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Jordan Loewenstein, D.C. | La Jolla Chiropractor

Exercise & Stretch Library

Foot & Ankle Pain
By Location

Pick the part of your foot or ankle that hurts. You’ll get the conditions that actually live there, the clues that tell them apart, and the specific stretches and exercises for each one.

Five Locations Mapped
A Program For Each Diagnosis
UTC San Diego — Near UCSD
The First-Step Test
Morning pain narrows it fast
Pinpoint Means Bone
One fingertip changes the plan
Achilles Has Two Versions
And they need opposite treatment
Rehab Past Pain-Free
That is why ankles keep rolling
Start Here

Where Does It
Actually Hurt?

Foot and ankle pain sorts out well by location because the foot is a small area with very distinct problem spots. Heel pain in the morning is a different problem from a pebble feeling in the ball of the foot, and both are different from an ankle that keeps rolling. Pick your spot below and the list narrows quickly.

Two questions do most of the sorting here. Can you cover the sore spot with one fingertip, directly on a bone? If yes, and your training recently jumped, that is a stress fracture question and it comes before any exercise. And are the first steps in the morning the worst of the day? That single pattern identifies the most common foot problem there is.

The Foot & Ankle Map

Pick Your
Sore Spot

ClickTapWhere It Hurts

Pick the spot on your foot or ankle that hurts. You’ll get the conditions that live there, the clues that tell them apart, and the stretches and exercises for each one.

Bottom of the heel

The Bottom of the Heel

Heel pain is the most common foot complaint there is, and most of it is one condition. The useful thing is that the exact spot on the heel, and what the first steps of the morning feel like, separate the four possibilities quickly.

Narrow It Down

Two questions do the work: are the first steps of the morning the worst part of the day, and where exactly on the heel does it hurt?

1
Most common
Plantar FasciitisPlantar fasciopathy
First steps out of bedInside of the heelBetter then worse
The inside front corner of the heel bone, where the arch tissue attaches. You can usually press one thumb right on it.
Most likely yours if
  • The first few steps in the morning are the worst of the day, then it eases as you move
  • It comes back after sitting for a while, and again at the end of a long day
  • Pressing that spot on the inside of the heel reproduces it exactly
  • It followed a jump in walking, running, or standing on hard floors
Stretches & mobility · daily
Strengthening · every other day
Do
  • Stretch the toes back before your first step out of bed. Do it sitting on the edge of the mattress
  • Wear supportive shoes indoors. Barefoot on hard floors is the most common thing keeping it going
  • Load the calf. Heel raises three times a week do more than stretching alone
Don’t
  • Walk barefoot on tile or hardwood while it is flaring
  • Roll it aggressively on a golf ball for ten minutes. Two minutes, moderate pressure
  • Expect a quick fix. Three to six months is normal, though it improves along the way
2
Heel Fat Pad PainHeel fat pad syndrome
Middle of the heelDeep bruise feelingWorse on hard floors
The centre of the heel, not the inside corner. It feels like a deep bruise.
Most likely yours if
  • The sore spot is dead centre under the heel, not toward the arch
  • It feels like a bruise, and hard surfaces are noticeably worse
  • Not especially bad first thing in the morning, which separates it from plantar fasciitis
  • More common with age, higher body weight, or after a heavy heel landing
Stretches & mobility · daily
Strengthening · every other day
Do
  • Use a cushioned heel cup. This one responds to padding more than to stretching
  • Choose cushioned shoes over minimalist ones
  • Reduce time standing on concrete
Don’t
  • Treat it as plantar fasciitis and stretch it endlessly. The location is different and so is the fix
  • Walk barefoot on hard floors
  • Add a rigid orthotic without cushioning. This needs padding, not arch support
3
Nerve Pain In The HeelBaxter’s nerve entrapment
BurningInside of the heelNot worse in the morning
The inside of the heel, similar to plantar fasciitis, but the quality of the pain is different.
Most likely yours if
  • Burning, tingling or shooting rather than a dull ache
  • It does not follow the classic first-steps-in-the-morning pattern
  • It can be there at rest, or even at night
  • Often mistaken for plantar fasciitis that is not responding to treatment
Stretches & mobility · daily
Strengthening · every other day
Do
  • Get it properly diagnosed if plantar fasciitis treatment has not worked after a few months
  • Avoid tight shoes and firm arch supports pressing into the inside of the heel
  • Keep the calf and foot strong
Don’t
  • Keep hammering plantar fasciitis treatment that is not working
  • Roll aggressively over the sore spot. Nerves do not like compression
  • Assume all heel pain is the same thing
!
Get this imaged
Heel Stress FractureCalcaneal stress fracture
Mileage spikeHurts squeezing the heelWorse with impact
Deep in the heel bone, and it hurts when you squeeze the heel from both sides.
Get this checked if
  • You sharply increased running, marching or standing in the weeks before
  • Squeezing the heel from both sides is painful. That is different from pressing underneath it
  • It hurts with every impact, and it is getting worse rather than better
  • Common in runners, military recruits, and people with low bone density or irregular periods
Do
  • Get imaged. X-rays are often normal early, so ask about an MRI if suspicion is high
  • Stop impact activity until it is cleared
  • Mention the training increase and, if relevant, any nutrition or menstrual history
Don’t
  • Run through it
  • Assume a normal X-ray rules it out
  • Keep increasing mileage on the theory that it will loosen up
Self-checks you can do right now

