Plantar Fasciitis

The name suggests inflammation, and clinicians increasingly prefer “plantar fasciopathy” because the tissue changes are more degenerative than inflammatory. That distinction matters for treatment: it responds to loading rather than to rest and anti-inflammatories alone.

What it feels like

Sharp pain under the heel, characteristically worst on the first few steps in the morning or after sitting, easing as you move and often returning after prolonged standing or at the end of the day.

That morning pattern is distinctive enough to be a strong diagnostic clue.

Why it happens

Load exceeding what the tissue can currently tolerate. Common contributors: a sudden increase in walking or running, prolonged standing at work, a change of footwear, weight gain, and reduced ankle mobility or calf strength.

Heel spurs often show on X-rays of people with plantar fasciitis, but they are also common in people with no pain and are generally not the cause.

How we treat it

Loading the tissue progressively, alongside addressing what is overloading it: calf strength, ankle mobility, footwear and activity levels.

What to expect

Assessment includes your calf, ankle and foot mechanics, not just the painful spot. Bring the shoes you actually wear.

You will get a loading programme and specific footwear guidance. As with other tissue-loading problems, the home programme carries most of the result.

How long it takes

Often months rather than weeks, particularly if it has been present a while. Improvement is usually gradual. Consistency matters more than any single treatment.