persistent pain

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Your body is 45 miles of nerves travelling through it connecting all body parts. Nerves work like an alarm system. At all times nerves have some electricity flowing through them which is normal and shows you are alive.

Lots of different factors (sleep habits, exercise levels, stress, movements, etc.) can cause this electrical activity to go up or down. People with ongoing pain have an extra sensitive alarm system. Think of a house alarm; it should only go off if, for example, if a window breaks. Your house alarm system is so sensitive (i.e. your nerves are so sensitive) that the alarm goes off if a leaf hits the window i.e. there is no damage done but you still experience pain.

Pain is multidimensional, the over flowing cup


As pain persists it becomes less about tissue damage and more about anything in your life or something in particular that can make you more sensitive. Look at pain as the overflowing of a cup. Many things contribute to what is in that cup. You can have a lot of physical, mechanical, emotional and social stressors and have no pain but at some point, a sudden increase in one of those stressors or a new stressor puts you just over the edge and the water flows out and now you have pain.

Pain occurs when we fail to tolerate and adapt to all the stressors in your life. We need to keep that cup from overflowing. You have lots of options for change. Turn down one or two taps or build a bigger cup. You can build a bigger cup in lots of ways.

Here are just some examples:

  • Understanding the contributors to your own pain
  • Getting regular aerobic exercise – 30 minutes 5 days a week
  • Sleeping
  • Having personal goals

Beliefs and expectations

How you perceive your condition can influence what you feel. If you’re convinced that your body is fragile and needs protection then you can be more likely to have pain. You’ll have pain as a protective response. You may also increase tension in your body, as a way of guarding this. This is often contributed to by the messages about pain and injury that you are given from health professionals, family, friends and the internet. If you are told your spine is fragile and that you have disc degeneration or two bulging discs it’s not unusual to feel quite negative about your situation. This can lead to us catastrophising. Unfortunately, it’s this misinformation about your pain that leads to these catastrophic thoughts.

General health

Just being less healthy can make you more sensitive so perhaps you have some joint degeneration like everyone else does it is possible that having poor health will sensitise you to have the physical contributors to pain. The positive here is that general strategies of just getting healthier can also improve pain and disability. You don’t have to wait for pain to go before getting active again. Getting more active will contribute to pain going.

Anxiety and depression

Just like muscle tears, you can have anxiety and depression and not have pain. You can tolerate these factors but sometimes they contribute and they promote the pain that you have. In the same way that you don’t have to fix a disc or degeneration to eliminate pain you don’t have to eliminate depression or anxiety to get out of pain. There are several strategies you can use to get out of pain and decrease your disability.

Social isolation or a loss of your sense of self

Pain can often make you not feel like yourself. You stop doing the things that are important to you. You stop your hobbies, spending time with friends or doing things with your family. These social variables can contribute to your increased sensitivity.


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What’s great about all these factors and this complexity?

You can tolerate each of these factors. You get to work addressing the ones that are important to you but none of them must change for you to get out of pain. Often improving one or two of these is enough to make a huge difference. Further, sometimes just understanding that these factors are important can help in your situation.

Ankle injuries are one of the highest recurring injuries. This is often because of inadequate rehabilitation, underdosing of exercises and not enough treatment sessions. 

The ligaments of the ankle can be sprained and or torn such as when landing on the inside or outside of your foot. If there is a complete tear of the ligaments, the ankle joint may become unstable. Over time, this instability can result in weakness to the bones and cartilage of the ankle joint.

Most sprained ankles occur in the lateral ligaments on the outside of the ankle. Your foot can twist unexpectedly during many different activities, such as:

Walking on an uneven surface
Participating in sports that require cutting actions or rolling and twisting of the foot such as tennis, football, and soccer

With a sprained ankle you may experience:

An area that is painful to touch
A feeling of instability of the ankle
Pain associated with walking

Without proper treatment and rehabilitation, a more severe sprain can weaken your ankle, making it more likely that you will injure it again. Repeated ankle sprains can lead to long-term problems, including chronic ankle pain, arthritis, and ongoing instability.

If the muscle is affected this is called a strain and can happen when the fibres of the muscle stretch or tear. With a muscle strain you may notice:

pain in the affected muscle
muscle tightness or spasm
loss of some, or all, of the function in the affected muscle
blood collecting under the skin at the site of the strain – this is known as a haematoma and it looks like a large, dark-red bruise

Repeated ankle injuries can be debilitating, lead to chronic pain and prevent you from participating in the activities that you love. Here at the P&P Clinic we ensure that you get a comprehensive assessment, an accurate diagnosis and a thorough plan from day one to ensure you get long term results. We pride ourselves on giving the most accurate diagnoses, and this is why our patients have experienced such success in their treatments.

We will provide specific hands-on techniques to help you get to your goals faster and we will provide you with sport specific or tailored exercises that are designed in such a way to help you return to what you love doing. Generalised exercises that are not functional in nature tend to be least successful when it comes to rehabilitation, if your goal is to return to running then your exercises will be designed in such a way to mimic some of those movements and get you running longer, stronger and pain-free. Our treatment techniques will ensure a speedy recovery from ankle and foot pain whilst reducing the risk of recurring injury.

Understanding Pain

How it can stop you doing the things you love

Helpful Advice

Advice to help you become pain-free

Ebook Download


You Tube

Helpful videos to help your understand pain

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