The Foot and Ankle Outcome Score, or FAOS, is a 42-item patient-reported outcome measure used to assess foot- and ankle-related pain, symptoms, daily function, sport and recreation function, and quality of life. It helps professionals track how a client perceives their foot or ankle problem over time, but it does not diagnose a condition, confirm pathology or determine return-to-sport readiness on its own.
Foot and ankle problems can affect walking, running, stairs, jumping, balance, footwear tolerance, work demands, sport participation and confidence with daily movement.
The Foot and Ankle Outcome Score, commonly called the FAOS, is a patient-reported outcome measure designed to capture the client’s own view of their foot or ankle symptoms and function.
It is commonly used for:
ankle sprain
chronic ankle instability
ankle fracture recovery
Achilles-related presentations
plantar heel pain
foot and ankle osteoarthritis
post-operative foot or ankle recovery
sport and recreation limitations
long-term progress tracking
The FAOS includes five subscales: Pain, Symptoms, Activities of Daily Living, Sport and Recreation, and Foot/Ankle-Related Quality of Life. Each subscale is transformed to a 0–100 score, where 100 represents no problems and 0 represents extreme problems.
This article uses the Measurz Evidence-First Outcome Measure Article Optimiser structure, including scoring, population-specific interpretation, meaningful change, reliability, validity and Measurz recording guidance.
Outcome measure: Foot and Ankle Outcome Score
Abbreviation: FAOS
Body region: Foot and ankle
Type: Patient-reported outcome measure
Number of items: 42
Subscales: Pain, Symptoms, Activities of Daily Living, Sport/Recreation, Quality of Life
Score range: 0–100 for each subscale
Higher score means: Better perceived foot and ankle status
Lower score means: More pain, symptoms, limitation or quality-of-life impact
Best used for: Baseline assessment, reassessment, progress tracking and outcome reporting
Key limitation: FAOS does not diagnose a condition or clear someone for sport on its own
The FAOS is a foot- and ankle-specific questionnaire designed to measure the client’s perceived symptoms, function and quality of life.
It includes five subscales:
Pain
Other Symptoms
Activities of Daily Living
Sport and Recreation Function
Foot- and Ankle-Related Quality of Life
The FAOS was developed from the structure of the Knee injury and Osteoarthritis Outcome Score and adapted for foot and ankle conditions. The original validation work studied people undergoing ankle ligament reconstruction, and later studies have examined its use across other foot and ankle populations.
The FAOS is useful because physical tests do not always explain how a client experiences their foot or ankle problem.
A client may show improving range of motion, strength or balance but still report:
difficulty walking longer distances
pain with stairs
poor confidence on uneven ground
difficulty returning to running
reduced sport participation
swelling or stiffness after activity
frustration with recurring symptoms
reduced quality of life
The FAOS can help professionals:
establish a baseline
identify which domains are most affected
monitor change over time
support client education
guide goal-setting conversations
compare symptoms and function across reassessments
combine client-reported outcomes with objective testing
improve reporting quality in Measurz
The FAOS should support assessment reasoning and progress tracking. It should not be used as a stand-alone diagnostic, treatment or clearance tool.
The Pain subscale captures pain frequency and pain during common activities.
It may provide insight into pain during:
walking
standing
stairs
loading tasks
rest
night-time symptoms
The Symptoms subscale captures other foot and ankle symptoms, such as:
swelling
stiffness
restricted movement
mechanical symptoms
general symptom severity
The ADL subscale captures day-to-day function.
This may include:
walking on flat ground
stairs
standing
household tasks
getting in and out of positions
general daily mobility
The Sport/Recreation subscale captures higher-demand activities.
This may include:
running
jumping
twisting
pivoting
cutting
recreational activity
sport participation
The Quality of Life subscale captures broader personal impact.
