Every step is a test of ankle and foot capacity.

Stretching or tearing of the ligaments on the outside of the ankle, most often the ATFL and CFL, usually when the foot rolls inward.

• Lateral pain, swelling and bruising
• Pain with walking or weight-bearing
• Ligament tenderness and sometimes a sense of instability

Injury to the ligaments connecting the tibia and fibula above the ankle joint. It often takes longer to recover than a lateral sprain.

• Pain at the front or above the ankle
• Pain with leg rotation, walking or push-off
• Marked difficulty loading the leg, sometimes with little bruising

Stretching or tearing of the medial ankle ligament complex after eversion or rotational trauma. Fracture or syndesmosis injury may coexist.

• Medial ankle pain and swelling
• Pain with weight-bearing
• Deltoid-ligament tenderness and sometimes instability

Repeated episodes of the ankle giving way after sprains, associated with mechanical laxity and/or reduced neuromuscular control.

• Giving way on uneven ground or during sport
• Recurrent ankle sprains
• Persistent pain, swelling or lack of confidence after the initial injury

A load-related condition usually affecting the tendon 2–6 cm above the heel, with changes in tendon structure and capacity.

• Achilles pain and stiffness, especially in the morning
• Pain at the start of or after running and jumping
• Mid-tendon thickening and tenderness

A load-related disorder where the Achilles attaches to the calcaneus, sometimes accompanied by bony or bursal change.

• Pain at the back of the heel
• Pain with firm shoes, uphill walking or heel raises
• Stiffness, thickening or tenderness at the insertion

A partial or complete tendon tear, usually during forceful push-off, sprinting or jumping. Prompt assessment is required.

• A pop or feeling of being struck at the back of the leg
• Sudden pain and swelling
• Marked push-off weakness and difficulty performing a heel raise

Progressive dysfunction of the tendon supporting the medial arch, often forming part of progressive flatfoot deformity.

• Pain and swelling behind the medial malleolus or along the arch
• Progressive arch lowering and heel deviation
• Difficulty or inability to perform a single-leg heel raise

Overload, tearing or displacement of the peroneal tendons behind the lateral malleolus, often after a sprain or cutting sport.

• Pain behind or below the lateral malleolus
• Pain with eversion, running or uneven ground
• Tendon snapping and sometimes instability

Irritation of the tendon at the front of the ankle and top of the foot, often related to hills, running or shoe pressure.

• Anterior ankle or medial-foot pain
• Pain while lifting the foot or walking uphill
• Tenderness and sometimes swelling along the tendon

Cartilage degeneration, often following previous fracture or injury at the ankle or foot joints. Imaging alone does not define symptom severity.

• Pain with walking and loading
• Stiffness, swelling and restricted movement
• Difficulty on uneven ground or during toe-off

Injury to cartilage and underlying bone at the talar dome, often after an ankle sprain or fracture.

• Persistent deep ankle pain after trauma
• Recurrent swelling with activity
• Clicking, catching, locking or instability

Compression of soft tissue or bone at end range: anteriorly in dorsiflexion or posteriorly in plantarflexion.

• Anterior pain with squatting, descending stairs or sprinting
• Posterior pain during pointe, kicking or landing
• Restricted movement and sometimes swelling or locking

Joint inflammation from rheumatological disease, crystals or infection. Septic arthritis is a medical emergency.

• Joint pain, warmth, redness and swelling
• Sudden severe onset with gout or infection
• Fever, a nearby wound or systemic illness requires urgent assessment

A load-related condition of the plantar fascia near its heel attachment; a heel spur is not necessarily the pain source.

• Plantar-medial heel pain
• Worst pain during the first steps after sleep or rest
• Symptoms after prolonged standing, walking or running

Irritation or reduced cushioning capacity of the tissue beneath the calcaneus, often from repeated impact or pressure.

• Deep pain in the centre of the heel
• Greater pain barefoot or on hard surfaces
• A bruised feeling during standing and walking

Progressive deviation of the great toe towards the lesser toes with medial prominence of the first metatarsal head.

