Evidence-based care at Vantage Point
Foot Physiotherapy in Bondi Junction
Assessment and treatment for foot pain, from heel pain and pain in the ball of the foot to big toe and arch problems, with a clear explanation of what is going on and a plan built around strength, footwear and load.
- APA Musculoskeletal Physiotherapists
- Running and walking assessment with video analysis
- Rehabilitation before and after foot surgery
Symptom profiles
Which best describes your symptoms?
Foot pain presents in distinct ways, and where you feel it and how it started point to different structures and a different starting point for treatment. Select the one closest to yours.
Plantar Heel Pain
Pain under the heel, often sharpest with your first steps in the morning or after sitting. It is one of the most common causes of foot pain in adults.
You might notice
- Sharp pain under the heel with your first steps in the morning
- Pain after sitting that eases as you warm up, then builds again with long periods on your feet
- Tenderness on the inside of the heel
What is usually happening
Plantar heel pain usually means the plantar fascia, the thick band under your foot, has become sensitive to load, often after more time on your feet, more running or a change in footwear. A best practice guide recommends starting with education, stretching and taping, then adding other treatments only if progress is slow. In a trial of 48 people, high-load strength training improved foot function more than stretching at 3 months, with similar results by 12 months (Morrissey et al., 2021; Rathleff et al., 2015).
Common causes
Plantar fasciopathy
Irritation of the plantar fascia where it attaches to the heel bone, the most common cause.
Fat pad irritation
Bruising or thinning of the fat pad under the heel, often worse on hard ground and barefoot.
Nerve irritation
Irritation of a small nerve on the inside of the heel, causing burning or tingling.
Heel stress fracture
A bone stress injury in the heel bone, which can follow a jump in running or walking.
What we look at in your assessment
Where your pain sits and how it behaves, calf and foot strength with VALD dynamometry, your footwear, and your walking and running with video analysis. If a stress fracture or another cause is suspected, we arrange imaging through your GP or a sports physician.
How treatment usually starts
Education on load and footwear, taping and stretching to settle pain, then progressive calf and foot strengthening. If progress is slow, we refer you to a podiatrist for options such as shockwave or custom orthoses.
Related services
Pain in the Ball of the Foot
Pain, burning or numbness under the ball of the foot or between the toes, often worse in tight or high-heeled shoes and on long walks or runs.
You might notice
- Burning or sharp pain between the third and fourth toes
- A feeling like standing on a stone or a folded sock
- Pain under the ball of the foot that eases when you take your shoes off
What is usually happening
Forefoot pain usually comes from too much load through the front of the foot, from footwear, foot shape, running or long periods on your feet. Many people settle with changes to footwear and load. For Morton's neuroma, an irritated nerve between the toes, a corticosteroid injection improved foot health at 3 months compared with a local anaesthetic injection alone in a trial of 131 people (Thomson et al., 2013).
Common causes
Morton's neuroma
An irritated, thickened nerve between the toes, usually between the third and fourth.
Metatarsalgia
Pain under the ends of the long foot bones, often from load through the forefoot.
Plantar plate injury
A strain or tear of the ligament under the base of a toe, sometimes with the toe drifting or lifting.
Stress fracture
A bone stress injury in one of the long foot bones, common in runners and walkers.
What we look at in your assessment
Whether the pain comes from a nerve, joint, ligament or bone, your footwear, foot posture and toe strength, and how you walk and run with video analysis. If a stress fracture or plantar plate tear is suspected, we arrange imaging.
How treatment usually starts
Footwear changes and a metatarsal pad or taping to offload the area, adjusting running or walking load, then foot and calf strengthening. If symptoms persist, we work with your GP, podiatrist or sports physician on options such as an injection.
Related services
Big Toe Pain and Stiffness
Pain or stiffness at the base of the big toe, from arthritis, a bunion or a sprain, often worse when pushing off, running or wearing tight shoes.
