Heel Pain & Plantar Fasciitis

What plantar fasciitis is

The plantar fascia is a band of tissue running along the sole, from the heel to the ball of the foot. Plantar fasciitis is irritation of that tissue near the heel, and it is one of the more common reasons for heel pain. The classic pattern is sharp pain with the first steps in the morning or after sitting, easing as you get going.

Why it happens

It is usually load related. A change in activity, time on your feet, footwear, body weight or foot mechanics can all tip the tissue past what it is coping with. Heel pain has other causes too, which is why an assessment matters before settling on a plan.

Who tends to get it

Plantar heel pain is common in people who spend long periods on their feet, in runners and walkers who have recently increased their distance or pace, and after a change to less supportive footwear. A recent change in activity or load is one of the most common triggers, which is why the assessment spends time on what changed before the pain started.

What can help early on

Before your appointment, a few things often take the edge off. Easing back the activity or load that triggered the pain, wearing supportive shoes rather than going barefoot on hard floors, and gentle calf and foot stretching can all help settle an irritated fascia. Avoid pushing through the sharp first step pain in the morning, as that tends to keep the tissue aggravated. These are general measures rather than a diagnosis, and if the pain is not settling it is worth being assessed, because several other things can cause heel pain.

How we approach it

The podiatrist takes a history, examines the heel and foot, and looks at how you load through the step. The plan addresses what is driving it and may combine loading work, footwear changes and in clinic treatments. Plantar heel pain often takes time to settle, and the podiatrist will be straight with you about the likely timeframe.

How we treat it

A plan usually combines a few elements rather than relying on one. Managing the load on the fascia and rebuilding its tolerance through graded strengthening is often central. Footwear changes or orthoses can reduce the strain on the tissue while it settles, where the assessment shows they would help. For symptoms that are persistent, in clinic options such as radial shockwave therapy may be considered as part of the plan. Where how you walk or run is part of the picture, a gait and biomechanical assessment can inform the plan. The right combination depends on your assessment, and the podiatrist will explain what each part is for.

When to seek assessment

It is worth being assessed if the pain is not improving after a few weeks of sensible self care, if you have numbness, tingling or pain that wakes you at night, or if the heel pain followed an injury. These can point to causes other than plantar fasciitis that are worth checking.