Plantar Fasciitis & Heel Pain
That sharp pain under the heel on your first steps of the morning is usually plantar fasciitis — an overload of the tissue under the foot. It is slow to settle, but with the right loading and a bit of patience it gets better, and we can speed it along.
Plantar fasciitis: the most common cause of heel pain
Plantar fasciitis — more accurately plantar fasciopathy — is an overload of the thick band of tissue (the plantar fascia) that runs under the foot and attaches to the heel bone. It is the most common cause of heel pain. The classic sign is sharp pain under the heel with your first few steps in the morning or after sitting, which eases as you warm up and then returns after being on your feet for a while.
What it feels like
A sharp or bruise-like pain under the heel, worst on the first steps of the day or after rest, and after long periods standing or walking. It is usually one foot, and pressing the inside of the heel reproduces it.
Why it happens
It builds when the load on the fascia outstrips what it can handle — a jump in running or walking, a lot of standing, tight or weak calves and reduced ankle movement, less supportive footwear, or carrying more body weight.
It settles — but it rewards loading and patience
Plantar heel pain is slow to resolve and can take many months, but it does get better. The most effective self-management combines calf and plantar-fascia stretching with progressive, heavy strength work for the foot.
High-load strength training
Loading the fascia with slow, heavy heel-raises (done with the toes propped up to tension the fascia) improved pain faster at three months than stretching alone in a randomised trial (Rathleff et al., 2015). Strength plus stretching is the core of a good programme.
Settle the load, support the foot
Temporarily easing the aggravating load, supportive footwear or an insole, and calf/ankle mobility all help the fascia cope while it recovers. For cases that stay stubborn, shockwave therapy is a well-recognised next step.
Sources & further reading
Rathleff MS, Mølgaard CM, Fredberg U, et al. High-load strength training improves outcome in patients with plantar fasciitis: a randomised controlled trial with 12-month follow-up. Scand J Med Sci Sports 2015;25(3):e292–e300. onlinelibrary.wiley.com
Physiotherapy assessment for plantar fasciitis
Your first appointment is a proper assessment, in two parts:
Subjective assessment
A detailed discussion about how it started, what makes it better or worse, how it is affecting your work, training and daily life, and your goals — including any event you are building towards.
Objective assessment
A hands-on examination — strength, movement, loading and specific tests — to pin down the diagnosis and what is driving it. Where it will change your plan, we can arrange diagnostic ultrasound scanning in-house.
Book your heel pain assessment
Get a clear diagnosis (it isn’t always the fascia), a loading plan that works, and honest timelines — plus footwear and shockwave options if you need them.