This may include:
confidence
frustration
lifestyle impact
awareness of the foot or ankle problem
participation restriction
perceived long-term impact
The FAOS may be useful for:
exercise professionals
rehabilitation practitioners
strength and conditioning coaches
allied health support teams
performance professionals
movement assessment professionals
students learning outcome measures
professionals using Measurz or MAT for structured progress tracking
It may be relevant for clients with:
acute ankle injury
chronic ankle instability
ankle fracture
Achilles tendon symptoms
plantar heel pain
foot pain
ankle osteoarthritis
post-operative foot or ankle recovery
sport-related foot and ankle limitations
persistent swelling, stiffness or pain
Use the FAOS when you want to understand how a foot or ankle problem affects the client’s symptoms, function and quality of life.
It may be useful at:
initial assessment
onboarding
reassessment
post-injury monitoring
post-operative milestones
return-to-running planning
return-to-sport planning
discharge or progress review
The FAOS is most useful when repeated over time using the same version and scoring method.
Use caution when:
the client cannot complete the questionnaire independently
literacy, language or cognitive factors affect responses
the wrong language version is being used
the client has multiple body regions contributing to limitation
the client has not attempted the activities being scored
many items are missing
the score is being used as a pass/fail decision
the result is interpreted without physical assessment context
The FAOS should not be used to:
diagnose a condition
confirm injury
determine tissue healing
identify the exact cause of symptoms
clear someone for sport
replace professional judgement
replace medical assessment when needed
FAOS questionnaire
Official scoring guidance or validated calculator
Measurz recording workflow
Client-reported symptom and function notes
Baseline and retest dates
Optional related physical test results, such as:
ankle range of motion
weight-bearing lunge test
calf strength testing
single-leg balance
hop testing
gait or running assessment
swelling or girth measures
Explain the purpose of the questionnaire before the client completes it.
Example wording:
“This questionnaire helps us understand how your foot or ankle is affecting your pain, symptoms, daily function, sport and quality of life. It does not diagnose the problem on its own, but it helps us monitor change over time.”
The FAOS can be completed:
on paper
digitally
independently
with assistance
before a session
during reassessment
as part of a Measurz workflow
Ask the client to:
answer based on their current foot or ankle problem
choose the response that best matches their experience
answer every item where possible
avoid overthinking each question
ask for clarification if they do not understand the wording
complete the same version at each retest
Record whether the FAOS was completed:
independently
digitally
on paper
verbally
with assistance
This matters because assistance, wording clarification or completion format may influence responses.
If help is required:
explain instructions without leading the answer
avoid telling the client which option to choose
record that assistance was provided
use the same assistance approach at retest where possible
Do not guess missing responses.
Use the official scoring guidance for the version being used. If too many items are missing for a subscale, record that subscale as incomplete rather than creating an unreliable score.
Each item is scored from 0 to 4.
Each subscale is transformed to a 0–100 score.
General scoring direction:
100: no foot or ankle problems
0: extreme foot or ankle problems
The five subscales should be interpreted separately rather than combined into one unsupported total score.
Retest at meaningful time points, such as:
baseline
after a training block
after a rehabilitation phase
pre-return to running
pre-return to sport
after a flare-up
after post-operative milestones
discharge or progress review
For consistency, record:
date
current activity level
recent flare-ups
recent training load
whether the client has returned to the activities being scored
any major changes in work, sport or footwear demands
The FAOS is a self-report questionnaire, so it does not create physical testing risk.
However, a major worsening in score may support further assessment if the client reports:
severe deterioration
major quality-of-life impact
worsening function
severe pain or swelling
unexpected decline
new symptoms
The FAOS has five separate subscale scores.
Each subscale ranges from 0 to 100.
Higher scores indicate better perceived foot and ankle status.
Lower scores indicate more reported problems.