The first-step test. Sit on the edge of the bed, then stand and walk. If those first ten steps are the worst of the day and then it eases, that is plantar fasciitis until proven otherwise.

The thumb map. Press the inside front corner of the heel, then the dead centre. Inside corner points to plantar fasciitis. Centre points to the fat pad.

The squeeze test. Squeeze the heel bone from both sides at once. Pain with that, in someone whose mileage jumped, points to a stress fracture and means stop and get imaged.

In the meantime
  • Shoes on indoors. Barefoot on tile or hardwood is the single thing that keeps heel pain going.
  • Stretch before the first step. Pull the toes back for thirty seconds before you stand up in the morning.
  • Load the calf. Heel raises three times a week. Stretching alone rarely resolves this.
  • Cushion, then support. A heel cup for fat pad pain, arch support for plantar fasciitis. They are not interchangeable.
  • Give it three to six months. It improves along the way, but heel pain is genuinely slow and knowing that upfront helps.
Stop and get it looked at if

A sharp increase in training followed by heel pain that hurts when you squeeze the heel from both sides, or pain that is steadily worsening with every step. Stress fractures need imaging, not stretching.

Back of the heel and Achilles

The Achilles and Back of the Heel

The Achilles has two completely different problems depending on height, and they need opposite treatment. The one in the middle of the tendon wants eccentric heel drops off a step. The one down at the bone gets worse from exactly that. Getting this backwards is the most common self-treatment mistake in the whole foot.

Narrow It Down

Measure the height. Two inches above the heel bone is one problem. At the bone is a different one.

!
Rule this out first
Achilles RuptureAchilles tendon rupture
A pop or a kickCannot push offWeak on tiptoe
A gap or sudden pop two to three inches above the heel bone.
Get this checked if
  • You felt a pop, snap, or like someone kicked you in the back of the leg
  • You cannot push off, rise onto your toes on that leg, or walk normally
  • Often happens in a push-off moment in tennis, basketball or squash
  • You may be able to walk, which is exactly why this gets missed
Do
  • Get seen the same day. Timing genuinely affects the treatment options
  • Keep the foot pointed down and stay off it until assessed
  • Mention that you felt a pop, which is the key detail
Don’t
  • Assume it cannot be a rupture because you can still walk. Many people can
  • Stretch it or test it by hopping
  • Wait to see if it settles over the weekend
1
Most common
Achilles TendinopathyMid-portion Achilles tendinopathy
Two inches above the heelStiff in the morningWarms up then hurts later
A thickened, tender section two to three inches above the heel bone, in the middle of the tendon.
Most likely yours if
  • Stiff and sore for the first steps in the morning, then it warms up during activity and hurts more afterward
  • You can feel a thickened or nodular section when you pinch the tendon
  • It followed a jump in running volume, hill work or speed work
  • Squeezing that section reproduces it
Stretches & mobility · daily
Strengthening · every other day
Do
  • Do the eccentric heel drops daily. This is one of the best-evidenced protocols in all of musculoskeletal medicine
  • Expect some soreness during them. That is acceptable and expected here
  • Keep running at reduced volume if pain stays under 3 out of 10 and settles within 24 hours
Don’t
  • Rest it completely. Tendons get worse without load
  • Do hill sprints or speed work while it is irritable
  • Give up at week four. This protocol takes about twelve weeks
2
Insertional Achilles PainInsertional Achilles tendinopathy
Right at the boneShoe backs hurtStretching makes it worse
Right where the tendon meets the heel bone, at the very bottom, not up in the tendon.
Most likely yours if
  • The sore spot is at the bone itself, not two inches above it
  • The backs of shoes rub and hurt, and there may be a bony bump
  • Stretching the calf makes it worse rather than better. That is the key difference
  • Often in slightly older or less active people, not just runners
Stretches & mobility · daily
Strengthening · every other day
Do
  • Do heel raises on flat ground, not off a step. Dropping the heel below level compresses the tendon against the bone
  • Use a small heel lift in your shoe to offload it
  • Choose shoes with a soft, low back
Don’t
  • Do eccentric heel drops off a step. That is the protocol for the mid-portion, and it makes this version worse
  • Stretch the calf aggressively
  • Wear stiff-backed shoes or boots that press on the bump
3
Bursitis Behind The HeelRetrocalcaneal bursitis
Swollen behind the heelBoth sides tenderShoe pressure
The soft spot just in front of the Achilles, between the tendon and the heel bone.
Most likely yours if
  • Swelling and tenderness on both sides of the tendon where it meets the heel
  • Squeezing side to side just above the heel is painful
  • Shoe backs are unbearable
  • Often alongside insertional Achilles pain
Stretches & mobility · daily
Strengthening · every other day
Do
  • Take the pressure off. Backless shoes or a soft-backed shoe for a few weeks
  • Use a heel lift to reduce tension on the area
  • Ice for 10 to 15 minutes after activity
Don’t
  • Push into the swelling with stretching
  • Wear rigid boots or dress shoes with hard heel counters
  • Ignore it if it is red, hot and you are unwell. That needs medical review
Self-checks you can do right now

