Are you waking up to heel pain?

Learn about plantar fasciitis and how a foot specialist can help!

If you experience pain on the bottom of your foot during your first few steps in the morning or during or after exercise, you may have plantar fasciitis. While the condition can usually be treated with ice, rest, and over-the-counter painkillers in the short term, early intervention by a physiotherapist can prevent the condition from worsening and facilitate quicker recovery. Read on to learn more about plantar fasciitis and how we treat it at Recover Physio.


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Joe Cousens – Physiotherapist

A patient receiving plantar fasciitis treatment at Recover Physio in Norwich

What is plantar fasciitis?

Plantar fasciitis is a common orthopaedic condition characterised by inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot, connecting the heel bone to the toes. This condition often causes intense heel pain, particularly during the first steps in the morning or during or after exercise.

The primary symptom of plantar fasciitis is sharp, stabbing pain in the heel, typically concentrated at the bottom of the foot near the heel bone. This pain is usually most severe when you first wake up as whilst asleep through the night, the foot’s position allows the fascia to contract and tighten. Upon standing, the sudden stretching of the fascia can cause significant discomfort. As the day progresses and the foot tissues loosen up, the pain may decrease but can return after long periods of standing, walking, or sitting.

Additional symptoms include:

  1. Tenderness: The bottom of the foot, especially near the heel, may feel tender to the touch.
  2. Stiffness: Stiffness in the foot, especially in the morning, is common. This can make walking or standing uncomfortable.
  3. Swelling: Mild swelling may occur around the heel and arch of the foot.
  4. Pain after exercise: Unlike typical exercise-induced injuries, pain from plantar fasciitis usually worsens after activity rather than during it.

Who can get plantar fasciitis

The primary cause of plantar fasciitis is overuse, particularly from repetitive activities that put stress on the heel and attached tissue. Improper footwear lacking adequate arch support, thin soles, or poor cushioning can exacerbate the condition. Sudden increases in activity levels, which strain the plantar fascia, in addition to tight calf muscles or Achilles tendons, also contribute. Walking or standing on hard surfaces for extended periods and jobs involving heavy lifting can increase the load on the feet, further exacerbating the condition.

Plantar fasciitis can affect a diverse range of individuals, but certain factors increase the risk. Many of our patients are aged between 40-60 and have an active lifestyle, either due to their hobbies or occupation.

Here are some of the factors that can increase the risk of plantar fasciitis:

  • People increasing their level of activity, such as increasing running, getting back into team sports or dancing, which can increase the repetitive stress on the feet
  • People with flat feet, high arches, or abnormal walking patterns like overpronation or supination are more prone to plantar fasciitis
  • Those with excess body weight, which increases pressure on the plantar fascia
  • Pregnant women often experience plantar fasciitis due to increased weight and changes in foot mechanics
  • Certain comorbidities, such as arthritis and diabetes, can increase the risk, as these conditions often lead to additional foot problems
  • Women are generally slightly more affected by plantar fasciitis than men

Can physio help treat plantar fasciitis?

Physiotherapy can be highly effective in treating plantar fasciitis. It helps alleviate pain, reduce inflammation, and improve foot mechanics to prevent recurrence. Physiotherapists employ various techniques, such as addressing any abnormal biomechanics, stretching exercises, manual therapy, strengthening exercises, and advice on footwear and orthotics, to address the condition comprehensively.

Patients experiencing symptoms of plantar fasciitis should consider seeing a physiotherapist early on in the course of the condition to confirm the diagnosis and start the treatment intervention as soon as possible.

Early intervention by a physiotherapist can prevent the condition from worsening and facilitate quicker recovery. However, if the pain is more chronic or if there is uncertainty about the diagnosis, a Physiotherapist will still be able to assess and start their treatment based on the findings and stage of the condition.

Treating plantar fasciitis early generally leads to better outcomes. Early intervention can help mitigate pain and inflammation more effectively and reduce the risk of the condition becoming chronic. When treated early, the likelihood of developing compensatory movement patterns that can lead to other musculoskeletal issues decreases. Physiotherapy initiated at an early stage often results in a shorter recovery period and a higher likelihood of complete resolution of symptoms. Conversely, delayed treatment may lead to prolonged pain and disability, requiring more extensive and prolonged interventions.

Who else can treat plantar fasciitis?

If you are experiencing heel pain in the morning or post activity, seeing a physio will help you get a diagnosis through an expert assessment. We will work with you assessing biomechanics and identity and abnormalities or factors contributing to your pain. From this we will be able to develop a personalised treatment plan as there are a number of reasons someone may develop plantar fasciitis and their individual lifestyle and goals will play a big part in the process.

Plantar fasciitis can be treated in different ways by different professions. Biomechanical podiatrists, may be able to prescribe arch supports to help offload the plantar fascia. Occasionally, we may recommend a referral to orthopaedic consultant who may recommend a corticosteroid injection, this will help with any inflammation which can reduce inflammation and pain.

Another treatment option would be extracorporeal shockwave therapy, a non-invasive treatment to stimulate healing.. It has excellent results when someone has had symptoms for a long time as it helps to restart your body’s natural healing processes, which, along with our other treatment interventions, can cure your symptoms.

The aim of any intervention is to treat your everyday pain and symptoms and then to address the underlying cause and prevent them from coming back.  

Plantar fasciitis treatment at Recover Physio

At Recover Physio, our treatment for plantar fasciitis is comprehensive and tailored to everyone’s individual needs. Our approach begins with a thorough initial assessment, which gives you the opportunity to explain your issue. We will make sure that we fully understand and then complete a physical examination focusing on foot mechanics, your muscles, and gait (how you walk).

We use the results of the assessment to tailor make a treatment programme for you. This will include some manual therapy techniques such as deep tissue massage, mobilisations and dry needling (this is entirely optional as we understand it is not for everyone. If we feel it would help, we would of course discuss this at length with you first). These would be used to reduce the tension in plantar fascia and the muscles in your calf which will help with the stiffness and pain into the heel. We would also ask you to complete a personalised home exercise programme which would help with pain management but also address the underlying cause of your symptoms. 

The most common reason that people develop Plantar Fasciitis is their biomechanics overloading the tissues and not muscular weakness. To help us fully assess why this is happening, we may also ask you to bring in well work footwear to assess or for you to walk or jog on a treadmill. This will also help use to see how you are moving and why you may be overloading the tissues.

We also have an extracorporeal shockwave machine in the clinic. This will help to cure chronic cases that people have been living with for some time.  Used alongside are other treatments and exercise programmes, we are able to treat Planter Fasciitis at any stage of its presentation.

If you would like to know how the team at Recover Physio can help you live your life without heel pain, why not speak to one of our friendly physios first? Just click below to request a callback from a member of our team!

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