video running gait analysis can reveal how your foot strike is loading the tissue, and our sports rehabilitation team can guide your return to activity. Because the knee and hip influence the foot, we look at the whole leg, and you can read more on our related ankle and foot pain guide.

We cannot promise a specific result, since every case is different. What we can offer is skilled hands, real recovery, and clear answers. Many people find that with the right plan, that first painful step in the morning fades and their ankle feels steady again.

A simple self-check

Reasonable to start with self-care if the pain is mild, tied to a clear increase in activity, and improves over a week or two with reduced load, supportive shoes, and gentle stretching.

Time to see a physical therapist if foot or ankle pain has lasted more than a week or two, keeps returning, limits your walking or running, or if your ankle keeps giving way after a sprain. Getting a sprain properly rehabbed is one of the best ways to prevent repeat injuries. In Illinois, you can often begin physical therapy without a physician referral, though some limits and insurance requirements apply.

Seek prompt medical care if you cannot bear weight after an injury, the foot or ankle is very swollen or deformed, there is numbness, or you suspect a fracture. Those signs deserve a prompt evaluation before starting rehab.

How long does foot and ankle pain take to settle?

We avoid firm promises, since every case is different, but here is what is typical. Plantar fasciitis often improves over several weeks to a few months with consistent stretching, footwear changes, and the right strengthening, though it can be stubborn if only rested. A straightforward ankle sprain can settle in a few weeks, but rebuilding full strength and balance to prevent re-injury usually takes longer and is worth finishing. After your first visit, we will give you an honest, individualized sense of your timeline.

Rehabbing a sprain the right way: the phases

Because an under-rehabbed ankle sprain is such a common source of long-term trouble, it helps to understand what full recovery actually involves. Rehab generally moves through a few overlapping phases.

Settle it down. Early on, the focus is on calming pain and swelling and protecting the ankle while it begins to heal, while gently keeping motion where it is comfortable.
Restore motion. As pain eases, gentle movement restores the ankle’s normal range so it does not stay stiff.
Rebuild strength. Targeted strengthening of the muscles that support and control the ankle is what starts to make it feel stable again.
Retrain balance. This is the step most people skip. A sprain disrupts the ankle’s sense of position, so balance training is essential to stop it from giving way.
Return to activity. Finally, a graded return to walking, running, or sport rebuilds confidence and load tolerance.

Settle it down. Early on, the focus is on calming pain and swelling and protecting the ankle while it begins to heal, while gently keeping motion where it is comfortable.

Restore motion. As pain eases, gentle movement restores the ankle’s normal range so it does not stay stiff.

Rebuild strength. Targeted strengthening of the muscles that support and control the ankle is what starts to make it feel stable again.

Retrain balance. This is the step most people skip. A sprain disrupts the ankle’s sense of position, so balance training is essential to stop it from giving way.

Return to activity. Finally, a graded return to walking, running, or sport rebuilds confidence and load tolerance.

Skipping the later phases is why so many ankles re-sprain. Finishing the job is what makes recovery last.

Choosing supportive shoes

Footwear has a real effect on foot and ankle pain. You do not need the most expensive shoes, but a few features help: a supportive but not overly stiff sole, a comfortable and secure fit, and enough cushioning for the surfaces you spend time on. For plantar fasciitis in particular, avoiding long stretches barefoot on hard floors and choosing shoes with good arch support often eases first-step heel pain. If you are returning to running, replacing worn-out shoes and building mileage gradually protects the foot and ankle while the tissue adapts.

Frequently asked questions

Why does my heel hurt most in the morning? Sharp heel pain with your first steps in the morning, easing as you warm up, is the classic sign of plantar fasciitis. Overnight the tissue tightens, and those first steps stretch it suddenly. Calf and plantar fascia stretching, supportive shoes, and targeted care usually help.

How long should an ankle sprain take to heal? Mild sprains often calm down within a few weeks, but the ankle is not truly recovered until strength and balance are rebuilt. Skipping that step is why so many people re-sprain. Proper rehab is what makes the recovery last.

Do I need special shoes or orthotics? Supportive footwear helps many people with foot and ankle pain, and off-the-shelf inserts are enough for a lot of cases. Custom orthotics are not always necessary. We can guide you on what fits your situation.

Can plantar fasciitis go away on its own? Sometimes, but it can be stubborn and often lingers for months if only rested. A focused plan of stretching, strengthening, and load management usually speeds things up and reduces the chance it returns.

Is it safe to keep running or walking for exercise? Often, with the right adjustments. We can usually help you keep moving by modifying distance, surface, and footwear while the tissue recovers, rather than stopping altogether, since staying active generally helps.

Should I use ice or heat on a fresh ankle sprain? In the first day or two after a sprain, gentle ice can help with pain and swelling, along with rest and elevation. Heat is generally better later on for stiffness once the early swelling has settled. Use whichever gives you relief, and let comfort and a gradual return to gentle movement guide you.

Get back on your feet

Foot and ankle pain can affect every step you take, but it does not have to be permanent. With the right plan, most people get back to walking, running, and standing comfortably. Muscle & Joint Physical Therapy has two Chicago locations, Lakeview and Ravenswood, with therapists who will answer your questions and remember your name.

Ready to start? Request an appointment online, or give us a call:

Lakeview: 773-857-0689
Ravenswood: 773-337-7747

Where Comebacks Happen.®

About the Author

Dr. Matt Johnson, PT, DPT, OCS, FAAOMPT, is the founder of Muscle & Joint Physical Therapy. A board-certified orthopedic specialist and Fellow of the American Academy of Orthopedic Manual Physical Therapy, he has advanced training in manual therapy and dry needling and treats everyone from weekend warriors to marathon runners, golfers, and CrossFit athletes.

This article is general health information, not medical advice, and reading it does not create a provider-patient relationship. Every person is different. Please talk with a licensed physical therapist or physician about your specific situation. If your symptoms are severe or worsening, please see a provider promptly.