The pinch test. Pinch the tendon between finger and thumb and work down it. A thickened, tender section a couple of inches above the heel is mid-portion tendinopathy. Tenderness right at the bone is insertional.

The stretch response. Does stretching the calf feel good or make it worse? Better points to mid-portion. Worse points to insertional, and it means no heel drops off a step.

The pop question. If you felt a pop or like you got kicked in the back of the leg, and you cannot rise onto your toes, get seen today. People with full ruptures often walk in unaided.

In the meantime
  • Find out which one you have first. The treatments are opposites. This is the single most important thing on this page.
  • Heel lift. A small lift in both shoes offloads the Achilles and helps almost every version of this.
  • Soft shoe backs. Anything pressing on the back of the heel keeps it going.
  • Keep loading it. Tendons do not recover with rest. They recover with graded load.
  • Twelve weeks. That is the realistic timeline for Achilles tendinopathy, and consistency matters more than intensity.
Stop and get it looked at if

A pop or a sensation of being kicked in the back of the leg, an inability to rise onto your toes, or a palpable gap in the tendon. Get seen the same day, and note that many people with a full rupture can still walk.

Outside of the ankle and foot

The Outside of the Ankle

Almost everything out here traces back to one event: rolling the ankle inward. The immediate question is whether anything is broken. After that, the thing that matters most is whether the sprain gets properly rehabbed, because the ones that do not become the ankles that keep rolling for years.

Narrow It Down

First: can you take four steps on it? If not, or if bone is tender, that is an imaging question before anything else.

