Don’t Just Manage Ankle Osteoarthritis - Take Control of It

Ankle osteoarthritis can be frustrating. It’s stubborn, load-sensitive, and often flares just when someone wants to be most active.

Recently, a golfer came to see me struggling with ankle O/A. Rounds of golf were becoming increasingly uncomfortable due to ankle stiffness and pain. He’d started shortening rounds, adjusting his swing, even questioning whether to give it up altogether.

That’s often the point people seek help.

Book an Ankle Assessment

Ankle Osteoarthritis: Where To Start

Ankle osteoarthritis (O/A) is very different from hip or knee arthritis. The ankle is a tighter joint with less tolerance for compression and shear. When it becomes stiff and painful, small changes in load can make a significant difference.

The first thing I look at isn’t an orthotic.

It’s footwear.

Before we talk prescriptions or casting, I assess:

• What level is your foot sitting at?

• Is the shoe stable enough?

• Is the heel height helping or increasing compression?

• Can we “open up” the joint slightly by altering rearfoot position?

  
  

Often, adding a small heel raise can reduce joint compression and improve comfort surprisingly quickly. It’s not dramatic. It’s mechanical. And it works.

Starting Quickly: Prefabricated First

With this patient, I began with a prefabricated shell. Why?

Because speed matters.

If someone is in pain and keen to stay active, waiting weeks for a custom device isn’t always the best first move. A well-selected prefabricated orthotic allows me to:

• Offload the ankle immediately

• Trial prescription concepts

• Modify progressively

• See how the joint responds

  
  

We adjusted and built onto this over several weeks. Incremental changes. Targeted modifications. Watching function improve round by round.

By the time he went on a long holiday to Australia, he was already significantly better.

When Custom Makes Sense

After his return, we reviewed progress.

He was improved - but still curious. Could we optimise further?

At this stage, we already had valuable data:

• How his ankle responded to heel elevation

• What rearfoot control he tolerated

• Where pressure redistribution helped

• What modifications gave measurable benefit

  
  

That’s when custom orthotics make sense. Not as a first guess - but as a refined prescription.

Because now we’re not experimenting.

We’re enhancing.

I casted him, incorporated additional prescription adjustments we couldn’t fully achieve with the prefab shell, and fine-tuned joint positioning more precisely.

A few weeks later, he returned:

“These are working really well.”

More golf. Less pain. Faster recovery after rounds.

That’s the goal.

Starting the Process

If ankle pain is limiting your activity, start with the basics:

• Review your footwear

• Assess joint stiffness and load tolerance

• Trial simple mechanical changes

  
  

You don’t always need to begin with custom orthotics.

You do need a clear, structured plan.

Small, precise adjustments can make a meaningful difference.

Book an Ankle Assessment

Comprehensive footwear review,

load assessment, and structured treatment plan.