Foot and Ankle Care for Service Members, Veterans and First Responders

Quick answer: Foot and ankle injuries are among the most common musculoskeletal problems in military and first responder careers, with ankle sprains leading the list. Heavy boots, load carriage, uneven terrain, and long shifts all contribute. Most are treatable, and proper rehabilitation can help prevent a single injury from becoming a recurring problem.

Careers that are hard on the feet

If you serve — or served — in the military, or work as a firefighter, paramedic, EMT, or law enforcement officer, your feet carry a load most jobs never ask for: heavy protective boots, body armor and gear, unpredictable terrain, sudden explosive movements, and shifts that keep you upright for many hours at a stretch.

The injury data reflect that reality. In a prospective study of U.S. Army units, foot and ankle conditions accounted for roughly 20% of musculoskeletal injuries, while the lower extremity as a whole accounted for nearly half. Across the U.S. Army over a seven-year period, 16% of soldiers were seen at least once for a foot or ankle injury, and ankle sprains and strains had the highest rate of any ankle or foot injury category.

The pattern also appears among first responders. U.S. occupational injury surveillance found sprains and strains were the leading injury type among EMS workers, firefighters, and police officers, accounting for roughly 33% to 41% of injuries treated in emergency departments. A later review of U.S. structural firefighting injuries likewise found strains and sprains were the leading injury category, accounting for a cumulative 54% across the studies it analyzed.

These injuries matter because they can affect mobility, physical readiness, time on duty, and the ability to perform demanding occupational tasks.

Why these careers cause foot and ankle problems

• Load carriage. Carrying gear, armor, and equipment increases the mechanical demands placed on the lower extremities with every step.
• Boots. Duty and combat boots protect against real hazards, but their weight, stiffness, design, and fit can affect gait and lower-extremity loading. Poorly fitting boots can also create pressure points, friction, and discomfort. Research in infantry soldiers found improper boot sizing significantly reduced footwear comfort, although it was not associated with a history of lower-leg overuse injury.
• Terrain and unpredictability. Uneven ground, stairs, ladders, curbs, and sudden changes in direction can create the forces that lead to ankle sprains and other acute injuries.
• Long shifts. Extended time standing and walking on hard surfaces repeatedly loads the feet and lower extremities and may aggravate heel, arch, tendon, and forefoot symptoms.
• Training volume. Rapid increases in running, marching, load carriage, or other physical training can increase the risk of overuse injuries, including stress injuries and tendon problems.

The most common problems we see

• Ankle sprains — one of the most frequent foot and ankle injuries and a common source of recurring instability
• Plantar fasciitis and heel pain — often aggravated by prolonged standing, walking, training, or footwear
• Achilles tendinopathy — associated with repetitive loading and changes in activity demands
• Stress fractures — often associated with repetitive loading and increases in training volume
• Blisters, calluses, and nail problems — seemingly small issues that can become significant when every shift requires hours in boots
• Chronic ankle instability — recurring giving-way or instability that can persist after an ankle sprain

What a podiatrist evaluates

A podiatrist assesses the specific demands of your job, not just the injury.

That can include examining your footwear and how it fits, assessing foot mechanics and ankle stability, determining whether pain is coming from bone, tendon, fascia, joint, skin, or nerve, and developing a treatment plan that accounts for the physical demands you need to return to.

For service members and first responders, the goal may extend beyond becoming comfortable enough for normal daily activity. It may include safely returning to running, climbing, lifting, prolonged standing, load carriage, or other occupational demands.

What actually helps

• Proper rehabilitation after ankle sprains. Current clinical guidelines support progressive exercise, strengthening, and balance or proprioceptive training as important components of rehabilitation. Incomplete rehabilitation can contribute to persistent instability and recurrent sprains.
• Proper boot and footwear fit. Correct sizing and fit can help reduce pressure, friction, and discomfort. Support or cushioning may also be appropriate depending on the condition and individual foot mechanics.
• Gradual training progression. Stress injuries and tendon problems often follow rapid increases in training load. Progressive increases give bones, tendons, and muscles more opportunity to adapt.
• Early attention to recurring problems. Blisters, calluses, persistent heel pain, or an ankle that repeatedly gives way are often easier to address before they begin interfering with work or training.

