Leeds Community Healthcare NHS Trust - Hip, Knee, Leg and Foot/Ankle Problems

Hip, knee and foot/ankle pain is relatively common. Pain can come from the joints, or from the soft tissues such as the muscles, tendons or ligaments. Your pain may have started suddenly after a sprain or strain, or an overuse injury, or your pain might have developed slowly over time. Joints in the hip, knee, foot and ankle may develop osteoarthritis as we get older or following an injury in the past, which can be another cause of pain and stiffness at times. Sometimes pain or symptoms of tingling and numbness in the leg(s) can be associated with back pain.

In most cases hip, knee or foot/ ankle pain has a simple cause and will settle down over time, using self-management approaches which can be carried out at home. Some conditions can be more persistent such as osteoarthritis, but even these can often be self- managed successfully with the right advice and exercises.

Here is some more information on hip, knee, foot and ankle problems including advice on what you can do, some exercises to try, and information on when you should seek medical care.

QWhat can I do to help my hip, knee, foot or ankle pain?
A new sprain or strain or an overuse injury can usually be managed at home and should start to improve within a few days. For other hip, knee, foot and ankle problems including longer-term pain, self–management at home using the advice and exercises below will usually help the problem to settle. This advice aims to reduce your symptoms and help the healing process.

Pain relief such as paracetamol or anti-inflammatory pain medication can help to control your pain so that you can keep moving normally.

Heat is a simple and safe way to relieve pain if your pain is more than a few days old. Apply a heat pack, wheat bag or small hot water bottle to the painful area. Always wrap the hot water bottle in a towel first to reduce the risk of burns. You can keep the heat pack applied for as long as it is comfortable; just make sure to check your skin regularly. You can buy heat gels to apply to the skin. These have the same effects as applying a hot or cold pack but are more portable when you are out and about.

Adjust your activities for a while. Often simply reducing the activity which caused the problem or stopping it temporarily can greatly improve your pain. You should aim to gradually re-introduce this activity and build it back up over time.

Exercise can help your recovery. Exercise improves joint nutrition, strengthens muscles and releases the body’s own natural painkillers called endorphins. It is important to get the right balance, avoid doing too much exercise that your pain flares up but too little that your joint stiffens and muscles weaken. A long term commitment to exercise is ideal and so it is important to try different types of exercise so that you find what you enjoy most.

Weight Management is particularly important for hip, knee, and foot/ankle problems. As these are load bearing joints, many conditions are exacerbated by excess weight. You can calculate your BMI to check if you would benefit from losing weight. Take a look at our MSK health and wellbeing information section for more help and support with weight management

Footwear is particularly important for foot and ankle problems and can also affect knee and hip problems. Foot size changes with age, swelling, weight-gain and arthritic changes. Healthy footwear that fits well and is supportive helps to keep our feet healthy and may help to reduce pain. Further advice on foot care and our podiatry (foot care) service can be found here: Leeds community podiatry service information
QWhen to seek further advice or medical care
- After high impact injury*
- If the pain is constant and severe, with night time pain which stops you sleeping and you are unable to bear weight
- If the joint is red, hot, swollen or you have infection signs such as fever
- If you have numbness or tingling in your leg and/ or your leg has become weak
- If you develop your hip/knee/ foot or ankle pain at the same time as feeling generally unwell or having a fever
- Pain fails to settle after engaging in management suggested above over 4-6 weeks
*If you have had a high impact injury to the knee which has resulted in immediate swelling or bruising, an audible pop or sound, severe pain and you are unable to bear weight through your leg – please visit Accident and Emergency

If you suffer a high impact injury and develop significant swelling some hours or a day later please see your GP
QExercises for hip, knee, foot and ankle problems
The joints and muscles in the leg all work together. Problems in the hip, knee, foot and ankle will often benefit from exercising all areas of the leg.

Hip Exercises

Common problems causing hip pain include groin strains, osteoarthritis (OA), joint and muscles problems can all be causes of ongoing hip pain.

Self- management using the advice above and the exercises below will help the problem to settle in most cases. However if this fails to help, ask a physiotherapist or GP for help.

As a general guide carry out the exercises below twice daily. Start with 5 repetitions of each exercise, working within your pain tolerance. It can be usual to experience an increase in your pain for up to 30 minutes following these exercises, adjust the number of repetitions if symptoms increase for longer. As your strength and movement improve, you should increase the number of repetitions up to 10.

Standing Hip Abduction

Stand straight holding a chair. Move your outside leg slowly to the side, keeping your knee straight and without changing the position of your pelvis or body. Bring your leg slowly back together. Repeat.

Bridge

Lie on your back (on the floor or on your bed) with your knees bent. Contract your buttocks to lift your hips off the floor/bed until your body is in line with your legs.

Slowly lower your buttocks to the starting position. Repeat

Sit to Stand

Sit on a chair that is against a wall so that it will not move when you stand up.

Fold your arms across your chest. With your feet slightly apart, lean forward so that your shoulders are over your feet and stand up fully.

Slowly return to sitting. Repeat.

Knee Exercises

Common problems causing knee pain include osteoarthritis, patellofemoral pain (Anterior Knee pain), tendinopathy, ligament and meniscal or cartilage injuries can all cause ongoing knee pain. Self- management using the advice above and the exercises below will help the problem to settle in most cases. However if this fails to help, ask a physiotherapist or GP for help.

Straight leg raise and hold

Lying on your back (on the floor or on your bed), with one knee bent and the other out straight, lift your straight leg keeping the knee straight. Aim to lift your heel about 10-15cm and hold for 10 seconds before lowering leg again. Repeat.

Sit to stand

Sit on a chair that is against a wall so that it will not move when you stand up.

Fold your arms across your chest. With your feet slightly apart, lean forward so that your shoulders are over your feet and stand up fully.

Slowly return to sitting. Repeat.

Quadriceps tightening

Lie down (on the floor or on your bed) with your legs out straight.

Tighten the muscles at the front of your thigh by trying to push the knee downwards

Hold the muscle contraction for 10 seconds (but without holding your breath). Then relax the muscle again. Repeat

Knee straightening

Lie down on your back with a rolled up towel or foam roller behind your thigh, just above the knee. Push the back of your thigh down into the towel or roller and lift your heel off the floor/bed so that your knee straightens. Lower your leg back to the starting position.

Foot and Ankle Exercises

Common problems causing foot and ankle pain include ankle sprain, osteoarthritis (OA), and achilles tendon problems. Self- management using the advice above and the exercises below will help the problem to settle in most cases. However if this fails to help, ask a physiotherapist or GP for help.

Calf muscle strengthening

Stand on the bottom step of our stairs, or on a small step, making sure you have something to hold onto for balance. Rise up onto the balls of your feet, keeping your knees straight, then slowly lower your heels as far as possible still keeping your knees straight. Repeat

Ankle stretches

Sit on your bed with your legs out straight and your feet hanging over the edge. Pull your toes towards you as far as possible then point your toes away from you as far as possible, moving your ankle joint up and down and trying to get as much range of movement as possible.

Ankle mobility in sitting

Sit on a chair with your feet on the ground slightly in front of your knees. From this position, lift the front of your feet off the ground as far as possible, keeping your heels on the floor. Try to get as much range of movement as possible.

Ankle circles

Sitting comfortably in a chair, lift one foot off the ground. Make circles with your ankle, trying to get as much range of movement as possible in all directions.

Image credits: Physiotec