You might notice
- Pain at the base of the big toe when you push off
- A stiff big toe that does not bend up as far as the other side
- A bump on the side of the joint, or pain in tight shoes
What is usually happening
The big toe joint takes load every time you push off. When it becomes stiff or painful, people often change how they walk, which can overload other parts of the foot. Many people with big toe arthritis or a bunion manage well with footwear changes, strengthening and changes to activity, and surgery is an option when symptoms do not settle.
Common causes
Hallux rigidus
Arthritis of the big toe joint, causing pain and stiffness, especially when pushing off.
Bunion (hallux valgus)
The big toe drifting toward the other toes, with a bump on the side of the joint.
Turf toe
A sprain of the big toe joint from being forced upward, common in field sports.
Sesamoid pain
Pain under the big toe joint from the two small bones in the tendon beneath it.
What we look at in your assessment
Big toe range and strength, how you push off when you walk and run, your footwear, and any scans. If surgery may be worth considering, we discuss it with you and your GP or a foot and ankle surgeon.
How treatment usually starts
Footwear changes, taping or a stiff insole to reduce painful movement, foot and calf strengthening, and changes to running technique or training where needed.
Related services
Foot Pain in Runners
Foot pain that builds with running or a jump in training, on top of the foot, through the midfoot or under the forefoot.
You might notice
- Pain that builds during or after runs and is worse the next morning
- A sore spot on top of the foot or on one bone
- Pain that started after more distance, speed or hills
What is usually happening
Most running-related foot pain comes from training load rising faster than the bones and tendons can adapt. Bone pain that builds with running needs prompt assessment, as a bone stress injury is managed with a graded return to running over weeks, guided by your symptoms and the site of the injury (Warden et al., 2014).
Common causes
Bone stress injury
Pain in a foot bone that builds with running, ranging from a stress reaction to a stress fracture.
Extensor tendon pain
Pain on top of the foot, often from tight laces or a jump in training.
Midfoot pain
Pain through the middle of the foot, from the joints, ligaments or tendons.
Tibialis posterior tendon pain
Pain along the inside of the ankle and arch, common in runners.
What we look at in your assessment
Your training history and load, running technique with video analysis, foot and calf strength with VALD dynamometry, and your footwear. If a bone stress injury is suspected, we arrange imaging through your GP or a sports physician.
How treatment usually starts
A modified training plan, progressive strength and tendon loading, and a graded return to running based on milestones, with changes to technique and footwear where they help.
Related services
Arch Pain and Flat Feet
Pain along the arch or the inside of the ankle, sometimes with an arch that is gradually flattening, common in active adults and people over 40.
You might notice
- Pain and swelling along the inside of the ankle and arch
- Difficulty rising onto your toes on one leg
- An arch that looks flatter than on the other side
What is usually happening
A flat foot is common and often pain free. Pain along the arch and inside of the ankle often comes from the tibialis posterior tendon, which supports the arch. In 36 adults with early-stage tibialis posterior tendon problems, orthoses with stretching helped, and adding progressive resistance exercise improved pain and function further over 12 weeks (Kulig et al., 2009).
Common causes
Tibialis posterior tendinopathy
Pain in the tendon that supports the arch, running behind the inner ankle bone.
Progressive collapsing foot
An arch that gradually flattens as the tendon and ligaments weaken, previously called adult acquired flatfoot.
Midfoot arthritis
Wear in the joints through the middle of the foot, causing aching and stiffness.
What we look at in your assessment
A single-leg heel raise test, foot posture, tendon loading tests, calf and foot strength with VALD dynamometry, and how you walk. If the arch is changing or symptoms are not settling, we arrange imaging and a review with a foot and ankle surgeon.
How treatment usually starts
Progressive strengthening of the tendon and calf, load management and footwear changes, working with your podiatrist if orthoses are needed. Surgery is reserved for feet that do not respond.
Related services
Recovery After Foot Surgery
Rehabilitation before and after foot surgery, from bunion correction to joint fusion and fracture fixation, starting when your surgeon advises and following their protocol.
