The short answer
If you have foot or ankle pain and don't know the cause, see a podiatrist first. A podiatrist is a physician who diagnoses and treats the foot and ankle, can take X-rays, prescribe medication, give injections, and perform surgery when it's needed. A physical therapist is a movement and rehabilitation expert who helps you rebuild strength, flexibility, and balance.
The two work best as a team. The podiatrist figures out what is wrong and sets the plan; the physical therapist is often a key part of carrying that plan out. The trouble starts when therapy begins before anyone has confirmed the diagnosis, because exercises can't fix a stress fracture, a nerve entrapment, or an infection.
What is a podiatrist?
A podiatrist is a Doctor of Podiatric Medicine (DPM). After college, podiatrists complete four years of podiatric medical school followed by a three-year, hospital-based medical and surgical residency. Every one of those years is focused on the foot, the ankle, and how they connect to the rest of the body.
That training covers the whole range of foot and ankle care: diagnosing conditions, reading imaging, prescribing medication, treating skin and nail problems, managing diabetic foot complications, setting fractures, making custom orthotics, and performing surgery. Many go further, earning board certification and membership in the American College of Foot and Ankle Surgeons. You can read about our physicians' training on our staff page.
What does a physical therapist do?
A physical therapist (PT) holds a Doctor of Physical Therapy (DPT) degree and specializes in restoring movement and function throughout the whole body. PTs are excellent at identifying weakness, tightness, and poor movement patterns, then designing exercise and hands-on treatment to correct them.
What physical therapists generally don't do is practice medicine. In most settings they don't order X-rays or MRIs, prescribe medication, give injections, or perform procedures. Their role is to rehabilitate a problem, which works best once someone has confirmed what that problem is.
Podiatrist vs. physical therapist at a glance
| Podiatrist (DPM) | Physical therapist (DPT) | |
|---|---|---|
| Training | Podiatric medical school plus a 3-year medical and surgical residency, all focused on the foot and ankle | Doctoral rehabilitation program covering the whole body |
| Main role | Diagnose and treat foot and ankle conditions | Restore movement, strength, and function |
| Medical diagnosis | Yes | Functional assessment; refers out when a medical problem is suspected |
| X-rays, ultrasound, MRI | Orders and reads imaging | Generally no |
| Prescription medication | Yes | No |
| Injections | Yes | No |
| Fractures | Diagnoses, casts or boots, and repairs surgically when needed | Rehabilitation after the bone has healed |
| Skin, nails, wounds, infections | Yes, including diabetic foot care | No |
| Custom orthotics | Evaluates, prescribes, and fits | Varies; some recommend or fit inserts |
| Surgery | Yes | No |
| Exercise and rehab programs | Prescribes home programs and refers for structured therapy | Yes, this is their core strength |
Why diagnosis comes first
Many foot and ankle problems feel alike from the outside. Heel pain can be plantar fasciitis, but it can also be a stress fracture of the heel bone, a pinched nerve, or inflammatory arthritis. A “bad sprain” can hide a fracture or a torn ligament. Burning and tingling in the arch might be tarsal tunnel syndrome rather than a muscle issue.
Each of those needs a different treatment, and some get worse with the stretching and loading that help others. When therapy starts without a confirmed diagnosis, patients can spend weeks of visits and copays working on the wrong problem while the real one progresses. A podiatry visit, often with an X-ray taken on-site, answers that question up front.
A podiatrist also looks at things a movement assessment isn't designed to catch: circulation, sensation, skin and nail health, and how conditions like diabetes or gout are affecting the foot.
When physical therapy is the right call
Physical therapy is one of the most useful tools in foot and ankle care, and we recommend it often. It tends to be most valuable when:
- You're recovering from foot or ankle surgery or a healed fracture
- You've had repeated sprains and need balance and strength work for ankle instability
- A diagnosed condition such as Achilles tendonitis or plantar fasciitis needs guided stretching and loading
- Your gait or muscle imbalances are contributing to pain further up the leg
- You're an athlete working toward a safe return to sport
If you already have a clear diagnosis from a physician and your symptoms are improving with therapy, there's usually no reason to change course.
How podiatrists and physical therapists work together
In a typical case, the podiatrist evaluates your foot, confirms the diagnosis, and handles the medical side of treatment, whether that's a boot, an injection, custom orthotics, or medication. When strengthening or mobility work will speed recovery, we refer you to physical therapy with specific goals. You return to us if progress stalls, so the plan can be adjusted rather than repeated.
That way each provider does what they do best, and nobody is guessing.
What about other options?
Physical therapy isn't the only place people go first. Here is how other common choices compare for foot and ankle problems.
| Where you go | Good for | Limits for foot and ankle problems |
|---|---|---|
| Podiatrist | Diagnosis and full treatment of the foot and ankle, from nails and skin to fractures and surgery | Focused below the knee; coordinates with other providers for the rest of the body |
| Primary care physician | Overall health, managing conditions like diabetes, initial evaluation | Broad training; persistent or structural foot problems are usually referred to a specialist |
| Urgent care | After-hours injuries, basic X-rays, infections that can't wait | Stabilizes and refers; not set up for follow-up or long-term foot care |
| Orthopedic surgeon | Bone and joint problems throughout the body | Many treat the whole musculoskeletal system; foot and ankle is a subspecialty for some |
| Chiropractor | Spine and joint alignment, back and neck pain | Doesn't prescribe medication, give injections, treat fractures or wounds, or perform surgery |
| Massage therapist | Muscle tension and soft-tissue soreness | Can't diagnose; may temporarily ease pain without addressing the cause |
| Shoe store or drugstore inserts | General comfort and cushioning | Sized for shoe size, not your foot; no evaluation of why it hurts |
If you're weighing inserts, our guide to custom orthotics vs. store-bought inserts covers that choice in more depth.
Signs you should see a podiatrist
- Foot or ankle pain that hasn't improved after two weeks of rest, ice, and supportive shoes
- Pain that has returned after a round of physical therapy or chiropractic care
- Heel pain that's worst with your first steps in the morning
- Swelling, bruising, or trouble bearing weight after a twist or fall
- An ankle that keeps rolling or feels unstable
- Numbness, tingling, or burning in the feet
- A bump, bunion, or toe that's changing shape
- An ingrown toenail, thickened nail, or skin problem that won't clear up
- Diabetes, especially with any cut, blister, or color change on the foot (see diabetic foot care)
When to get care right away
Don't wait for a routine appointment if you can't put any weight on the foot, the foot or ankle looks deformed, you heard a pop followed by sudden weakness in the back of the ankle, or you have a wound with spreading redness, warmth, drainage, or fever. Call our office, as same-day appointments are available for emergencies. If it's after hours or the symptoms are severe, go to urgent care or the emergency room.
Why choose Wasatch Foot & Ankle Institute?
Wasatch Foot & Ankle Institute is a podiatry practice serving Farmington, South Ogden, and the surrounding Davis and Weber County communities. Our board-certified, fellowship-trained physicians focus exclusively on the foot and ankle, and we offer on-site X-rays, custom orthotics, in-office procedures, and surgery under one roof.
When physical therapy will help, we'll tell you, set clear goals for it, and stay involved until you're back on your feet. Learn more about our Farmington and South Ogden clinics, or request an appointment at the office nearest you.
Medically reviewed by the physicians at Wasatch Foot & Ankle Institute. Our board-certified, fellowship-trained podiatrists provide foot and ankle care in Farmington and South Ogden, Utah. This page is for general education and is not a substitute for an in-person evaluation.