1
Most common
Ankle SprainLateral ankle ligament sprain
Rolled inwardSwelling fastOutside ankle bone
Just in front of and below the outer ankle bone, where the ligaments sit.
Most likely yours if
  • The ankle rolled inward, sole turning toward the other foot
  • Swelling and bruising appeared within hours
  • Tender in front of and below the bony bump on the outside
  • Painful to walk on for the first few days
Stretches & mobility · daily
Strengthening · every other day
Do
  • Start moving it early. Ankle alphabet from day one beats immobilizing it
  • Prioritise the eversion exercise. That is the direction that stops you rolling it again
  • Rebuild balance. Standing on one leg, then with eyes closed, genuinely reduces re-injury
Don’t
  • Rest it completely for two weeks. That produces a stiff, weak ankle that rolls again
  • Return to sport as soon as walking is pain-free. Strength and balance come first
  • Skip rehab. Around a third of ankle sprains become chronically unstable, almost always because rehab stopped early
2
Peroneal Tendon PainPeroneal tendinopathy
Behind the outer boneRunnersUneven ground
The tendons running behind and below the outer ankle bone, sometimes down the outside of the foot.
Most likely yours if
  • Tender along a cord-like line behind the bony bump, not in front of it
  • Worse running on uneven ground, camber, or trails
  • Often follows an old ankle sprain that was never fully rehabbed
  • Turning the sole outward against resistance reproduces it
Stretches & mobility · daily
Strengthening · every other day
Do
  • Load the tendon progressively with eversion work
  • Check your shoes. Worn outer edges accelerate this
  • Address the old ankle sprain if there is one. It is usually the root cause
Don’t
  • Keep running on cambered roads or technical trails while it is irritable
  • Stretch into sharp pain behind the ankle bone
  • Ignore snapping over the bone, which can mean the tendon is subluxing
3
Unstable AnkleChronic ankle instability
Keeps rollingUneven groundOld sprain
A general sense that the outside of the ankle gives way, rather than one tender point.
Most likely yours if
  • The ankle has rolled more than once, and it now feels untrustworthy
  • Uneven ground, kerbs and grass make you cautious
  • There may be little pain between episodes
  • It traces back to a sprain that never got proper rehab
Stretches & mobility · daily
Strengthening · every other day
Do
  • Train balance deliberately. Single leg stands, then eyes closed, then on a cushion. Two minutes a day
  • Strengthen eversion above everything else
  • Consider a brace for sport while you rebuild
Don’t
  • Accept it as just having weak ankles. It is trainable
  • Rely on taping forever without doing the strength work
  • Return to cutting sports before single-leg balance is solid
!
Get this imaged
Foot Or Ankle FractureFifth metatarsal or malleolar fracture
Cannot bear weightBony tendernessAfter a roll
The bony bump partway along the outside of the foot, or directly on the ankle bone itself.
Get this checked if
  • You cannot take four steps on it, either right after the injury or now
  • Tenderness directly on bone rather than on soft tissue
  • Pain at the bony bump halfway down the outside of the foot after rolling it
  • Rapid, significant swelling and bruising
Do
  • Get an X-ray. These are the standard rules for imaging an ankle injury and they exist because these fractures are easy to miss
  • Stay off it until it is cleared
  • Point out the bump on the outside of the foot specifically. That fracture is often missed on an ankle-only X-ray
Don’t
  • Walk it off
  • Assume it is just a bad sprain because you can hobble
  • Wait a week to see how it goes
Self-checks you can do right now

The four-step test. Can you take four steps, right after the injury and now? If not, get an X-ray. That is a standard clinical rule, not caution for its own sake.

Front or behind? Tenderness in front of and below the outer ankle bone is the ligament. Tenderness behind it, along a cord, is the peroneal tendons.

Run a thumb down the outside of the foot. There is a bony bump about halfway along. Tenderness there after rolling the ankle is a fracture until an X-ray says otherwise, and it is commonly missed.

In the meantime
  • Move it early. Ankle alphabet from day one. Immobilizing a simple sprain makes the outcome worse.
  • Train eversion above all. Pushing the foot outward against a band is the direction that stops the next roll.
  • Balance work counts as rehab. Two minutes of single-leg standing a day meaningfully lowers re-injury rates.
  • Do not stop at pain-free. Most ankles that keep rolling stopped rehab the week the pain went.
  • Brace for sport, strengthen for life. A brace is a bridge, not the fix.
Stop and get it looked at if

You cannot take four steps on it, there is tenderness directly on bone, or there is a tender bump halfway along the outside of the foot. All three mean X-ray before rehab.

Inside of the ankle and arch

The Inside of the Ankle

The inside of the ankle carries the tendon that holds up your arch, and the nerve that supplies the sole of your foot. Problems here get mislabelled as plantar fasciitis more than anything else on this page, and one of them can permanently flatten your foot if it is left too long.

Narrow It Down

Ask whether it aches or burns. A mechanical ache points at the tendon. Burning and tingling in the sole points at the nerve.

