Sarah was experiencing pain in her left foot and ankle when walking, walking uphill, climbing stairs and wearing normal shoes and so after conservative therapy failed to resolve the problem Sarah sought the advice of a foot and ankle surgeon.  Following further tests and imaging, surgery to her foot and ankle in the form of left Extensor Hallucis Longus tendon transfer and tendo-achilles debridement was advised, agreed and performed July 2018.  

“First six weeks following surgery I was unable to weight bear on my left leg so I hobbled around with the aid of a zimmer frame feeling very vulnerable, unable to manage everyday tasks! “

I was referred to Physiotherapy following an initial period of rest.  My left ankle was protected in a cumbersome air cast boot.  My physiotherapist treated my ankle with gentle stretches and soft tissue massage to reduce the stiffness in my calf muscle.  I spent some time rehabilitating in a hydrotherapy pool which allowed me to exercise my foot and ankle without placing too much weight through it.  As I gradually recovered I ditched the zimmer frame in favour of elbow crutches.  

The pain and inability to wear footwear due to swelling around my ankle remained a significant problem in the first ten months following surgery.  My surgeon advised and administered hydrocortisone steroid injection into my ankle that sadly did not provide the imagined pain relief.  Pushing the clutch pedal was too painful so a change to an automatic car was a necessary hassle to maintain my independence.  Working with my physiotherapist we discovered taping my ankle helpful in reducing pain temporarily and allowing me to walk further distances.  Acupuncture also provided short term relief from the pain however no treatment was providing long term relief or resolving the ankle swelling and I remained unable to wear shoes.

On routine follow-up my surgeon advised more radical ankle surgery in the form of an ankle fusion if the pain and swelling symptoms did not improve.  My physiotherapist advised I try Shockwave Therapy at Fay Pedler Physiotherapy before considering any further surgery as a fused ankle would likely improve the pain however severely restrict ankle movement permanently.

June 2019 – July 2019

I attended the Fay Pedler clinic and was placed under the care of clinical lead Ricky McKee.  Full assessment was undertaken which highlighted tight calf muscles and reduced range of ankle movement limited by pain.  My left heel remained swollen.  Ricky and I discussed and agreed my goals of pain-free walking when on the flat and with inclines.  I also wanted to be able to wear more than one pair of shoes as I had been wearing flip flops for eighteen months.


Ricky gave massage and trigger point release treatment to my tight calf muscles. A set of home exercises and stretches were prescribed.  Ricky counselled me of the possibility of not feeling any relief or benefit for a couple of shockwave therapy treatments.  This was not the case for me as I remember walking out of the practice pain free minus the limp and very happy. 

One week later I attended the practice to see Ricky and reported two days of almost complete pain relief following initial shockwave treatment.  I had managed to wear a pair of normal shoes without pain for the first time in months.  Ricky felt my calf muscles were less tight however remained tender.  Soft tissue massage was given once more, exercises performed and Shockwave delivered at a slightly higher intensity.

Two weeks further on I reported experiencing complete pain relief for two days following treatment, my symptoms had remained pretty good, certainly much better than before Shockwave therapy and I was able to wear a variety of shoes.  I had managed to walk over 15,000 steps which was likely to be the cause of residual pain.  Ricky worked on my calf muscles once more with a soft tissue massage and further shockwave therapy.

A further week on I was happy to report continual improvement with strength, range of movement and pain all improved.  I was achieving my goals and the distance I could walk was progressing.  I was limited to 3000 steps a day prior to Shockwave therapy, most recently whilst on holiday I achieved 25,000!

I am so grateful for the care and attention I received from Ricky and the team at Fay Pedler Physiotherapy.  Thanks to their support and expertise I have avoided further life-changing surgery, I am pain-free, have a variety of shoes to choose from and can walk without fear.