04/08/2026
Plantar fasciitis is one of the most common causes of heel pain - it's inflammation / degeneration of the thick band of tissue that runs across the bottom of your foot.
That band is called the plantar fascia. It connects your heel bone to your toes and supports the arch of your foot.
What it feels like
_ Sharp, stabbing pain at the bottom of the heel, right where the fascia attaches to the heel bone. Sometimes it spreads into the arch.
_ Worst with the first steps in the morning after getting out of bed, or after sitting for a long time. It eases a bit after you start walking, then can get worse again after standing or walking for a long time.
• Pain after exercise, not usually during exercise.
• Tightness in the Achilles tendon / calf.
Why it happens
It's not usually a single injury. It's repetitive micro-stress:
_ Overload: long periods standing, walking on hard surfaces, sudden increase in running or walking distance
_ Foot mechanics: flat feet, very high arches, over-pronation
_ Tight calves and Achilles tendon - puts more pull on the fascia
_ Risk factors: age 40-60 is peak, excess body weight, jobs that require standing, poor footwear with thin soles or poor arch support, barefoot walking on hard floors
How it is diagnosed
Usually clinical - history and physical exam. Doctor will press on the medial heel and ask about morning pain pattern, check calf tightness, foot posture.
Imaging is not always needed, but X-ray may be done to rule out stress fracture or heel spur, and ultrasound can show thickening of the fascia. If you have persistent symptoms, it's worth having it checked in person to rule out other causes like Achilles tendinopathy, tarsal tunnel, or heel fat pad irritation.
Treatment - what actually helps
Most cases improve in a few months with conservative care. Consistency matters more than one single cure.
1. Load management and pain relief
• Rest from aggravating activity, but stay mobile
• Ice roll: freeze a water bottle and roll it under the foot for 10-15 min, 2-3 times a day
_ NSAIDs like ibuprofen can help short term if you have no contraindications
2. Stretching and strengthening - most important
_ Calf stretch: wall stretch for gastrocnemius and soleus, 30 sec x 3, twice daily
_ Plantar fascia stretch: cross leg, pull toes back toward shin until you feel arch stretch, hold 30 sec x 3, especially before first steps in morning
_ Towel scrunches and short foot exercises to strengthen intrinsic foot muscles
3. Support the arch
• Avoid walking barefoot on hard floors
• Supportive shoes with good arch support and slightly cushioned heel. Avoid old, flat shoes.
• Silicone heel cups or prefabricated orthotic insoles often help
• Night splint that keeps ankle at 90 degrees can help if morning pain is severe
4. Other options if it does not improve in 6-12 weeks
• Physiotherapy, focused shockwave therapy
• Corticosteroid injection - can give relief but does not fix cause and repeated injections have risks
• Very rarely, surgical release is considered after 9-12 months of failed conservative care
Prevention
• Keep calf and foot muscles flexible
• Gradually increase walking/running distance, not all at once
• Maintain healthy weight
• Replace worn-out running shoes every 500-800 km
• If you stand a lot for work, alternate shoes and use an anti-fatigue mat
If you are having heel pain yourself, try tracking: when it hurts most, how long morning stiffness lasts, type of shoes you wear during the day, and recent activity changes. That information will make a clinic visit much more efficient.
