Foot & Ankle Physiotherapy in Perth

Achilles tendinopathy is one of the most common but also most poorly managed tendon conditions. With a well-structured progressive loading program (heavy slow resistance training being the most evidence-based approach), significant improvement is typically seen within 8-12 weeks. Complete resolution and return to full running and sporting activity usually takes 3-6 months. The biggest predictor of failure is inadequate loading progression -- either too much load too soon, or insufficient load that fails to drive tendon adaptation. Complete rest is counterproductive: tendons adapt to load and require progressive loading stimulus to recover. Passive treatments such as ultrasound and massage provide temporary symptom relief but do not drive the tendon adaptation needed for lasting recovery.

Plantar fasciitis (more accurately called plantar fasciopathy) describes pain at the underside of the heel arising from the plantar fascia -- the thick band of tissue connecting the heel to the toes. It is the most common cause of heel pain. Key features include sharp heel pain on the first steps in the morning, pain that eases with activity but returns after rest, and localised tenderness at the medial calcaneal tubercle (inner heel). Treatment includes calf strengthening and stretching, intrinsic foot muscle exercises, load management, footwear review, and in some cases heel pads or temporary orthotic support. Evidence also supports shockwave therapy for persistent cases. Surgery is rarely required.

It depends on the injury. Acute ankle fractures, significant stress fractures, and severe acute ligament ruptures sometimes require a boot or cast for protection in the initial phase. For most ankle sprains, the evidence does not favour prolonged immobilisation -- early protected movement produces faster recovery and better long-term outcomes. For tendon conditions, offloading with a heel lift or reduced activity is often more appropriate than full immobilisation. Your physiotherapist will advise based on the specific injury, its severity, and what the evidence supports for your presentation.

Yes, though physiotherapy plays a different role in stress fracture management than in soft tissue injuries. The primary treatment for a stress fracture is load protection during the healing phase, which typically takes 6-12 weeks depending on location and severity. Physiotherapy during this phase focuses on maintaining fitness through non-impact exercise (swimming, cycling), addressing any contributing biomechanical factors, and managing the transition back to loading. After healing, a structured return-to-sport program with progressive impact loading is critical to prevent recurrence. Risk factors for stress fractures include training load spikes, inadequate bone density, poor nutrition, and biomechanical factors -- all of which physiotherapy can help address.