1
Most common
Posterior Tibial Tendon PainPosterior tibial tendon dysfunction
Behind the inner boneArch flatteningCannot single heel raise
The tendon running behind and below the inner ankle bone and into the arch.
Most likely yours if
  • Tender along a cord behind the inner ankle bone, sometimes with swelling
  • You cannot rise onto the toes of that leg alone, or it is much harder than the other side
  • The arch may be flattening, and the foot rolling inward
  • Worse with prolonged standing or walking
Stretches & mobility · daily
Strengthening · every other day
Do
  • Get this one taken seriously early. Left alone it can progress to a permanently flat foot
  • Use arch support while you rebuild the tendon
  • Train single-leg heel raises. That is both the test and the treatment
Don’t
  • Ignore a collapsing arch
  • Keep walking long distances in unsupportive shoes
  • Assume it is just plantar fasciitis. The location behind the inner ankle bone is the tell
2
Tarsal Tunnel SyndromeTibial nerve compression at the ankle
Burning in the soleWorse at nightTingling
Behind the inner ankle bone, with symptoms radiating into the sole of the foot.
Most likely yours if
  • Burning, tingling or numbness in the sole, rather than a mechanical ache
  • Often worse at night or after prolonged standing
  • Tapping behind the inner ankle bone can send a zing into the foot
  • It can follow a sprain, or come with a flat foot
Stretches & mobility · daily
Strengthening · every other day
Do
  • Get it diagnosed. Nerve problems in the foot are frequently mislabelled as plantar fasciitis
  • Support the arch, which reduces tension on the nerve
  • Avoid tight ankle braces and straps pressing on that area
Don’t
  • Roll or dig into the area behind the inner ankle bone
  • Ignore progressive numbness or weakness
  • Keep treating it as a fascia problem if it burns and tingles
3
Inner Ankle SprainDeltoid ligament sprain
Rolled outwardLess commonCheck for fracture
The ligaments below the inner ankle bone. Much less common than the outer sprain.
Most likely yours if
  • The ankle rolled outward, which is the unusual direction
  • Tenderness and swelling below the inner ankle bone
  • Often occurs with a higher-energy injury, so a fracture must be ruled out
  • Painful to push the foot outward
Stretches & mobility · daily
Strengthening · every other day
Do
  • Get an X-ray. Inner ankle sprains carry a higher chance of an associated fracture
  • Start gentle motion early once cleared
  • Rebuild strength and balance as with any sprain
Don’t
  • Assume it is a routine sprain. This direction is less common and more suspicious
  • Skip imaging if you cannot bear weight
  • Return to sport before balance is restored
4
Shin SplintsMedial tibial stress syndrome
Along the inner shinMileage spikeDiffuse, not pinpoint
A diffuse ache along the inner edge of the shin bone, above the ankle.
Most likely yours if
  • The soreness runs along a stretch of several inches, not one pinpoint spot
  • It came on after increasing running, or switching surfaces or shoes
  • Sore at the start of a run, sometimes easing, then worse after
  • Pinpoint pain on one small spot is different and suggests a stress fracture
Stretches & mobility · daily
Strengthening · every other day
Do
  • Cut running volume about 30 percent and hold there for two to three weeks
  • Build calf and shin strength. Heel raises plus dorsiflexion work
  • Check shoe age and running surface
Don’t
  • Run through worsening pain
  • Ignore it if the pain becomes pinpoint on one spot. That is a stress fracture question
  • Come back to full mileage in one step
Self-checks you can do right now

The single heel raise. Stand on the painful leg alone and rise onto your toes ten times. If you cannot, or the arch collapses, that points strongly at the posterior tibial tendon and it deserves early attention.

Ache or burn? A pulling, mechanical ache is tendon. Burning, tingling or numbness spreading into the sole is nerve.

Diffuse or pinpoint? On the inner shin, a diffuse ache over several inches is shin splints. Pain you can cover with one fingertip is a stress fracture until proven otherwise.

In the meantime
  • Support the arch. Almost everything in this zone improves when the arch is supported while you rebuild.
  • Single-leg heel raises. Both the test and the treatment for the main problem here.
  • Watch the arch shape. Compare both feet standing. A flattening arch on one side needs looking at promptly.
  • Cut the mileage, not the movement. About 30 percent for two to three weeks, then rebuild.
  • Burning means nerve. And nerves do not respond to rolling and digging.
Stop and get it looked at if

An arch that is visibly flattening, an inability to do a single-leg heel raise, pinpoint pain on one spot of the shin bone, or numbness spreading through the sole. All of those need an in-person assessment.

Top of the foot and toes

The Top of the Foot and the Toes

Forefoot pain has one important dividing line: can you cover the sore spot with a single fingertip, directly on a bone? If yes, that is a stress fracture question and it comes before everything else. If the pain is spread out or between the toes, the list is much friendlier.

Narrow It Down

The question that matters: pinpoint on a bone, or spread across an area?