• A painful bump at the great-toe base
• Redness or shoe pressure
• Walking difficulty and toe deformity in advanced cases

Osteoarthritis of the first metatarsophalangeal joint that especially restricts great-toe extension during push-off.

• Pain and stiffness at the great-toe base
• Pain with walking, running or heel raises
• A dorsal bony prominence and progressive loss of movement

A clinical term for pain beneath the metatarsal heads related to overload, joint irritation or altered pressure distribution.

• Forefoot pain or burning
• A sensation of walking on a pebble
• Pain with standing, walking, running or tight shoes

Stretching or tearing of the plantar stabiliser of an MTP joint, most commonly affecting the second toe.

• Pain beneath the base of the toe
• Instability or a toe that elevates and deviates
• Swelling and pain during push-off

Thickening and irritation of an interdigital nerve, most often between the third and fourth metatarsals, from repeated compression.

• Burning forefoot pain spreading into the toes
• Numbness or tingling in adjacent toes
• A pebble-in-the-shoe sensation aggravated by narrow footwear

Overload or fracture of the small bones beneath the great-toe joint that bear load during push-off.

• Pain beneath the great-toe base
• Pain with running, jumping or toe walking
• Swelling or bruising, especially after trauma

A sprain of the plantar complex of the great-toe joint after forced hyperextension, often during sprinting on firm surfaces.

• Pain and swelling at the great-toe base after trauma
• Pain with push-off and direction change
• Restricted movement or instability in larger injuries

Lowering of the medial arch during loading that may be a normal, asymptomatic variant; it becomes clinically relevant when associated with pain or limitation.

• Fatigue or pain in the arch, heel or ankle
• Difficulty with long walks or sport
• The arch reappears when unloaded in flexible flatfoot

A high-arched foot that may concentrate pressure under the heel and forefoot and can sometimes be associated with neurological disease.

• Pain and calluses beneath the heel or metatarsals
• Instability and recurrent ankle sprains
• Toe deformity or difficulty fitting shoes

An abnormal connection between two or more hindfoot bones that may restrict movement and become symptomatic in adolescence.

• A rigid flatfoot with restricted movement
• Hindfoot or ankle pain
• Recurrent sprains and activity-related fatigue

Irritation of the heel growth plate in active children and adolescents; it is not an adult tendon disorder.

• Heel pain with running and jumping
• Tenderness when the calcaneus is squeezed from the sides
• Limping or toe walking after activity

Compression of the tibial nerve or its branches behind the medial malleolus, producing sensory symptoms in the sole.

• Burning, numbness or tingling in the sole and heel
• Symptoms aggravated by standing or walking
• Tenderness behind the medial malleolus and sometimes intrinsic-muscle weakness

A fracture of the lateral, medial and/or posterior malleolus, often with ligament injury. Joint alignment and stability determine urgency.

• Pain, swelling and bruising after trauma
• Inability or major difficulty bearing weight
• Deformity, an open wound or circulation change requires emergency care

A sprain, fracture or displacement at the tarsometatarsal complex of the midfoot. It may resemble a sprain but needs early recognition.

• Midfoot pain and swelling
• Bruising on the sole of the foot
• Severe pain with weight-bearing or push-off

A fracture at the base or shaft of the fifth metatarsal; a Jones fracture carries greater risk of delayed healing because of limited blood supply.

• Pain and swelling on the outside of the foot
• Pain with walking or loading
• Bruising and focal bony tenderness

Bone stress injury when repeated load exceeds recovery, often affecting a metatarsal, navicular, calcaneus or distal tibia.

• Gradual focal pain aggravated by activity
• Clear bony tenderness and sometimes swelling
• Pain progressing from sport to walking or rest

A fracture of a major hindfoot bone, usually after a fall from height or high-energy trauma.

• Marked heel or ankle pain and swelling
• Inability to bear weight
• Extensive bruising, deformity, numbness or an open wound requires emergency care

Progressive bone and joint damage in a neuropathic foot, most often associated with diabetes. A suddenly hot, swollen foot requires prompt assessment.

• Swelling, warmth and redness, sometimes with less pain than expected
• Progressive change in foot shape
• An ulcer, fever or suspected infection requires urgent assessment