Sharp heel pain first thing in the morning? You’re not alone.
Many people in Adelaide and across Australia suffer from this painful condition called plantar fasciitis.
The good news is there are simple and effective ways to ease pain, recover faster and prevent it from coming back.
This blog covers:
✅ What is plantar fasciitis?
✅ Common symptoms
✅ Common causes and risk factors
✅ How physiotherapists diagnose it
✅ Treatment options at home and professionally
✅ Exercises and Stretches you can do right now
✅ When to see your physiotherapist
✅ Ways to prevent plantar fasciitis
✅ Frequently asked questions
What is plantar fasciitis?
The plantar fascia is a thick band (like a rubber band) of connective tissue that runs along the bottom of your foot, from the heel bone to the toes.
It helps to support the arch of your foot, absorbs the load when you walk or run and acts like a spring.
“Plantar fasciitis” describes damage, overload or irritation to the tissue, which is often associated with inflammation or micro-tears. Over time, repeated stress to the plantar fascia can cause degeneration.
Common Symptoms of plantar fasciitis
- Sharp pain in the heel with your first few steps in the morning or after a period of rest
- Pain when standing for long periods, walking or after increased activity
- Pain that tends to ease after “warming up” the foot but might return after rest or at the end of the day
- Tenderness when pressing under the heel
- Stiffness in the arch of the foot or in the calf muscle
Common causes & risk factors
While plantar fasciitis can happen to anyone, certain factors make it more likely, particularly with our lifestyle and terrain here in Adelaide:
- Spending long hours on hard surfaces: Adelaide has a lot of hard floors, pavement and tiles especially in workplaces like factories and hospitals
- Unsuitable footwear: shoes without good support, cushioning or are too tight
- Tight calf muscles: stiffness in the Achilles tendon can limit mobility and increases the strain on the plantar fascia
- Overuse and sudden increases in activity: increasing physical activity too quickly such as running, walking or sports without proper conditioning
- Excess body weight: higher body mass places more load on the feet therefore increasing strain on the plantar fascia
- Age: more common in middle age(40-60 years) as tissue elasticity declines
- Biomechanical factors: flat feet (loose), high arches (locked) and leg length discrepancies can place additional strain on the tissues, not just the plantar fascia
Diagnosis: how physios determine if it's plantar fasciitis
Your physiotherapist will typically:
- Take a detailed history (i.e. how the pain started, when it hurts, what makes it better or worse, any changes to your lifestyle etc)
- Undertake a physical examination: assess foot posture and gait, palpate around the heel and foot, test calf and ankle flexibility
- Refer for imaging (if warranted): xrays and ultrasound to rule out other conditions (e.g. stress fracture)
Treatment options: for home care to professional help
Plantar fasciitis can be a very painful and debilitating condition. Even though this condition can be very severe, most people recover with conservative treatment.
Self-care / at home
- Rest and reduce aggravating activities such as long bouts of standing or walking especially on hard surfaces
- Ice bottle massage (3-5 minutes) a few times per day can provide temporary pain relief
- Wear supportive shoes to cushion and maintain “good” foot posture
- Arch supports or heel pads can reduce pressure
- Gentle calf stretches
- Low-dye tape of the foot during activity to reduce strain may help reduce pain early on
Shockwave therapy
- Shockwave therapy is a professional electrotherapy device which delivers non-invasive pulses of energy into the plantar fascia to stimulate healing
Night splints
- Wearing specially designed socks to keep your foot in a stretched position may help to reduce morning pain
Medication / cortisone injections
- Over-the-counter (OTC) pain relief such as paracetamol or anti-inflammatories may be advised by your doctor
- Cortisone injections may also be referred by your doctor however there are risks involved
Exercises & stretches you can do right now
Here are some simple and effective exercises you can do at home with minimal equipment. Make sure to do these exercises gently and avoid sharp pain.
Calf stretch against wall
- Put one foot in front of the other (tandem stance)
- Keep back leg stretch with the foot flat on the ground
- Shift your weight forward by pushing into the wall and bending your front leg
- Hold for 30 seconds and repeat 2-3x per day on both sides
Plantar fascia stretch
- Sit with one foot across the other
- Pull toes up towards shin to stretch the bottom of your foot
- Hold for 30 seconds and repeat 2-3x per day on both sides
Ice bottle massage
- Freeze a bottle of water
- Roll the frozen bottle under the arch of your foot and heel
- Gently roll the bottle back and forth for 3-5 minutes
- Repeat 2-3x per day
Toe scrunches using a towel
- Place a towel on the floor (sitting in a chair)
- Scrunch up the towel using your toes
- Repeat for 1-2 minutes, 2-3x per day
Calf raises
- Rise up onto your toes
- Make sure to push through the big toe
- Slowly lower back down
- Perform 30 reps, 2-3x per day
When to see your physiotherapist
You should see a health professional e.g. physio or podiatrist if:
- Pain and symptoms have lasted more than 4-6 weeks
- Pain is severely limiting your ability to walk and weight bear
- There is swelling or redness that is worsening, or other signs of infection
- You suspect a different injury (e.g. stress fracture)
- You have other complications (e.g. diabetes, circulation problems etc)
Plantar Fasciitis Prevention tips
Prevention is always the best strategy. Avoid and prevent plantar fasciitis, by trying to:
- Maintain a healthy body weight (less load = less stress)
- Wear good shoes with cushioning and arch support
- Replace worn out shoes (i.e. every 400-600km)
- Warm up before exercise
- Increase physical activity gradually
- Keep your foot, ankle and calves flexible with regular stretching
- Book in for regular remedial massage therapy to reduce strain and improve circulation
Frequently Asked Questions about plantar fasciitis
Does plantar fasciitis ever heal?
Yes, in most cases plantar fasciitis can heal and fully recover with conservative physiotherapy treatment. For many people, symptoms can significantly improve within 6-8 weeks however the timeline can vary depending on several factors.
What shoes are best for plantar fasciitis?
There is no “one-size-fits-all” shoe as each person’s feet are unique. It is recommended that you assess your foot posture, gait and biomechanics to determine which shoe brand and style is best for you.
Our physiotherapists can recommend specific shoe stores or podiatrists who can help you find the most suitable shoe for you.
How long will it take for my heel pain to go away?
Typical recovery is 3-12 months depending on severity, how early treatment starts, how long you’ve had the issue, how much self-help strategies you adopt etc. Generally speaking, many people notice significant improvement within 6-8 weeks with consistent care.
TL;DR: plantar fasciitis in a nutshell
Plantar fasciitis is one of the most common causes of heel pain and is often worst with your first steps in the morning.
It’s caused by an irritation or repetitive stress of the plantar fascia (thick band under your foot) and is linked to factors like poor footwear, tight calves, long hours on hard surfaces, foot and ankle biomechanics or sudden increases in physical activity.
✅ Most cases heal with consistent care (e.g. stretching, supportive shoes, strength exercises and reduced aggravating factors)
✅ Recovery usually takes 3-12 months, with noticeable improvements within 6-8 weeks
✅ Physio and podiatry treatments such as shockwave therapy, taping, joint mobilisation therapy (JMT) can speed up recovery
✅ Prevention
REFERENCES
Thomas, M.J., Whittle, R., Menz, H.B., Rathleff, M.S., Attenborough, A., Allan, R., … Roddy, E. (2021) ‘Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values’, British Journal of Sports Medicine, 55(19), pp. 1106–1118. doi:10.1136/bjsports-2020-102778.
