Plantar Fasciitis: Why Your Heel Hurts and What You Can Do About It

Heel pain is one of the most common foot problems we see in clinic. A frequent cause is plantar fasciitis, more accurately described as plantar heel pain or plantar fasciopathy. It usually causes pain under the heel, often worst with the first few steps in the morning or after sitting for a while.

What is plantar fasciitis?

The plantar fascia is a strong band of connective tissue running from the heel towards the toes. It helps support the arch of the foot and stores and releases energy when we walk and run. When the tissue is repeatedly overloaded, it can become painful and less tolerant of normal activity.

What does it feel like?

Typical symptoms include pain under or just in front of the heel, discomfort with the first steps after rest, and pain that may increase after long periods of standing, walking or running. Some people find the pain eases once they get moving, only to return later in the day.

Why does it happen?

There is rarely one single cause. Plantar heel pain can develop after a sudden increase in walking or running, a change in footwear, prolonged time on your feet, reduced calf or ankle flexibility, or simply because the tissue is being asked to cope with more load than it is currently used to.

What can help?

Treatment usually focuses on reducing irritation while gradually improving the foot and calf's ability to tolerate load. This may include temporary changes to activity, supportive footwear, calf and plantar fascia stretching, progressive strengthening exercises and, where appropriate, foot orthoses or insoles.

One commonly used strengthening approach involves heel raises with the toes slightly elevated, progressing from double-leg to single-leg work as symptoms allow. The important part is gradual progression rather than complete rest.

Do I need a scan?

Most cases can be diagnosed from the history and a clinical examination. Imaging is not always needed. Ultrasound or other imaging may be useful when symptoms are unusual, persistent, or when another cause of heel pain is suspected.

When should I get it assessed?

It is worth having heel pain assessed if it has lasted several weeks, is getting worse, is affecting your walking or sport, or if you have numbness, significant swelling, night pain or other symptoms that do not fit the usual pattern.

How Pentland Podiatry can help

At Pentland Podiatry in Penicuik, a musculoskeletal assessment can look at your symptoms, foot and ankle movement, strength, footwear and activity levels. From there, we can build a treatment plan aimed at reducing pain and helping you return to normal walking, exercise or sport.

If heel pain is limiting you, contact Pentland Podiatry to arrange an assessment.