Heel pain, plantar fasciitis

Heel Pain & Plantar Fasciitis

‘Plantar Fasciitis’ is a common, painful and debilitating condition affecting people of all ages. Commonly misdiagnosed as ‘heel spurs’, the true pathology is a soft tissue injury and requires specific advice and treatment.

What Causes Heel Pain?

The Plantar Fascia is a primary soft tissue structure that supports and functions to maintain the integrity of the foot's structure and motion. The plantar fascia maintains stability with standing and helps generate force to allow for efficient walking and running. As a result of overloading, this plantar fascia develops ‘micro-trauma’, creating an inflammatory process that further develops a chronic injury state. Initially, symptoms are felt occasionally and can be quite mild. This soon increases in severity and  regularity. Often, if left untreated, plantar fasciitis can be active for some years.


Whilst there is rarely one single cause, there is many contributing factors that we see clinically and include:

  • sudden increase in weight (such as pregnancy)

  • a sudden increase or change in activity

  • commencing activity in old footwear

  • decaying footwear where support has been lost

  • abnormal foot mechanics

  • abnormal body mechanics such as leg length discrepancies


The injury is common across all age groups and activities. Often, sufferers of plantar fasciitis report significant pain in the heel or arch of the foot when rising out of bed or after sitting for a while. As the condition worsens, this may then lead to symptoms with rest and during activity as well. As with most conditions we see, THE EARLIER WE CAN IDENTIFY AND TREAT PLANTAR FASCIITIS, THE FASTER IT WILL RECOVER.


Some Common Myths about Heel Pain:

  • “It will go away on its own”. True - in some cases, however it is not worth the risk of not treating. Plantar fasciitis can worsen dramatically if left untreated. If untreated, most people reduce their activity levels or change pain causing lifestyle patterns, and it does settle after a year or two, but often at the cost of other health issues brought on by a more sedentary life style.

  • ”I only need to stretch and ice”. Unfortunately, plantar fasciitis requires treatment from various angles targeting the different aspects of the condition. Stretching and icing are only part of the solution. We know that icing incorrectly and doing inappropriate stretches can exacerbate the condition.

  • "I have tried orthotics, they don’t work". There are many different types of  orthotic devices that claim to treat plantar fasciitis. The truth is that most don’t live up to the claims they make. Be sure to get professional advice from the people who specialise in this type of condition - podiatrists. Orthotics that are attempting to control your foot mechanics are only part of the solution, so if you have not been prescribed adjunctive therapies (ice/heat/stretching/footwear advice) then you need to speak to us. Clinically we also know that harder orthotics are not as effective as softer custom made orthotic devices. So, if your orthotic devices are uncomfortable or seem to be aggravating your foot pain, again – you need to speak to us. Beware of ‘silver bullet’ remedies that are often advertised to solve heel pain; they simply do not work.

  • “I have tried everything, nothing works”. We often hear this and when we delve closer, sufferers are jumping from treatment to treatment after a short  period of time. We know clinically that all aspects of managing plantar fasciitis must be undertaken at the same time. Further, even with diligent adherence to advice, plantar fasciitis can take time to settle down. Our best clinical estimation is that once treatment is initiated, it can take up to about half as long as the condition has been present to resolve. Hence, the earlier we see it, the quicker you are likely to get better.


Unlike some conditions that we treat, the treatment of plantar fasciitis does not lend itself well to an “ordering from the menu” approach, or, in other words, doing some, but not all, of the prescribed treatments. Plantar Fasciitis can be resistant to treatment, therefore it is necessary to do ALL of the treatments in a rigidly prescribed manner, or the success rate of treatment will fall somewhat below our expectations!