Ankle Bone Spur: Physiotherapy Exercise Protocol

A bone spur (osteophyte) around the ankle typically forms at the calcaneus (heel bone) — either on the inferior surface (where the plantar fascia attaches) or posterior surface (where the Achilles tendon inserts). The spur itself is often painless; the pain comes from the surrounding inflamed soft tissue — plantar fasciitis, Achilles tendinopathy, or bursitis.

What Causes Ankle Bone Spurs?

  • Chronic plantar fasciitis: Repetitive micro-tears at the calcaneal attachment trigger a bone-building response
  • Achilles tendinopathy: Traction spurs form where the Achilles inserts into the posterior heel
  • Overpronation: Excessive rolling inward of the foot increases tensile force on the plantar fascia
  • Obesity or sudden weight gain: Increased compressive and tensile loading on the heel

5 Key Physiotherapy Exercises

1. Gastrocnemius Calf Stretch (Long Knee)

Stand facing a wall. Place affected foot behind, heel flat on the floor, knee straight. Lean forward until you feel a strong calf stretch. Hold 45 seconds × 3 sets, 3 times daily. Reduces Achilles-plantar complex tension.

2. Soleus Calf Stretch (Bent Knee)

Same position as above, but bend the back knee slightly. This targets the deeper soleus, which attaches to the posterior calcaneus. Hold 45 seconds × 3 sets.

3. Plantar Fascia Stretch — Seated Toe Pull

Sit cross-legged. Pull all toes back toward shin. Using thumb, press along the plantar fascia from heel to toes. Hold 30 seconds × 3 sets. Do this before taking first steps in the morning.

4. Towel/Marble Pick-Up (Intrinsic Foot Strengthening)

Scrunch a towel with the toes, or pick up marbles with toes from the floor. 2 minutes daily. Strengthens the intrinsic foot muscles that support the plantar arch, reducing plantar fascia strain.

5. Eccentric Calf Lowering (Alfredson Protocol Modification)

Stand on the edge of a step. Rise onto toes with both feet. Shift weight to the affected foot only. Slowly lower heel below step level. Use both feet to rise back up. 3 sets × 15 reps, twice daily. Rebuilds Achilles tendon tensile strength and gradually deloads the calcaneal spur.