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Heel Pain (plantar fasciitis)

We are a private practice physiotherapy and sports injury clinic in Galway that specialises in treating heel pain. Heel pain or plantar fasciitis is the result of collagen degeneration of the plantar fascia at the origin (base of the foot), the heel, and the surrounding structures.

The plantar fascia plays an important role in the normal biomechanics of the foot. The fascia itself is important in providing support for the arch and providing shock absorption. Despite the diagnosis containing the segment “itis,” this condition is notably characterized by an absence of inflammatory cells.

There are many different sources of pain in the plantar heel besides the plantar fascia. Therefore, the term “Plantar Heel Pain” serves best to include a broader perspective when discussing this and related injuries.

Causes

Causes of plantar heel pain are often due to a repetitive strain causing micro-tears of the plantar fascia but can occur as a result of trauma or other multifactorial causes. There are many risk factors which contribute to plantar heel pain including but not limited to:

  • Loss of ankle dorsiflexion (talocrural joint, deep or superficial posterior compartment)
  • High arch OR flat feet deformities
  • Excessive foot pronation dynamically
  • Impact/weight-bearing activities such as prolonged standing, running, etc.
  • Improper shoe fit
  • Elevated BMI > kg/m2
  • Diabetes Mellitus (and/or other metabolic condition)
  • Leg length discrepancy
  • Tightness and/or weakness of gastrocnemius, soleus, or achilles tendon

Symptoms

  • Heel pain with first steps in the morning or after long periods of non-weight bearing
  • Tenderness to the anterior medial heel
  • Limited dorsiflexion and tight achilles tendon
  • A limp may be present or may have a preference to toe walking
  • Pain is usually worse when barefoot on hard surfaces and with stair climbing
  • Many patients may have had a sudden increase in their activity level prior to the onset of symptoms

Treatment

The condition can be disabling if not appropriately managed. An important tool is education:

  • Patients must understand that symptoms may take weeks or even months to improve (depending on circumstances of injury).
  • Patients should follow the advice given (e.g. rest from aggravating activities initially, ice, stretch).
  • Patients should be aware of the importance of a home exercise plan.

Common treatments include: stretching and strengthening of the gastrocnemius/soleus/plantar fascia; orthotics; ultrasound; iontophoresis; night splints and joint mobilization or manipulation.

Heel Pain (plantar fasciitis)

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Heel Pain (plantar fasciitis) FAQs

What is plantar fasciitis, and how does it cause heel pain?
Plantar fasciitis is an inflammation of the plantar fascia, a thick band of fascial tissue that runs across the bottom of your foot and connects your heel bone to your toes. The plantar fascia is responsible for shock absorption during gait and helps to support the medial longitudinal arch of the foot. When this tissue becomes inflamed or overstretched, it causes heel pain, often described as a sharp pain, particularly in the morning or after periods of rest.

What are the symptoms of plantar fasciitis?
Symptoms of plantar fasciitis include stabbing pain in the bottom of the heel, especially during the first steps of the day. The pain may decrease as you move around but could return after long periods of standing or after exercise.

How can West Coast Physio help treat plantar fasciitis?
At West Coast Physio, we offer specialized treatment for plantar fasciitis. Our approach includes exercises that stretch and strengthen the plantar fascia, Achilles tendon, and calf muscles. We also use manual therapy, taping, or orthotics to reduce pain and improve mobility. Targeted rehabilitation helps reduce inflammation and prevents future heel pain.

How long does it take to recover from plantar fasciitis with treatment from West Coast Physio?
Recovery times for plantar fasciitis vary based on the severity of the condition. Mild cases may improve within a few weeks with proper treatment and home exercises provided by West Coast Physio. More severe cases can take several months, especially if the pain has been chronic or if there are additional biomechanical issues.

Can plantar fasciitis be prevented?
Yes, plantar fasciitis can often be prevented with regular stretching and strengthening of the plantar fascia, calf muscles, and Achilles tendon. At West Coast Physio, we advise wearing supportive shoes with proper arch support, avoiding high-impact activities on hard surfaces, and maintaining a healthy weight to help prevent this condition. When initially starting a new exercise or running program often less is more.

When should I see West Coast Physio for heel pain?
You should seek help from West Coast Physio if your heel pain persists for more than a few weeks, especially if it is affecting your daily activities or if you notice stiffness, swelling, or discomfort that worsens over time. Early intervention helps prevent further damage and improves recovery outcomes.

What exercises are recommended for plantar fasciitis?
Common exercises include calf stretches, toe stretches, and rolling the foot over a tennis ball to stretch and massage the plantar fascia. Strengthening exercises that target the intrinsic foot and lower leg muscles (calf raises and tibialis anterior raises) also play a critical role in the rehabilitation process. At West Coast Physio, we can provide a personalized exercise program tailored to your needs.

Can orthotics or footwear help with plantar fasciitis?
Yes, orthotic devices and wearing supportive footwear can significantly reduce symptoms of plantar fasciitis. At West Coast Physio, we offer custom orthotics or recommend over-the-counter arch supports to help relieve pressure on the plantar fascia, reduce strain, and promote healing.

These treatments can be provided by your physiotherapist. It is important to get a correct diagnosis before starting into exercises. Your physio will give you exercises specifically designed to treat the condition without putting you at risk of injury aggravation. Here at West Coast Physio we are more than happy to talk to you about your injury and kickstart you on the road to recovery.

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COVID-19 INFORMATION

PHYSIOTHERAPY IS AN ESSENTIAL HEALTH SERVICE

During this pandemic, chartered physiotherapists at West Coast Physio will continue to provide services while following all relevant government COVID-19 guidelines to keep you safe during your visit, including screening for COVID-19 before each treatment.

Disclaimer: The information provided on this website is for informational purposes only and should not be treated as medical advice. If you have any questions about your condition, please do not hesitate to give us a call.

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