Plantar fascia is a real pain in the heel!

Plantar fascia is a real pain in the heel!

Plantar fascia, or plantar fasciopathy, is one of the most common causes of foot and heel pain particularly in the 40-60 year old age group and of course in runners!


  • Pain located on the medial plantar aspect of your heel where the plantar fascia inserts onto the heel bone.
  • Morning pain and stiffness on waking that can often improve as your foot “warms up.”
  • Aggravated by weight bearing activities such as walking, running and prolonged standing.
  • As the injury worsens the pain can be quite debilitating and very intense.


  • Changes in activity and load on the plantarfascia which is beyond the capacity of the tissue. For example, a sudden increase in type or intensity of activity.
  • Flat feet have been commonly been thought to contribute to the condition due to lowering of the medial longitudinal arch which increases the tensile loading within the plantar fascia.
  • Sudden changes in footwear can increase the workload on the plantarfasia. A classic example of this is when a patient returns from their beach holiday after wearing thongs for two weeks straight. Transitioning from wearing heels/work boots/dress shoes to thongs places a very different demand on the plantar fascia which results in overload of the tissue and pain.


Phase 1: Managing the pain:

  • Modify/Reduce activity levels
  • Education around footwear
  • Ice
  • Isometric exercises
  • NSAIDs (non steroidal anti-inflammatory medication)
  • Taping

Phase 2: Rehabilitation and building the plantar fascia activity tolerance.

  • Staged and progressive exercise-based program to help manage the pain and restore the loading capacity of the tendon.
  • Appropriate stretching of the calf and plantarfascia.
  • Address movement restrictions at the big toe and ankle to optimise long term recovery.
  • Improve the strength of the foot intrinsic muscles which help support the foot structure.

Things you might be thinking:

Are heel spurs the cause of my pain?

  • Heel spurs are very common and research has indicated there is no correlation to heel pain and having heel spurs. So best to just leave them alone.

plantar-a-1-removebg-previewShould I use gel shoe inserts?

  • Gel inserts can provide a lovely cushion for your heel when it is feeling sore. They won’t be the magical cure but can help manage your symptoms.

What about Shock Wave Therapy?

  • Extracorporeal shock wave therapy (ESWT) is designed to stimulate cellular repair. Studies indicate that shock wave therapy can be effective in reducing the pain associated with plantar fascia.
  • Shock wave can be an effective treatment option when used in conjunction with activity modification and a rehabilitation program.

Should I get foot orthotics?

  • Foot orthotics have been shown to help reduce pain in patients with a 6-12 week history of heel pain.
  • Anecdotally there is evidence to support the prescription of orthotics if the patient feels it helps to alleviate their symptoms.

How long will it take?

  • Average recovery time is 3-6 months. A small percentage of the population can take years to fully recover. Addressing the symptoms early is key to reducing the chronic nature of the condition.

Key tips:

  • Get early management and guidance from your physiotherapist or podiatrist.
  • Respect the pain.
  • Remember our body likes steady and progressive changes in activity to allow strength adaptation.

If you need to book and appointment email Cara at Or book online via the Nick Hose Fitness website.

You can also book online by clicking the link below.


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03 5593 3229
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