Heel pain and plantar fasciitis
Sharp heel pain with your first steps in the morning, or after sitting? Plantar fasciitis is a common cause, and a mix of loading, footwear and calf work can help it settle.
About heel pain
Heel pain is very common, and healthdirect notes it is most often caused by plantar fasciitis. The plantar fascia is a thick band of tissue under your foot that runs from your heel to your toes and supports your arch. When it is overloaded, it becomes painful where it attaches to the heel bone.
The classic sign is a sharp pain under the heel with your first steps in the morning or after sitting, which eases as you warm up, then aches again after a long day. Common triggers include a sudden increase in walking or running, long shifts standing on hard floors, worn or unsupportive shoes, bare feet on tiles, tight calves and weight gain. Heel spurs on an X-ray are common in people with no pain and are not usually the cause.
Pain at the back of the heel is a different problem. It often comes from the Achilles tendon, which joins your calf to the heel bone, and feels stiff in the morning and sore after running, hills or stairs. In active kids aged about 8 to 14, heel pain is often Sever's disease, an irritation of the growth plate.
Ease the load on your heel
Wear supportive, cushioned shoes, even around the house instead of going barefoot on tiles. A few ankle pumps before you get out of bed can make the first steps easier. Cut back rather than stop: swap some walking or running for cycling or swimming while it settles. Gentle calf stretches and rolling your arch over a ball can ease morning pain.
How we treat it
We ask about your work, footwear and activity, and examine your foot, ankle and calf. We watch you walk, and if you run we can look at your running too. Calf and hip strength, a stiff ankle and the way your foot lands can all add load to the heel.
Treatment may include:
- strengthening for your calf and foot, including slow, heavy heel raises
- calf and plantar fascia stretches
- taping to support the arch in the short term
- footwear advice, and whether an insert or heel raise might help
- a plan to manage walking, standing at work and running while it settles
- hands-on treatment or dry needling for tight calf muscles, if they suit you
If you are on your feet for sport, our sports physiotherapy team can plan your return to running. See also our page on running injuries.
Read more on our blog: How does physio help plantar fasciitis?, 6 things you need to know about tendinopathy and Foot health tips.
you felt a sudden snap or kick at the back of your heel and now can't stand on tiptoe, which can be an Achilles rupture, or your heel pain started after a fall or a jump from a height. Also see a doctor if your foot is hot, red and swollen and you feel unwell, you have numbness, burning or tingling in your foot, especially if you have diabetes, or the pain is constant, worse at night and not linked to activity.
Getting started
Who you'll see
One of our physiotherapists, one to one in a private room. You can choose your physiotherapist when you book. Meet the team.
Your first appointment
60 minutes. We listen to your story, check how you move, explain what we find and start treatment, then give you a short plan to follow at home. Follow-up appointments are 30 minutes.
Cost and rebates
First appointment $225. Follow-up $150, or $135 on a pass. No referral needed. We claim private health rebates on the spot with Tyro (works like HICAPS) where available. We are not a bulk billing clinic: with a GP care plan (GPCCMP), you pay in full and Medicare pays $63.40 back for up to five allied health visits a year. If you can't make an appointment, please give us 24 hours notice. Funding and referrals.
Where and when
Suite 2, 69 Eyre Street, North Ward, Townsville. Free parking on both sides of Eyre Street, plus an accessible bay right outside. Open Monday to Thursday 7 am to 7 pm, Friday 7 am to 3:30 pm and Saturday 7 am to 1:30 pm. Book online or call 07 4724 0768.
Common questions
Do I need a scan?
Usually not. Plantar fasciitis is diagnosed from your symptoms and an examination. A heel spur on an X-ray doesn't usually explain the pain.
How long does plantar fasciitis take to settle?
It can be slow, often several months, and it varies from person to person. A consistent plan for loading, footwear and activity gives you the most control over it.
Do I need orthotics?
Not always. Supportive shoes, taping and strengthening are often tried first. If an insert might help, your physio will explain why and what type.
Should I stop running or walking?
Usually you can keep going at a level that doesn't flare the pain for the rest of the day or next morning. Your physio will help you find that level and build from there.
Do I need a referral?
No. Private patients can book straight in, and we claim private health rebates on the spot where available.