When to seek care

Get evaluated if you cannot bear weight after an injury, have significant swelling or deformity, have pinpoint pain over a bone, have an ankle that repeatedly rolls or gives way, or experience foot or ankle pain that keeps returning during work or training.

Persistent symptoms should not have to wait until a fitness test, deployment workup, academy, or demanding shift forces the issue.

A note on September 11

On September 11, we remember the lives lost and honor the first responders, service members, veterans, and families whose lives were changed by that day and the years that followed.

Metro Foot & Ankle is grateful for the opportunity to care for those who serve and have served in our community.

Frequently asked questions

Are foot and ankle injuries really that common in the military?

Yes. Research in U.S. Army populations has found foot and ankle conditions accounted for roughly 20% of musculoskeletal injuries, while one seven-year analysis found 16% of active-duty soldiers were clinically seen at least once for a foot or ankle injury.

Can my duty boots be causing my foot pain?

They can contribute to certain problems. Boot weight, stiffness, design, fit, friction, and pressure can all affect the feet. Poor fit can cause discomfort and skin problems, but foot pain can have many causes, so persistent symptoms should be evaluated rather than attributed to footwear alone.

Why does my ankle keep rolling after an old sprain?

Recurring giving-way can be a sign of chronic ankle instability following an ankle sprain. Rehabilitation commonly includes progressive strengthening and balance or proprioceptive training to improve stability and function.

Will treatment affect my ability to stay on duty?

Treatment depends on the diagnosis and the physical demands of your job. Many common foot and ankle problems can be managed without surgery, with the goal of restoring function and safely returning you to the activities your work requires.

I'm a veteran — can I still be seen for an old injury?

Yes. Previous injuries can contribute to chronic pain, arthritis, weakness, or instability years later. An evaluation can help determine what is causing the current symptoms and what treatment options are appropriate.

Ready to get evaluated?

Dr. Kayla Wright, DPM, provides foot and ankle care for patients in Tempe and across the East Valley.

Book an Appointment or call 480-831-0700.

About the author

Dr. Kayla Wright, DPM, is an ABFAS Board Certified podiatric physician and foot & ankle surgeon serving Tempe and the East Valley. Her clinical interests include biomechanics, athletic and dance-related injuries, and comprehensive medical and surgical foot and ankle care.

Learn more at drkaylawright.com (opens in a new tab).

This article is for general educational purposes and is not a substitute for individualized medical advice, diagnosis, or treatment. Please consult a qualified healthcare professional about your specific situation.

Sources

• Teyhen DS, Goffar SL, Shaffer SW, et al. Incidence of Musculoskeletal Injury in US Army Unit Types: A Prospective Cohort Study. J Orthop Sports Phys Ther. 2018;48(10):749–757. (opens in a new tab)
• Wallace RF, Wahi MM, Hill OT, Kay AB. Rates of Ankle and Foot Injuries in Active-Duty U.S. Army Soldiers, 2000–2006. Mil Med. 2011;176(3):283–290. (opens in a new tab)
• Reichard AA, Jackson LL. Occupational Injuries Among Emergency Responders. Am J Ind Med. 2010;53(1):1–11. (opens in a new tab)
• Garcia J, Bazzocchi MCF, Fite K, Ocampo JD, et al. Review and Statistical Analysis of U.S. Structural Firefighting Injuries: Their Causes and Effects. Fire. 2024;7(2):46. (opens in a new tab)
• Andersen KA, Grimshaw PN, Kelso RM, Bentley DJ. Musculoskeletal Lower Limb Injury Risk in Army Populations. Sports Med Open. 2016;2:22. (opens in a new tab)
• Nesterovica D, Vaivads N, Stepens A. Relationship of Footwear Comfort, Selected Size, and Lower Leg Overuse Injuries Among Infantry Soldiers. BMC Musculoskelet Disord. 2021;22. (opens in a new tab)
• Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther. 2021;51(4):CPG1–CPG80. (opens in a new tab)