You might notice
- Swelling and stiffness after your operation
- Difficulty walking normally once you are out of the boot or post-operative shoe
- Wanting to get back to walking, work or sport
What is usually happening
After foot surgery, swelling, stiffness and calf weakness are common, and a staged plan within your surgeon's limits helps you return to normal walking. We test strength and balance before you return to running or sport.
Common surgeries
Bunion correction
Realigning the big toe joint, with a staged return to walking and normal shoes.
Joint fusion
Fusing a painful arthritic joint, often in the big toe or midfoot.
Fracture fixation
Plates or screws to hold a broken foot bone, such as a fifth metatarsal fracture.
Neuroma removal
Removing a Morton's neuroma that has not settled with other treatment.
What we look at in your assessment
Your surgeon's protocol, swelling and range of movement, walking, balance, and strength testing with VALD dynamometry once it is safe to test.
How treatment usually starts
Before surgery, prehab builds strength and range. Afterwards, settling swelling and restoring movement come first, then staged strengthening, walking and balance work within your surgeon's limits, progressed by measured milestones. We communicate with your surgeon throughout.
Related services
Ankle sprain, an ankle that keeps giving way or Achilles pain? See ankle physiotherapy.
The research
What the Research Tells Us
Heel pain is common and can be slow to settle. A best practice guide, built from the research, experienced clinicians and the views of people with heel pain, recommends a stepped approach.
That is how we plan your care: a clear core plan first, with checkpoints along the way, and other treatments added only if you need them.
Heel pain: a stepped plan
- 1
From your first visit
The core plan
Education on load and footwear, calf and plantar fascia stretching, and taping.
- 2
Slow progress after 4 to 6 weeks
Add shockwave therapy
Shockwave therapy alongside the core plan, through a podiatrist we refer you to.
- 3
Still slow to improve
Add custom orthoses
Custom foot orthoses, made by a podiatrist.
Based on a best practice guide for plantar heel pain informed by a systematic review, expert clinical reasoning and patient values (Morrissey et al., 2021).
Strength training
Faster gains in foot function
In 48 people with plantar fasciitis, high-load strength training improved foot function more than stretching at 3 months, with similar results by 12 months (Rathleff et al., 2015).
Orthoses
A small, short-term benefit
In 135 people with plantar heel pain, custom and prefabricated orthoses gave small improvements in function at 3 months compared with a sham insole, and no difference at 12 months (Landorf et al., 2006).
Morton's neuroma
An injection helped at 3 months
In 131 people with Morton's neuroma, a corticosteroid injection improved foot health at 3 months compared with a local anaesthetic injection alone (Thomson et al., 2013).
Arch pain
Exercise added to orthoses helped more
In 36 adults with early tibialis posterior tendon problems, adding progressive resistance exercise to orthoses and stretching gave greater improvements in pain and function over 12 weeks (Kulig et al., 2009).
Runners
Bone pain needs early assessment
Bone stress injuries in runners are managed with a graded return to running over weeks, guided by symptoms and the site of the injury (Warden et al., 2014).
Most foot pain settles with the right load, the right footwear and a stronger foot and calf. That is why we measure your strength and build your plan around what you want to get back to.
Your treatment
Five Steps, Each With a Clear Goal
Every consultation is 45 minutes. Your plan is built around what matters to you, whether that is walking on the sand, a morning run or a full day on your feet.
- 1
Assess
A detailed history and examination of your foot, ankle, knee and hip, including your footwear and how you walk and run.
Goal: A clear diagnosis
- 2
Explain
What is causing your pain, what to expect, and which activities are safe to keep doing.
Goal: Confidence to keep moving
- 3
Settle
Hands-on treatment, dry needling where it helps, taping, and changes to your footwear and how you load the foot to calm pain.
Goal: Pain under control
- 4
Strengthen
Progressive foot, calf and hip strength, with VALD dynamometry to compare sides and track change.
Goal: Strength targets met
- 5
Stay well
A return to walking, running or sport based on milestones, and a plan to keep your feet strong.
