Heel pain - What is it and what can I do about it?

If you wake up in the morning and feel a sharp pain in your heel with those first few steps, you are not alone. Plantar heel pain is one of the most common foot conditions seen in active people, especially those who spend long hours on their feet, enjoy running or walking, or have recently changed their activity level or footwear. The good news is that most cases can be managed effectively with the right assessment, care, and consistency.

What Is Plantar Heel Pain
Plantar heel pain is a broad term that refers to pain felt under the heel, most often caused by irritation or overuse of the plantar fascia. The plantar fascia is a thick band of connective tissue that runs along the bottom of the foot, connecting the heel bone to the toes. It supports the arch and helps absorb shock with every step. When this tissue becomes strained, inflamed, or overloaded, pain develops where it attaches to the heel bone.

While the condition is often referred to as plantar fasciitis, research shows that many cases involve a combination of inflammation, microtears, and degenerative change within the fascia. This is why plantar heel pain can become chronic if left untreated or if activity continues without modification.

Here is an audio snippet of our Podiatrist Timothy Leahy discussing plantar heel pain on ABC radio:
Link to audio file

Common Symptoms
The most recognisable sign is sharp heel pain with the first steps in the morning or after periods of rest. The pain may ease as you move but can return after prolonged standing or walking. Some people describe a dull ache through the heel or arch by the end of the day. Pain is typically worse barefoot or in unsupportive shoes. In long-standing cases, mild swelling or thickening of the heel tissue may be felt.

Causes and Contributing Factors
Plantar heel pain often develops from a mix of mechanical overload and poor foot function. Common contributing factors include:
• Flat or high-arched feet that alter load through the fascia
• Tight calf muscles or Achilles tendon
• Sudden increase in training volume or intensity
• Standing for long periods on hard surfaces
• Unsupportive or worn-out footwear
• Weight gain or changes in body composition
• Reduced ankle mobility or poor shock absorption

Every person’s pattern is slightly different, which is why a thorough assessment is essential to target the root cause rather than just the symptoms.

How We Assess Plantar Heel Pain at Enhance Podiatry
At Enhance Podiatry, we start with a detailed history and functional examination to identify what is driving your pain. This may include gait analysis, footwear review, strength and flexibility testing, and pressure mapping to measure how your foot loads during walking. In some cases, imaging such as ultrasound may be recommended to evaluate the fascia and surrounding structures.

This approach allows us to build a plan that addresses both short-term relief and long-term prevention.

Treatment and Management
The aim is to reduce pain, promote healing, and restore normal foot function. Your management plan may include:
• Load modification and temporary activity adjustment to reduce stress on the fascia
• Stretching and strengthening exercises for the calves, feet, and lower limbs
• Custom orthotics to improve arch support and offload the heel
• Footwear advice to ensure proper cushioning and stability
• Manual therapy or taping to relieve tension on the fascia
• Shockwave therapy or other evidence-based modalities when indicated

Most patients notice improvement within weeks when treatment is consistent and tailored to their lifestyle. The key is gradual progression back to full activity rather than complete rest.

Preventing Recurrence
Once symptoms settle, prevention focuses on maintaining strong, flexible, and well-supported feet. Continue regular stretching of the calves and plantar fascia, replace worn shoes early, and maintain a healthy weight and activity routine. Paying attention to early twinges of heel pain and acting quickly can prevent flare-ups from returning.

Taking the Next Step
Plantar heel pain can be frustrating, especially for people who love to stay active, but recovery is absolutely achievable with the right plan. Early assessment makes a big difference and helps you return to moving freely and confidently.

At Enhance Podiatry, we help people of all ages overcome heel pain and get back to doing what they love without limitation. Book an appointment today and take the first step towards lasting relief and better movement.