What it is
Plantar fasciitis (often called plantar heel pain) is inflammation and degenerative change at the origin of the plantar fascia on the underside of the heel. It is the most common cause of chronic heel pain in adults and can affect both active and sedentary people.
Common causes / risk factors
- Repetitive load or overload to the plantar fascia (running, prolonged standing).
- Tight calf muscles / gastrocnemius tightness.
- Sudden increases in activity, poor footwear, obesity, and biomechanical foot abnormalities (high or low arches).
- Age (most common in middle age).
Symptoms
- Sharp or stabbing pain under the heel, especially with the first steps in the morning or after prolonged sitting.
- Pain often decreases after initial activity but can worsen again with prolonged standing or after exercise.
Evidence-based treatments
- Education and activity modification (reduce aggravating activities).
- Targeted exercise therapy (stretching and progressive plantar-fascia/calf loading programs).
- Foot orthoses (off-the-shelf or custom) can reduce load and relieve symptoms for many patients.
- Night splints, taping (short-term), and short courses of NSAIDs for pain control.
- Shockwave therapy and corticosteroid injections can be considered in persistent cases; surgical options are rare and reserved for refractory cases. Current literature supports a conservative, progressive loading + supportive device approach first.
How Clear Step Podiatry can help
- Comprehensive assessment (history, gait & foot posture exam) to identify contributing factors (calf tightness, footwear, training changes).
- Individualised loading program and rehab plan with progressive strengthening and calf flexibility work.
- Custom or prefabricated orthotics prescription and footwear advice to reduce plantar stresses.
- On-site treatments: taping, night splint fitting, shockwave therapy where indicated, and image referral if the presentation is atypical.
- Ongoing follow-up and modification of treatment until symptoms resolve.