!
Get this imaged
Metatarsal Stress FractureMetatarsal stress fracture
Pinpoint on a boneMileage spikeSwelling on top
Pinpoint on one of the long bones on top of the foot, usually the second or third.
Get this checked if
  • You can cover the sore spot with one fingertip, directly on a bone
  • It followed a sharp increase in running, walking, marching or dancing
  • Swelling on top of the foot, and it hurts with every step
  • It is getting worse week over week rather than fluctuating
Do
  • Get imaged. Early X-rays are often normal, so ask about an MRI if suspicion is high
  • Stop impact activity until cleared
  • Mention any recent training increase, and any nutrition or menstrual history if relevant
Don’t
  • Run through it
  • Assume a normal X-ray clears it
  • Keep training on the theory it is just a bruise
1
Most common in the forefoot
Morton’s NeuromaInterdigital neuroma
Between the toesPebble in the shoeTight shoes
Between the third and fourth toes, in the ball of the foot.
Most likely yours if
  • It feels like a pebble or a fold in your sock under the ball of the foot
  • Burning or numbness radiating into the toes
  • Tight or narrow shoes and high heels make it much worse
  • Taking the shoe off and rubbing the foot gives relief
Stretches & mobility · daily
Strengthening · every other day
Do
  • Change your shoes. A wide toe box is most of the treatment
  • Try a metatarsal pad placed just behind the ball of the foot, not under it
  • Get it confirmed if it is not settling. Injections help some people
Don’t
  • Wear narrow or pointed shoes, or heels, while it is symptomatic
  • Put a pad directly under the sore spot. It goes behind it
  • Ignore progressive numbness in the toes
2
Ball Of Foot PainMetatarsalgia
Under the ballLike a bruiseWorse barefoot
Under the ball of the foot, spread across rather than between the toes.
Most likely yours if
  • A bruised, burning ache under the ball of the foot
  • Worse barefoot on hard floors, and after long walking or standing
  • Often with calluses under the same area
  • No specific pebble sensation between the toes
Stretches & mobility · daily
Strengthening · every other day
Do
  • Cushion the forefoot and use a metatarsal pad
  • Loosen the calves. Tight calves push load onto the forefoot with every step
  • Rotate shoes and avoid thin, flat soles
Don’t
  • Walk barefoot on hard floors
  • Wear heels while it is sore
  • Ignore a pinpoint spot on one bone, which is a different problem
3
Top Of Foot Tendon PainExtensor tendinopathy
Laces areaTight shoesHurts lifting the toes
Across the top of the foot, roughly under the laces.
Most likely yours if
  • Aching across the top of the foot, worse where shoes press
  • Lifting the toes upward against resistance reproduces it
  • It followed tight lacing, a shoe change, or a jump in hill walking
  • No pinpoint bony tenderness, which separates it from a stress fracture
Stretches & mobility · daily
Strengthening · every other day
Do
  • Loosen the laces, or skip an eyelet over the sore spot
  • Reduce hill walking for a couple of weeks
  • Load it gradually with dorsiflexion work
Don’t
  • Keep lacing tightly over the tender area
  • Assume top-of-foot pain is always a stress fracture, though do check for a pinpoint bony spot
  • Push through worsening pain
Self-checks you can do right now

The one-finger bone test. Press along each long bone on top of the foot. Pinpoint tenderness on one bone, in someone whose training jumped, is a stress fracture until imaging says otherwise.

The squeeze test. Squeeze the forefoot from both sides. A click or a shot of pain into the toes suggests a neuroma.

Under or between? Pain under the ball of the foot is metatarsalgia. A pebble sensation between the third and fourth toes is a neuroma.

In the meantime
  • Widen the toe box. More forefoot problems resolve with shoe changes than with anything else.
  • Metatarsal pad goes behind. Just behind the ball of the foot, not under the sore spot.
  • Loosen the laces. Skip an eyelet over any tender area on top.
  • Stretch the calves. Tight calves drive load into the forefoot on every single step.
  • Respect pinpoint bone pain. That is the one thing here that does not wait.
Stop and get it looked at if

Pinpoint tenderness on one bone on top of the foot after a training increase, swelling with every step, or pain that is worsening week over week. Stress fractures need imaging, and early X-rays are often normal.

The Movements

Stretches &
Exercises

Every movement referenced above, in one place, with a video demo. Nothing here should reproduce sharp pain. Work in the range that feels clean and let it expand week by week. Two rules govern all of it, and they are spelled out right after this section.

Stretches and mobility

Daily is fine. For heel pain, do the toe pull before your first step out of bed.