Pain: 0–100
Symptoms: 0–100
Activities of Daily Living: 0–100
Sport/Recreation: 0–100
Quality of Life: 0–100
A higher score may suggest:
fewer symptoms
less pain
better daily function
better sport or recreation function
better perceived quality of life
improved confidence with the foot or ankle
A lower score may suggest:
more pain
more symptoms
reduced daily function
reduced sport or recreation capacity
reduced confidence
greater quality-of-life impact
A FAOS score does not prove:
the diagnosis
the tissue source of symptoms
the severity of structural injury
readiness to return to sport
whether imaging is required
whether a specific intervention caused the change
Example wording:
“Your FAOS results show that your daily function has improved, but sport and recreation are still more limited. This does not tell us exactly what structure is causing symptoms, but it helps us understand how your foot or ankle is affecting the activities that matter to you.”
For general fitness clients, FAOS can help show how foot or ankle symptoms affect:
walking
stairs
gym training
daily activity
recreational exercise
Interpretation cautions:
scores may change with recent activity
pain expectations may influence responses
sport items may be less relevant if the client does not participate in sport
For athletes, the Sport/Recreation and Quality of Life subscales are often especially important.
A client may score well on daily activities but still report limitations with:
running
jumping
cutting
landing
uneven ground
confidence in competition
Interpretation should include sport-specific testing. A high FAOS score should not be treated as return-to-sport clearance on its own.
For older adults, FAOS may help identify how foot and ankle symptoms influence:
walking tolerance
stairs
balance confidence
participation
independence
Interpretation cautions:
other health conditions may affect scores
general strength and balance may influence responses
broad reference values should be used cautiously
FAOS may be less appropriate for some younger clients depending on comprehension and version suitability.
Consider:
age
literacy
parent or guardian assistance
sport exposure
whether the questionnaire wording fits the client
For persistent symptoms, FAOS can help monitor long-term impact beyond pain alone.
Scores may be influenced by:
confidence
fear of recurrence
activity avoidance
frustration
flare-up patterns
participation restrictions
FAOS can help show whether perceived function is improving during return-to-activity planning.
However:
high FAOS scores should not be used as clearance on their own
sport-specific capacity should still be tested
strength, ROM, balance, hop and workload measures should be considered
Body mass may influence foot and ankle symptoms, function and reference score interpretation. The 2023 Danish FAOS reference study included supplemental questions on previous foot and ankle problems and body mass index, supporting the need to interpret broad reference values in context.
For post-operative clients, FAOS can help track perceived recovery over time.
Interpretation should consider:
surgical procedure
healing stage
expected restrictions
activity exposure
swelling and pain patterns
medical or surgical guidance where relevant
Meaningful change values help interpret whether a score change is likely to matter.
Key terms:
MCID / MIC: the smallest change that may be meaningful to clients or professionals, depending on the method used
MDC: the amount of change likely needed to exceed measurement error
SEM: the estimated measurement error around a score
Responsiveness: the ability of the measure to detect change over time
A 2021/2022 study examined minimal important change values for FAOS in people who underwent operative treatment for foot and ankle conditions. The authors noted that FAOS is widely used, but more evidence on longitudinal validity was needed; the study used predictive modelling to estimate minimal important change values.
A separate ankle fracture recovery study examined FAOS validity, reliability, responsiveness and minimal clinically important difference during early recovery after ankle fracture. Those findings are useful for ankle fracture contexts, but they should not be automatically applied to all foot and ankle conditions.
When interpreting change:
compare each subscale to baseline
check whether the change exceeds available MIC, MCID, MDC or SEM for the relevant population
look for consistent improvement across relevant subscales
compare the score change with client goals
check whether activity exposure has increased
consider pain, swelling, strength, ROM and balance findings
Reported meaningful change values may vary by:
condition
language version
surgical versus non-surgical population
follow-up timeframe
anchor method
scoring method
baseline severity
Use the value that best matches the client group and testing context. Where no matching value exists, rely more heavily on baseline comparison, repeated measurement, client-reported change, physical assessment and professional judgement.
