Plantar fasciitis is irritation of the thick band of tissue running along the sole of the foot, where it attaches to the heel bone. It is the most common cause of heel pain in adults, and it responds well to treatment — though recovery is usually measured in months rather than weeks.

What it feels like

• Sharp pain under the heel with the first few steps out of bed in the morning
• Pain that eases after a few minutes of walking, then returns later in the day
• Worse again after sitting for a long stretch and then standing up
• Tenderness when you press the inside of the heel
• Worse on hard floors, or in flat and unsupportive shoes

Common causes

• A sudden increase in load — more walking, running or time on your feet than usual
• Reduced ankle flexibility, usually from tight calf muscles
• Footwear with little support, or worn-out running shoes
• Standing for long periods on hard surfaces at work
• Changes in foot structure, in either a high-arched or a flat foot

How physiotherapy helps

The plantar fascia responds to load, so the core of treatment is a progressive loading programme rather than rest alone. Your physiotherapist works out how much the tissue currently tolerates and builds up from there. Treatment commonly includes:

• A graded calf and foot strengthening programme, which is the part with the strongest evidence behind it
• Calf and plantar fascia stretching, particularly before the first steps of the day
• Manual therapy and soft tissue work to the calf, ankle and sole of the foot
• Advice on footwear, and on taping or an insole if your foot needs support while symptoms settle
• Laser therapy or electrotherapy for pain where they suit your presentation
• A plan for returning to running or to standing work without provoking it again

What to expect at your first visit

Your physiotherapist takes a history, examines the foot and ankle, checks your calf flexibility and strength, and looks at how you walk. Heel pain has several possible causes, so part of the assessment is ruling out the others. They will explain what they have found and agree a plan with you. Most people begin treatment in the same appointment.

When to see a doctor instead

See your physician if the heel pain started after a specific injury and you could not put weight on the foot afterwards, if there is numbness or tingling in the foot, or if the heel is hot, swollen and painful at rest. Pain that is worse at night and unrelated to activity should also be reviewed medically.

Booking an appointment

You do not need a doctor’s referral to see a physiotherapist in Ontario. Some extended health plans ask for one before they will reimburse you, so it is worth checking your policy.

We are at 2600 Skymark Avenue, Building 3, Unit 102, Mississauga, open Monday to Friday 9:00 AM – 10:00 PM and Saturday and Sunday 9:00 AM – 7:00 PM, with free parking. See our fees or call 647-998-4727.

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This page is general information, not medical advice. An assessment with a registered physiotherapist is the way to find out what is causing your symptoms and what will help.