Foot

What It Is

Plantar fasciitis is one of the most common causes of heel pain (American Academy of Orthopaedic Surgeons, n.d.). The plantar fascia is a strong, flat band of tissue (a ligament) that runs along the bottom of the foot and connects the heel bone to the front of the foot. It supports the arch in your foot (American Academy of Orthopaedic Surgeons, n.d.). Too much pressure on the plantar fascia can damage or tear the tissue, and the body's response is inflammation, which causes the heel pain. Tight calf and foot muscles can make it worse (American Academy of Orthopaedic Surgeons, n.d.). The pain is usually felt on the bottom of the foot near the heel, and is often worst with the first few steps in the morning or after a long rest, and after (rather than during) exercise (American Academy of Orthopaedic Surgeons, n.d.).

The condition is most common in people aged 40 to 60. It is also more likely in people who stand for long periods on hard surfaces, do a lot of high-impact activity such as running, are overweight, or have flat feet or a high arch (American Academy of Orthopaedic Surgeons, n.d.; NHS, 2025). You can get the condition in one foot or both feet.

Long-standing tension where the plantar fascia attaches to the heel bone can lead to a heel spur (a small bony growth). However, heel spurs do not cause plantar fasciitis pain, and most people who have a heel spur have no heel pain at all (American Academy of Orthopaedic Surgeons, n.d.).

Plantar Fasciitis Anatomy

The feet are full of flexible structures consisting of bones, muscles, ligaments, joints and other soft tissues that allow you to stand upright and perform activities such as running, walking and jumping. Three sections make up the feet:

The forefoot contains five longer bones and five toes.
The midfoot is a collection of bones forming arches in the feet. These include three cuneiform bones, the navicular bone and the cuboid bone.
The hind foot is composed of the ankle and the heel. The talus bone supporting the leg bones form the ankle. The heel bone is the largest out of all the bones in the foot.

Tendons, muscles and ligaments run along the surface of the feet, which allows all of the complex movements that are needed to maintain balance and motion. The Achilles tendon connects the calf muscle to the heel, which is essential for jumping, running and being able to stand on your toes.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Plantar Fasciitis

Stretching your calves and plantar fascia is the most effective way to relieve the pain, and a physical therapy programme may also include massage (American Academy of Orthopaedic Surgeons, n.d.). I can guide you through stretches and foot-strengthening exercises and provide hands-on treatment for your calf and foot. See the My Approach tab for how I work.

More than 90 percent of people with plantar fasciitis improve within 10 months of starting simple treatments like the ones below (American Academy of Orthopaedic Surgeons, n.d.).

1. Rest

Give your feet adequate time to rest and recover from the injury. Reduce or stop activities that cause the foot to hurt, especially those where your feet pound on hard surfaces, such as running. Low-impact exercise such as cycling or swimming puts less stress on your feet (American Academy of Orthopaedic Surgeons, n.d.). Avoid running or walking on any hard surfaces.

2. Ice

To help reduce swelling and pain, try using ice on your heel. Put an ice pack (or a bag of frozen peas) wrapped in a towel on your heel for up to 20 minutes every 2 to 3 hours (NHS, 2025). Another option is to roll your foot over a cold water bottle or ice for 20 minutes, 3 to 4 times a day (American Academy of Orthopaedic Surgeons, n.d.). This is best used in the early stages of plantar fasciitis, but under my guidance, it may be used for longer periods/chronic conditions too.

3. Get New Shoes

Choose comfortable shoes with a low heel, a thick, cushioned sole and good arch support (NHS, 2025; American Academy of Orthopaedic Surgeons, n.d.). Soft insoles, heel pads and shoe inserts can also help (NHS, 2025; American Academy of Orthopaedic Surgeons, n.d.). I can help you work out what you need and how to get it, and point you to a chiropodist or podiatrist if you need a custom orthotic. If you are a keen sportsperson or runner, go to a specialist running shop to get your gait and foot position checked.

4. Get Some Treatment

See the My Approach tab for the hands-on treatment, stretches and exercises I can offer. Sometimes using a golf ball or squash ball under your foot and massaging your sole can help too.

5. Gait Analysis

It may be useful to have your gait checked. I can do this with a visual check of how you walk and run; some clinics also use gait scanners and pressure plates. This can provide useful information on foot biomechanics in case this is a cause or contributing factor to plantar fasciitis.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Shockwave therapy: high-energy sound wave pulses are applied to the heel to try to stimulate healing. Results are mixed, and NICE says the evidence on how well it works is inconsistent, so it is usually only considered when other treatments have not helped (American Academy of Orthopaedic Surgeons, n.d.; National Institute for Health and Care Excellence, 2009).