Published FAOS reference values are available.
A 2023 national representative sample study established FAOS reference values using Danish adult population data. The sample was drawn from 9,996 adult citizens, with 2,759 completed FAOS responses. The study was designed because FAOS is widely used but reference values were missing to help interpretation.
These reference values provide useful context, but interpretation should consider whether the reference population matches the client’s:
age
sex
country
health status
injury status
surgical history
BMI
activity level
sport or work demands
Practical guidance:
Scores closer to 100 generally suggest fewer reported problems.
Lower scores suggest greater pain, symptoms, functional limitation or quality-of-life impact.
Sport/Recreation and Quality of Life may remain limited even after daily function improves.
Population reference values provide context, not strict pass/fail thresholds.
The client’s own baseline is often the most useful comparison.
A 10-point FAOS difference across subscales was predefined as clinically relevant in the 2023 reference value study, but this should be treated as a study-specific interpretation threshold rather than a universal pass/fail rule.
The FAOS has been studied across several foot and ankle populations.
Evidence supports its use as a foot- and ankle-specific patient-reported outcome measure, although measurement properties can vary depending on:
condition
language version
population
scoring method
follow-up timeframe
baseline severity
The original FAOS validation work supported its use after ankle ligament reconstruction.
A 2018 systematic review examined the measurement properties of commonly used foot- and ankle-specific questionnaires, including FAOS, FFI and FAAM. The review found that FAOS and FAAM were promising, but also noted that limitations should be considered when interpreting results.
More recent validation work has examined FAOS in populations such as chronic ankle instability and ankle osteochondral lesions, supporting its broader use while still requiring population-specific interpretation.
Reliability and validity are stronger when:
the correct version is used
the same scoring method is repeated
all relevant items are completed
subscales are interpreted separately
retesting occurs at meaningful time points
results are interpreted alongside physical and functional assessment
Interpret cautiously when:
many items are missing
the client has not attempted sport or work tasks yet
only one subscale changes slightly
the change is smaller than known measurement error or meaningful change
symptoms are strongly influenced by a recent flare-up
the score is being used without objective assessment context
Common errors include:
treating FAOS as a diagnosis
using one score as a clearance decision
combining subscales into an unsupported total score
ignoring missing items
using inconsistent scoring methods
not recording the version used
not recording the completion date
comparing scores without considering activity exposure
over-interpreting small changes
using reference values as strict pass/fail cut-offs
Limitations include:
self-report can be influenced by mood, expectations and recent activity
sport items may be less meaningful if the client has not returned to sport
scores do not identify the exact physical cause of symptoms
MCID, MDC and SEM values may vary across populations
reference values may not match the client’s age, sport, country or condition
FAOS should be paired with physical tests and client goals
The FAOS may help professionals:
document baseline foot and ankle status
identify whether pain, symptoms, sport or quality of life are most affected
track change over time
monitor post-injury or post-surgical recovery
support goal setting
improve client education
communicate progress with a broader team
strengthen Measurz reports
For athletes, FAOS can help identify whether sport and recreation are still limited after daily function improves.
For general population clients, it may help track walking, stairs, swelling, pain and participation.
For persistent symptoms, it can show whether the condition is affecting confidence, lifestyle and activity choices.