Ankle Alphabet demonstrationWatch demo
01
Ankle Alphabet
Trace the letters A to Z in the air with your big toe. Moves the ankle through every direction without loading it. The safest starting point after any ankle injury.
1 to 2 rounds · 2x daily
Standing Calf Stretch demonstrationWatch demo
02
Standing Calf Stretch
Back leg straight, heel down, lean into a wall. Then repeat with the back knee slightly bent to catch the deeper soleus. Tight calves drive almost everything in this list.
Hold 30s · 3x each, straight and bent
Plantar Fascia Stretches demonstrationWatch demo
03
Plantar Fascia Stretches
Pull the toes back toward you to put the arch on stretch, and roll the arch over a ball or frozen bottle. Do the toe pull before your first step out of bed.
Hold 30s · 3x · before standing
Plantar Fascia Release demonstrationWatch demo
04
Plantar Fascia Release
Massage and soft tissue work for the bottom of the foot. Firm but not brutal. Two minutes is plenty.
1 to 2 min · daily
Whole-Foot Follow-Along demonstrationWatch demo
05
Whole-Foot Follow-Along
A complete guided routine for stubborn heel pain, including the hip and calf work most people skip.
2 to 3x per week

Strengthening

Every other day, except the Achilles heel drops which are done daily. A light band is all you need.

Heel Raises demonstrationWatch demo
01
Heel Raises
Rise onto the balls of the feet, lower slowly over three seconds. Start on two legs, progress to one. The single most important exercise for the foot and ankle.
3 sets of 15
Eccentric Heel Drops demonstrationWatch demo
02
Eccentric Heel Drops
Rise on two legs, shift to one, then lower that heel below the step over three seconds. The specific loading protocol for Achilles tendinopathy. Expect it to feel sore, and that is fine.
3 sets of 15 · daily
Ankle 4-Way With Band demonstrationWatch demo
03
Ankle 4-Way With Band
All four directions in one circuit: up, down, in and out. The efficient way to rebuild a whole ankle after a sprain.
2 rounds
Ankle Eversion demonstrationWatch demo
04
Ankle Eversion
Push the foot outward against a band. This is the direction that protects you from rolling the ankle again, so it matters more than the others.
3 sets of 15
Ankle Inversion demonstrationWatch demo
05
Ankle Inversion
Pull the foot inward against a band. Targets the tendon that holds up your arch.
3 sets of 15
Ankle Dorsiflexion demonstrationWatch demo
06
Ankle Dorsiflexion
Pull the foot upward against a band. Strengthens the front of the shin, which helps with shin splints and foot drop.
3 sets of 15
Ankle Plantar Flexion demonstrationWatch demo
07
Ankle Plantar Flexion
Press the foot down against a band. A gentler way to load the calf and Achilles before you are ready for heel raises.
3 sets of 15
Two Rules

How To Know If
You’re Doing Too Much

These two rules apply to every program on this page, wherever your pain is. They are the same ones I give patients in the office, and they replace the guesswork about whether to push through something.

1
The 3 out of 10 rule

Some discomfort during these exercises is normal and even useful. Pain above about a 3 out of 10 is not. If an exercise pushes past that, reduce the range, the weight, or the number of reps.

2
The 24-hour rule

You should be back to your normal baseline within 24 hours. If it is more sore the next morning, you did too much. Cut the volume roughly in half and build back from there.

Feet are slow, and that is normal
Plantar fasciitis commonly takes three to six months to fully resolve, though it improves steadily along the way. Achilles tendinopathy runs about twelve weeks on a proper eccentric protocol. Ankle sprains feel functional within a few weeks but need around three months of strength and balance work before the re-injury risk really drops, and stopping early is exactly why so many ankles keep rolling. Stress fractures need six to eight weeks off impact, full stop. The common thread is that feet respond to consistent loading rather than rest, and to shoe changes more than most people expect.
Don’t Wait On These

Signs You Should
Skip the Exercises

Most foot and ankle pain responds well to load management, shoe changes and progressive strengthening. These are the exceptions, and several of them need imaging first.

You cannot take four steps on it, right after an injury or now
A pop or a feeling of being kicked in the back of the leg, or you cannot rise onto your toes
Pinpoint tenderness directly on a bone after a training increase, with pain that worsens week over week
Tenderness on the bony bump halfway along the outside of the foot after rolling the ankle
An arch that is visibly flattening, or you cannot do a single-leg heel raise
A hot, red, swollen foot with a fever, or in anyone with diabetes
Numbness spreading through the sole, or any weakness lifting the foot
Any foot wound, ulcer or colour change in someone with diabetes. That is same-week, not wait-and-see
Not sure which one you’ve got? That is exactly what a first visit is for.
Book an Exam
Common Questions

Foot & Ankle
Questions

What causes heel pain first thing in the morning?

