Heel Pain

Heel Pain

Heel pain affects everyone from time to time. However, when it persists for longer periods of time and the feet have been rested after a busy day of strenuous activity or standing–and does not resolve on its own, it could be a sign of plantar fasciitis.

Signs and Symptoms of Plantar Fasciitis

The heel bone and base of the toes are connected by a thick band of connective tissue that stretches across the bottom of the foot, known as the plantar fascia. It is important to understand that this is not a muscle, nor is it elastic in nature. Inflammation of the tissue leads to stabbing pain that is most intense in the morning after waking up, or after long periods of sitting or standing throughout the day.

While anyone can develop plantar fasciitis, the most common causes of the condition include:

  • Walking/working out with shoes that do not provide adequate support, especially for people with a high arch, flat feet, or biomechanics issues that cause weight to be distributed unevenly as a person walks and stands.
  • Sudden increases in activity
  • weight gain
  • prolonged periods of standing

How Does the Plantar Fascia Become Inflamed and Injured?

The plantar fascia primarily provides shock absorption to the heel and foot. Through increased pressure, repeated stretching, and wear and tear, the tissue can develop small tears that lead to painful swelling and inflammation. In addition to long distance running and obesity, plantar fasciitis can also develop as a result of other factors including:
Increased age
Physical activities like ballet and other sports that involve added stress and pressure on the heels
Occupational risks for developing chronic heel pain are higher for individuals who spend long hours and shifts on their feet, such as teachers, nurses, those working on production lines and retail workers
Irregular gait, overpronation


Treatment for plantarfascitis should always begin with confirmation of the diagnosis. It is only one possible diagnosis for heel pain and is often times used as a catch all for any planter pain.

Once the diagnosis is confirmed, then the underlying cause must be determined in order to provide appropriate information for our patients to make an informed decision on the best course of treatment for them.

Treatments may be as varied as footwear advise and behavioural changes to functional orthotic therapy, shock wave therapy, cold laser therapy, cortisone, taping, oral anti-inflamitories, and physical therapies. One size does not fit all in this category, and it is vitally important to understand that some therapies aim to treat the symptom whereas others are aimed at addressing the cause preventing subsequent return of pain and longterm disability. Combinations may be recommended but a clear understanding is essential to make the correct choice for you.