For Measurz users, FAOS is most useful when combined with objective measures such as:
ankle dorsiflexion ROM
calf strength
single-leg balance
hop testing
gait or running assessment
swelling measures
pain with key movements
Record:
outcome measure name: Foot and Ankle Outcome Score / FAOS
version used
date completed
completion method: paper, digital, interview or assisted
language/version used
condition or presentation being tracked
side involved: left, right or bilateral
Pain subscale score
Symptoms subscale score
ADL subscale score
Sport/Recreation subscale score
Quality of Life subscale score
score range: 0–100
direction of scoring: higher score indicates better status
missing items, if any
assistance provided, if any
current pain score, if relevant
current symptoms
current activity or sport exposure
key functional limitations
confidence or participation goals
baseline comparison
MCID/MDC/MIC comparison where supported
related physical assessment findings
interpretation notes
retest date
referral or further assessment notes where appropriate
Record whether the main limitation appears to be:
pain dominant
symptom or swelling dominant
daily function limitation
sport/recreation limitation
quality-of-life limitation
mixed presentation
unclear due to incomplete responses
This improves:
repeatability
communication
client education
assessment reasoning
monitoring over time
team consistency
reporting quality
Use the related outcome-measure articles below to build internal linking between body regions, function scales, pain beliefs and return-to-activity monitoring.
The FAOS measures self-reported foot and ankle pain, symptoms, daily function, sport and recreation function, and quality of life.
The FAOS has 42 items across five subscales.
Each subscale is converted to a 0–100 score. A higher score indicates better foot and ankle status.
FAOS is usually interpreted using five separate subscale scores rather than one combined total score.
No. FAOS does not diagnose a condition. It helps measure the client’s perceived symptoms, function and quality-of-life impact.
Meaningful change depends on the population and condition. MIC, MCID, MDC or SEM values should be matched to the client group and measure version where available.
FAOS can support return-to-sport reasoning, especially the Sport/Recreation and Quality of Life subscales, but it should not be the only clearance measure.
It can be repeated at baseline, reassessment, after a training or rehabilitation phase, and at key return-to-activity milestones.
FAOS is a 42-item foot- and ankle-specific patient-reported outcome measure.
It includes Pain, Symptoms, ADL, Sport/Recreation and Quality of Life subscales.
Each subscale is scored from 0 to 100.
Higher scores indicate better perceived foot and ankle status.
FAOS does not diagnose a condition or clear a client for sport.
Meaningful change values should be matched to the population and context.
Published reference values are available, but they should be used as context rather than strict pass/fail standards.
Measurz should record each subscale, version, completion method, side, baseline comparison, related findings and retest plan.
Chen, L., Lyman, S., Do, H., Karlsson, J., Adam, S. P., Young, E., & Ellis, S. J. (2023). Foot and Ankle Outcome Score (FAOS): Reference values from a national representative sample. Foot & Ankle Orthopaedics, 8(4), 24730114231213369. https://doi.org/10.1177/24730114231213369
Larsen, P., Al-Bayati, M., & Elsøe, R. (2021). The Foot and Ankle Outcome Score (FAOS) during early recovery after ankle fracture. Foot & Ankle International, 42(9), 1179–1184. https://doi.org/10.1177/10711007211002811
Roos, E. M., Brandsson, S., & Karlsson, J. (2001). Validation of the Foot and Ankle Outcome Score for ankle ligament reconstruction. Foot & Ankle International, 22(10), 788–794. https://doi.org/10.1177/107110070102201004
Sierevelt, I. N., Zwiers, R., Schats, W., Haverkamp, D., Terwee, C. B., Nolte, P. A., & Kerkhoffs, G. M. M. J. (2018). Measurement properties of the most commonly used foot- and ankle-specific questionnaires: The FFI, FAOS and FAAM. Knee Surgery, Sports Traumatology, Arthroscopy, 26, 2059–2073. https://doi.org/10.1007/s00167-017-4748-7
Tapaninaho, K., Uimonen, M. M., Saarinen, A. J., & Repo, J. P. (2022). Minimal important change for Foot and Ankle Outcome Score (FAOS). Foot and Ankle Surgery, 28(1), 44–48. https://doi.org/10.1016/j.fas.2021.01.009
Yoshida, T. H., et al. (2022). Validation of Foot and Ankle Ability Measure and the Foot and Ankle Outcome Score in individuals with chronic ankle instability. Journal of Orthopaedic Surgery and Research, 17, 113. https://doi.org/10.1186/s13018-022-02925-9
