What is plantar fasciitis?
The plantar fascia is a thick band of connective tissue that runs along the sole of your foot, from the heel bone to the base of your toes. It supports the arch and helps your foot absorb shock with every step.
Plantar fasciitis develops when the fascia is overloaded faster than it can recover. The tissue becomes irritated where it attaches to the heel, which is why the pain is usually felt under the inside edge of the heel. Despite the name, it is less an inflammation than a tissue that has been asked to do too much, which is also why rest alone rarely fixes it.
It affects around one in ten people at some stage of life, most often between 40 and 60, and is common in runners, people who stand for long periods at work, and anyone whose activity has recently changed. Most cases settle with the right care, although recovery is measured in months rather than days.
Symptoms of plantar fasciitis
Heel pain that is worst with the first steps of the day is the classic sign. Other common symptoms include:
- A sharp or stabbing pain under the heel when you get out of bed or stand after sitting
- Pain that eases as you warm up, then returns after long periods of standing or walking
- Tenderness when you press under the inside of the heel
- An ache along the arch of the foot
- Pain after exercise rather than during it
- Stiffness in the heel and calf in the morning
Pain that is worse at night, numbness or tingling, or pain following a fall or injury point to other causes and should be assessed promptly.
Causes and risk factors
Plantar fasciitis is almost always a load problem: the fascia has been stressed beyond what it is conditioned for. Common triggers include:
- A sudden increase in walking, running or standing, such as a new job, a new exercise program or a holiday on foot
- Flat or unsupportive footwear, including thongs, ballet flats and worn-out runners
- Tight calf muscles, which increase the pull on the heel
- Flat feet or very high arches, which change how load passes through the foot
- Weight gain, which increases the load on every step
- Long hours on hard floors, common in hospitality, retail and healthcare
- Age, with most cases between 40 and 60 as tissue becomes less elastic
A so-called heel spur sometimes shows on X-ray. Spurs are common in people without heel pain, and treating the fascia, not the spur, is what settles the symptoms.
How we treat plantar fasciitis at Kooyong Podiatry
Treatment starts with finding out why your fascia is overloaded, then reducing that load while the tissue recovers and strengthens. At your first appointment we assess your feet, footwear and the way you walk, then build a plan that may include:
- A progressive stretching and strengthening program for the calf and foot, tailored to what you can manage
- Footwear advice, including specific shoe styles and brands that suit your feet and your day
- Strapping to offload the heel in the early, painful stage
- Prefabricated or custom orthotics (insoles) to support the arch and spread load more evenly
- A graded return to running or sport, with milestones you can measure
What you can do at home
- Wear supportive, cushioned shoes and avoid going barefoot on hard floors, especially first thing in the morning
- Stretch your calves and the arch of your foot every day. We will show you how at your appointment
- Ease back on running and jumping for a while. Cycling and swimming keep you active without loading the heel
- When you return to activity, build up gradually rather than all at once
- Simple pain relief may help in the short term. Check with your pharmacist or GP first
When to see a podiatrist
Book an appointment if:
- Your heel pain has not improved after two to three weeks of home care
- Pain wakes you at night or is there even when you are resting
- You notice numbness, tingling, swelling or redness
- The pain started after a fall or injury
- You have diabetes or poor circulation. Please see us promptly
The earlier plantar fasciitis is treated, the faster it tends to settle. Cases that have been present for many months usually take longer to turn around.
Most people notice improvement within six to eight weeks of starting treatment, and the majority are much better within three to six months. Long-standing cases can take longer. Sticking with the strengthening program is the single biggest factor in how quickly it settles.
No. You can book directly with Kooyong Podiatry. If your GP has set up a Chronic Disease Management plan, bring the paperwork and we will process the Medicare rebate for you.
Usually yes, with some changes. Running and jumping load the heel heavily, so we often suggest swapping them for cycling, swimming or walking while the fascia settles, then building back up gradually. Stopping all activity tends to slow recovery rather than speed it up. We will give you a clear plan for what to do, what to avoid, and when to progress.