Goal: Back to what matters to you
Fees and funding
Consultations and Rebates
Every consultation is 45 minutes. The number of consultations you need depends on your foot and your goals, so we discuss your plan with you at your first visit.
Book an AppointmentWays to claim
- Private health: rebates claimed on the spot with HICAPS
- Medicare: rebates with a GP referral
- Workers compensation: fees set by SIRA, with approvals coordinated with your case manager
- CTP: fees set by SIRA
Common Questions
Do I need an X-ray or scan for my foot?
Not always. Most foot pain can be diagnosed with a thorough history and examination. We arrange imaging through your GP or a sports physician when a fracture, bone stress injury or tear is suspected, or when your pain is not improving as expected.
Do I need orthotics?
Not always. Many people improve with footwear changes, taping and strengthening. For heel pain, custom and prefabricated orthoses gave small improvements in function at 3 months compared with a sham insole, and no difference at 12 months (Landorf et al., 2006). If orthotics are likely to help, we work with a podiatrist.
What shoes should I wear?
While heel pain settles, supportive, comfortable shoes with a slightly higher heel than toe usually help, and long periods barefoot or in flat, unsupportive shoes are best avoided (Morrissey et al., 2021). For pain in the ball of the foot, a wider toe box and a lower heel help. We look at your shoes at your assessment.
Can I keep running with foot pain?
Often, with changes to how far, how fast and how often you run. The exception is pain in a bone that builds with running or is still there the next morning, which needs assessment for a bone stress injury before you keep going.
Should I get an injection for my foot pain?
It is a decision for you and your doctor. For Morton's neuroma, a corticosteroid injection helped more than a local anaesthetic injection at 3 months (Thomson et al., 2013). For heel pain, injections have not yet been well tested (Morrissey et al., 2021). We are happy to talk it through with you and your GP or specialist.
When should I see a doctor urgently?
Seek urgent medical care if you cannot put weight on your foot after an injury, if your foot looks deformed or is cold or numb, or if it is red, hot and swollen, especially if you have diabetes or feel unwell.
How many sessions will I need?
It depends on your foot, how long you have had symptoms and your goals. We give you an estimate at your first visit and review it as you meet each step's goal.
Can I claim my physio through private health?
Yes. Rebates are claimed on the spot with HICAPS. Medicare rebates are available with a GP referral, and workers compensation and CTP claims are accepted once approved.
What research is this page based on?
The studies referenced on this page are listed below.
- Kulig K, Reischl SF, Pomrantz AB, Burnfield JM, Mais-Requejo S, Thordarson DB, Smith RW. Nonsurgical management of posterior tibial tendon dysfunction with orthoses and resistive exercise: a randomized controlled trial. Phys Ther. 2009;89(1):26–37.
- Landorf KB, Keenan AM, Herbert RD. Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial. Arch Intern Med. 2006;166(12):1305–1310.
- Morrissey D, Cotchett M, J’Bari AS, Prior T, Griffiths IB, Rathleff MS, Gulle H, Vicenzino B, Barton CJ. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. Br J Sports Med. 2021;55(19):1106–1118.
- Rathleff MS, Mølgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. High-load strength training improves outcome in patients with plantar fasciitis: a randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2015;25(3):e292–e300.
- Thomson CE, Beggs I, Martin DJ, McMillan D, Edwards RT, Russell D, Yeo ST, Russell IT, Gibson JN. Methylprednisolone injections for the treatment of Morton neuroma: a patient-blinded randomized trial. J Bone Joint Surg Am. 2013;95(9):790–798.
- Warden SJ, Davis IS, Fredericson M. Management and prevention of bone stress injuries in long-distance runners. J Orthop Sports Phys Ther. 2014;44(10):749–765.
- Clinically reviewed by David Cohen and Zachary Ehrenfeld, APA Musculoskeletal Physiotherapists and Directors of Vantage Point Physiotherapy. Last reviewed October 2026.