That pattern is close to diagnostic for plantar fasciitis. The tissue on the bottom of the foot tightens overnight, so the first ten steps are the worst of the day and it eases as you move. Pull your toes back and hold for thirty seconds before you stand up, wear supportive shoes indoors, and add calf strengthening. Heel pain that is not worse in the morning is more likely fat pad pain or a nerve.

What is the difference between Achilles tendonitis at the bone and higher up?

It matters a great deal, because the treatments are opposite. Mid-portion Achilles tendinopathy sits two to three inches above the heel bone and responds to eccentric heel drops off a step. Insertional Achilles pain sits right at the bone, and dropping the heel below level compresses the tendon and makes it worse. For insertional pain, do heel raises on flat ground only and use a small heel lift.

How do I know if my ankle sprain needs an X-ray?

The standard rule is whether you can take four steps on it, either immediately after the injury or now. If you cannot, or if there is tenderness directly on bone rather than soft tissue, get imaged. Also check the bony bump about halfway along the outside of the foot, because a fracture there is commonly missed on an ankle-only X-ray.

Why does my ankle keep rolling?

Because the first sprain was probably never fully rehabbed. Around a third of ankle sprains go on to chronic instability, almost always because rehab stopped when the pain stopped. The fix is strengthening eversion, pushing the foot outward against a band, plus balance training. Two minutes a day of single-leg standing, progressing to eyes closed, measurably reduces re-injury.

What is the pebble feeling in the ball of my foot?

That sensation, like a folded sock or a stone under the ball of the foot with burning into the toes, is typical of a Morton's neuroma, usually between the third and fourth toes. Narrow shoes and heels make it worse. A wide toe box and a metatarsal pad placed just behind the ball of the foot, not under it, resolve many cases.

Do I have shin splints or a stress fracture?

The distinguishing feature is how spread out it is. Shin splints ache along several inches of the inner shin. A stress fracture is pinpoint, meaning you can cover it with one fingertip, and it tends to worsen week over week rather than fluctuate. Pinpoint bone pain after a training increase should be imaged, and early X-rays are often normal.

Should I stretch or strengthen plantar fasciitis?

Both, but strengthening is the part most people skip. Stretch the toes back before your first step in the morning, and stretch the calf with the knee both straight and bent. Then add heel raises three times a week. Calf strength changes the load going through the fascia with every step, and it does more over time than stretching alone.

How long does foot and ankle pain take to get better?

Plantar fasciitis commonly takes three to six months, though it improves along the way. Achilles tendinopathy runs about twelve weeks on a proper heel drop protocol. Ankle sprains are usually functional within weeks but need three months of strength and balance work to stop them recurring. Stress fractures need six to eight weeks off impact.

Can a chiropractor help with foot and ankle pain?

Yes. Foot and ankle problems are usually load problems, and load comes from above, so the hip, knee and the way you walk all matter. Dr. Loewenstein assesses the whole chain, uses hands-on care to restore ankle and foot motion, and builds the loading program that resolves it. Treatment starts on the first visit at the UTC San Diego office.

UTC San Diego · Mon–Fri 9am–7pm · Sun 10am–4pm

Find Out What’s
Actually Going On

Narrowing it down by location gets you most of the way there. A hands-on exam gets you the rest of the way, and treatment starts on visit one.

Book an Appointment(858) 558-3111
5151 Shoreham Place, Suite 175 · UTC San Diego, CA 92122 · Near UCSD
JL
Dr. Jordan Loewenstein, D.C.
D.C. · M.S. Nutrition · ART Certified · Webster Certified · sdspinecare.com
Clinically reviewed August 2026
Related Pages
Foam Rolling: How to Do It RightKnee Pain by LocationHip Pain by LocationLow Back Pain ExercisesExercise & Stretch LibraryAbout Dr. Loewenstein
This page is general educational information and is not a substitute for a professional diagnosis or individualized medical advice. Pain location narrows the possibilities, it does not confirm a diagnosis. Stop any exercise that causes sharp pain. If you cannot bear weight, felt a pop in the back of the leg, have pinpoint tenderness on a bone, or have diabetes with any foot wound or colour change, seek an in-person evaluation promptly.