What is plantar fasciitis?
The plantar fascia is a thick band of connective tissue running from your heel to your toes. It supports the arch, stabilises the foot, and helps store and release energy with every step.
Plantar fasciitis happens when this tissue becomes irritated or overloaded. Contrary to popular belief, your book explains that the issue is often not just inflammation, but rather breakdown, stiffness, and oversensitivity of the fascial tissue.
Heel spurs may appear on scans, but many people with heel spurs have no pain at all, so the spur is not usually the cause.
Key facts
• Plantar fasciitis is when the strong tissue under your foot becomes irritated or overloaded.
• This can cause heel pain, especially with your first steps in the morning.
• You may be at risk if your foot, ankle, or hip movement has changed or if your activities overload the fascia.
• If you think you have plantar fasciitis, see a health professional.
• Effective treatment includes targeted exercises, mobility work, movement correction, and supportive strategies like taping.
What are the symptoms of plantar fasciitis?
The main symptom is pain under the heel or along the arch. This pain can feel sharp first thing in the morning, then ease slightly as you move, only to return with prolonged standing or activity.
People often describe:
• sharp morning pain when stepping out of bed
• aching or burning in the arch
• pain after rest
• discomfort after long walks or standing
• tenderness around the inner heel
Your book emphasises that morning pain occurs because inflammation and fluid settle around the fascia when you’re off your feet. The first steps stretch the irritated tissue, triggering a sharp pain response.
What causes plantar fasciitis?
While sports that stress the heel can contribute, your book explains that plantar fascia pain is usually caused by movement dysfunction, not simply overuse.
Common contributors include:
• stiff ankles that reduce shock absorption
• limited hip mobility, especially tight hip flexors
• weak shin muscles that fail to control foot loading
• poor foot–hip coordination
• restricted big toe extension, which prevents normal push-off
• prolonged sitting (causing hip stiffness)
• modern shoes that weaken the intrinsic foot muscles
These factors force the plantar fascia to take more load than it is designed for, eventually leading to pain.
When should I Get Help?
If your heel pain lasts longer than 6–8 weeks, you should see your physiotherapist or another qualified clinician. Persistent symptoms may require assessment to rule out other causes, such as:
• stress fractures
• nerve entrapment
• Achilles tendinopathy
• fat pad irritation
If your symptoms worsen rapidly, cause significant disability, or are accompanied by numbness, swelling, or sudden trauma, seek medical help sooner.
How is plantar fasciitis diagnosed?
Diagnosis is usually based on symptoms and physical assessment. A health professional may ask about:
• your activity levels
• footwear
• work demands
• the pattern of your pain throughout the day
They may check for:
• tenderness along the arch
• limited ankle mobility
• weak shin or hip muscles
• poor balance
• reduced big toe extension
In my book, I teach several home-based clinical tests that mirror what a physiotherapist would check, including hip flexor length, hip external rotation, big toe extension, and tibialis strength. These tests help pinpoint the root cause of overload.
Imaging such as x-rays or ultrasound is rarely needed unless symptoms are atypical or persistent.
How is plantar fasciitis treated?
My book outlines a treatment model based on three phases of recovery, rather than relying on passive treatments or quick fixes.
Phase 1: Pain Relief
This stage focuses on calming symptoms and reducing overload. Your book recommends:
• ball rolling to desensitise the fascia
• foot and ankle pumps to clear inflammation
• supportive taping to reduce strain during daily activity
• releasing the calf and tibialis muscles to reduce tension on the fascia
These strategies help ease morning pain and reduce irritation so the tissue can begin to heal.
Phase 2: Rehabilitation
Once pain settles, correcting the underlying cause becomes essential. Your book emphasises targeted exercises based on clinical tests. These may include:
• hip flexor stretches
• piriformis stretch for hip rotation
• big toe extension drills
• tibialis strengthening
• calf and ankle mobility work
• single-leg balance training to restore the foot–hip connection
This phase rebuilds proper movement patterns so the fascia no longer carries excess load.
Phase 3: Maintenance
When your pain is significantly better, maintaining progress requires only a few minutes a day. Your book recommends:
• daily balance work
• occasional ball rolling
• your most helpful corrective exercise
This keeps the fascia resilient so the condition does not return.
Medicines for plantar fasciitis
Pain-relief medicines such as ibuprofen or paracetamol may help during flare-ups, but they do not address the root cause. My book stresses that plantar fascia recovery comes from rebuilding movement, not relying on medication.
Other treatment options
If symptoms persist, clinicians may consider shockwave therapy or injections, but my book explains these should only be used when conservative rehabilitation has failed, because they do not correct the movement dysfunction that caused the problem. Surgery is rarely needed.
Can plantar fasciitis be prevented?
You can reduce your risk by:
• maintaining hip and ankle mobility
• strengthening shin and intrinsic foot muscles
• improving balance and foot–hip coordination
• avoiding long-term use of overly cushioned or restrictive footwear
• gradually progressing into higher loads or barefoot activity
My book emphasises that the best prevention is restoring natural movement so the fascia is not overloaded in the first place.
What are the complications of plantar fasciitis?
If untreated, plantar fasciitis can lead to altered walking patterns, hip or knee pain, and chronic sensitivity in the heel. Your book explains that pain often persists because people never address the underlying mobility and strength deficits, leading to repeated flare-ups.