Ankle & lower leg
Ankle Pain & Achilles Injuries — North Vancouver
An ankle sprain that still isn't right six weeks later. Achilles stiffness that warms up after ten minutes but comes back the next morning. Recurring rolls on trail runs. Ankle injuries are often under-treated because the initial pain fades — we pick up where that leaves off.
What it is
Understanding your ankle pain & achilles injuries.
The ankle is the joint most commonly injured in sport, and also one of the most commonly under-rehabilitated. A lateral ankle sprain is treated with a few days of ice and then declared healed once the swelling goes down — but the proprioceptive deficit and mechanical laxity that remain are what cause the second, third, and fourth sprains. Chronic ankle instability is almost always the downstream result of an under-treated first injury.
Achilles tendinopathy is the other major category. The Achilles is the thickest, strongest tendon in the body — and one of the most load-sensitive. Insertional Achilles pain (at the back of the heel) and mid-portion pain (a few centimetres up the tendon) behave differently and respond to different treatment approaches. Knowing which one you have changes the protocol significantly.
We also see posterior tibial tendon dysfunction, peroneal tendon injuries, sinus tarsi syndrome after complex sprains, and stress reactions in the fibula or calcaneus in high-mileage runners. The foot and ankle work as a unit with the knee and hip — a thorough assessment includes looking at the whole chain.
What to expect
Acute lateral ankle sprains typically resolve functionally in 4–8 weeks with a proper proprioceptive program, though full stability sometimes takes longer. Achilles tendinopathy is more variable: mid-portion responds well to loading over 8–12 weeks; insertional cases take longer and respond differently to certain exercises (heel drops below neutral are contraindicated early). Your physiotherapist will set a realistic timeline at your first appointment after assessing which structure is involved and how irritable the tissue currently is.
Get a plan
Not sure if we're the right fit?
Send us a quick note about what's going on. A physiotherapist — not a receptionist — will read it and reply with what they'd recommend. No commitment to book.
Common questions
About ankle pain & achilles injuries.
My ankle was X-rayed and nothing was broken — why does it still hurt?+
X-ray rules out fracture but doesn't assess ligament integrity, joint mechanics, or the proprioceptive deficit that follows even a mild sprain. Persistent pain after a negative X-ray is common and usually means the ligament and joint rehab hasn't been completed.
Is Achilles pain the same as plantar fasciitis?+
No — they're different structures. Plantar fasciitis is on the underside of the heel; Achilles tendinopathy is at the back. They can occur together in the same foot, which is why a proper assessment matters. We treat both, and the management is quite different.
Should I stretch my Achilles?+
For mid-portion Achilles tendinopathy, moderate stretching can help. For insertional Achilles pain, aggressive stretching — especially heel drops below the step — compresses the tendon against the bone and often makes it worse. We'll tell you which type you have and which exercises are appropriate.
I keep rolling the same ankle. Can that be fixed?+
Yes. Chronic ankle instability responds well to a targeted balance and strength program that re-educates the muscles and restores the joint's position sense. Some patients with persistent mechanical laxity benefit from bracing during high-risk activity while rehab progresses. Surgical reconstruction is rarely necessary.
Do you direct-bill extended health?+
Yes. We direct-bill most major extended-health plans, plus ICBC and WorkSafeBC for ankle injuries sustained in accidents or at work.
This page is for general information only and does not constitute medical advice, diagnosis, or treatment. Individual presentations vary — assessment findings and treatment plans differ from person to person. If you are experiencing severe symptoms, neurological changes (numbness, weakness, bowel or bladder changes), or a significant trauma, contact your physician or emergency services. Physiotherapy at Medstar Sport Physio & Health is provided by physiotherapists registered with the College of Physical Therapists of British Columbia (CPTBC).