How I can help (see the My Approach tab)

Hands-on work for the calf and foot

Stretching and foot-strengthening exercises

Footwear, insole and taping advice

Tips

Follow the stretching plan I give you. Stretches to the calf muscles and Achilles tendon can help. Also plantar fascia stretches using a golf ball under the sole of the foot may provide some relief, but again follow my recommendations.
It is important to do the exercises as I recommend them. Doing them will make it more likely you will have a reduction in heel pain.
It is acceptable to feel slight pain when doing the exercises, but let me know if your symptoms worsen.
Build back up to running gradually once your pain has settled, following my advice.
If you are overweight, you might want to try losing a few pounds to take the added stress off your foot (NHS, 2025; American Academy of Orthopaedic Surgeons, n.d.).
For those who have flat feet or high arches, the likelihood that you will get the condition is increased over those with normal arches (American Academy of Orthopaedic Surgeons, n.d.).
Make sure your shoes fit properly and they aren't worn out, especially if you are a long distance runner (American Academy of Orthopaedic Surgeons, n.d.).
Try to minimize the amount of time you spend standing, walking or running on hard surfaces, and avoid walking or standing for long periods barefoot (NHS, 2025).
Avoid high heels and tight, pointy shoes. If you need to wear dress shoes, insert a gel heel pad (NHS, 2025; American Academy of Orthopaedic Surgeons, n.d.).

Treatment

My Approach

Two line drawings of the muscles on the sole of the foot: a deeper layer with the long toe tendons fanning out to the toes, and the surface layer of muscles running from the heel towards the toes. — These small muscles sit just above the fascia — they're what I work through, and what the arch exercises build.

Plantar fasciitis is irritation of the thick band along the sole of your foot, usually where it attaches to the heel. A tight calf and Achilles pull on that band with every step, so I treat the whole back of the leg, not just the sore heel. My aim is to settle the pain, then build flexibility and strength so your foot copes with standing, walking and running again.

I start by assessing how your foot, ankle and leg move, how you stand, walk and run, and your calf flexibility and foot strength. I also ask about your footwear, the surfaces you stand on and your training.

When It's Flared

Leaving the heel mostly alone, with gentle work on the foot and up through the calf
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
Cutting back what aggravates it, with swimming or cycling meanwhile
Taping to support the arch in the short term, and I'll show you how to tape it yourself

As It Settles

Warmth, then myofascial and trigger point work through the calf and the small muscles of the foot
Cross-fibre work near the heel, followed by a stretch and a short cool application
Moving the ankle for a few minutes before standing up in the morning or after sitting
Stretches for the sole and the calf
Foot strengthening, such as towel scrunches, building to calf raises and balance work
A gradual return to running or sport

I'll look at your shoes, help you work out whether heel cups or insoles would help and how to get them, and point you to a chiropodist or podiatrist if you need a custom orthotic.

If the heel pain is sharp and getting worse with activity, or you have tingling or loss of feeling in your foot, see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly, with a reassessment at about 4 to 6 weeks, then less often as you manage more on your own. Improvement is usually gradual: more than 90 percent of people improve within 10 months of starting simple treatments.

What I Focus On

Assessment

Calf & Sole Release

Stretching

Foot Strength

Footwear & Support

Please read

When to See a Doctor First

When to see a family doctor or nurse practitioner

See your family doctor or nurse practitioner if your heel pain is severe or stopping you doing normal activities, is getting worse or keeps coming back, has not improved after 2 weeks of treating it at home, or you have tingling or loss of feeling in your foot. If you have diabetes and heel pain, see your family doctor or nurse practitioner, as foot problems can be more serious with diabetes (NHS, 2025).

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Plantar fasciitis and bone spurs (OrthoInfo). Available at: https://www.orthoinfo.org/diseases--conditions/plantar-fasciitis-and-bone-spurs/ (Accessed: 7 October 2026).
NHS (2025) Heel pain. Available at: https://www.nhs.uk/symptoms/foot-pain/heel-pain/ (Accessed: 7 October 2026).
National Institute for Health and Care Excellence (2009) Extracorporeal shockwave therapy for refractory plantar fasciitis (HTG200, formerly IPG311). Available at: https://www.nice.org.uk/guidance/htg200/chapter/1-Recommendations (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooPlantar Fasciitis

What It Is

Plantar Fasciitis Anatomy

Self-Care & Treatment

How to Treat Plantar Fasciitis

1. Rest

2. Ice

3. Get New Shoes

4. Get Some Treatment

5. Gait Analysis

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Flared

As It Settles

Typical Course

When to See a Doctor First

When to see a family doctor or nurse practitioner

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooPlantar Fasciitis

What It Is

Plantar Fasciitis Anatomy

Self-Care & Treatment

How to Treat Plantar Fasciitis

1. Rest

2. Ice

3. Get New Shoes

4. Get Some Treatment

5. Gait Analysis

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Flared

As It Settles

Typical Course

When to See a Doctor First

When to see a family doctor or nurse practitioner

References

Related Conditions

Flat Foot (Pes Planus)

Achilles Tendinopathy

Morton's Neuroma

Calf Strain / Calf Tear

Heel Spur

Book a session