Heel Pain and Plantar Fasciopathy
Heel pain is one of the most common reasons people see a podiatrist. It can make the first steps of the morning hard, cut a walk short and stop you running. At Sports and Structural Podiatry in Maroochydore, we work out what is causing your heel pain and build a plan with you to settle it.
What it is
What causes heel pain?
Not all heel pain is the same, and the right treatment depends on the cause. Common causes include:
Plantar fasciopathy
The most common cause. Pain is felt under the heel, often worst with the first steps in the morning or after sitting, and may ease as you get moving. It may occur with or without a heel spur.
Achilles tendon pain
Pain at the back of the heel where the Achilles tendon attaches, or a little higher up. Read more about Achilles tendon pain.
Heel bursitis
Irritation of a small fluid-filled sac near the back of the heel, often aggravated by the back of a shoe pressing on it.
Fat pad irritation
Pain in the middle of the heel that is often worse on hard floors or when walking barefoot.
Heel pain in children
Active children and teenagers can develop pain where the Achilles attaches to the growing heel bone, often during growth spurts or a busy sports season.
Nerve-related heel pain
Burning, tingling or pain on the inside of the heel can come from an irritated nerve and needs a different approach to plantar fasciopathy.
Why it happens
What makes heel pain more likely
- A sudden increase in walking, running or time on your feet
- Long hours standing on hard floors at work
- Footwear with little support, or walking barefoot more than usual
- Tight calf muscles or reduced ankle movement
- Changes in body weight
- The way your feet move and take load when you walk or run
Most heel pain builds up over time when the load on the tissue rises faster than it can adapt. Finding which of these applies to you is the first step to settling it.
Your first visit
What happens at your heel pain assessment
Every treatment plan starts with listening. Your first appointment usually covers four things.
01
Your history
When the pain started, what makes it better or worse, your work and activity levels, your footwear and any previous treatment.
02
Examination
We examine the area to find where the pain is coming from and check for other conditions that can cause similar symptoms.
03
Movement and footwear
We look at how your feet and legs move and load when you walk, and at the shoes you wear most days.
04
A clear plan
We explain what we found in plain language and agree a treatment plan with you, including what you can keep doing while it settles.
Treatment
Heel pain treatment options
Most heel pain is managed without surgery. Depending on what your assessment shows, your plan may include:
Load management
Practical changes to how much you stand, walk or run while the tissue settles, without stopping everything.
Strength and stretching
Exercises for the calf and foot, progressed over the following weeks as the tissue adapts.
Footwear advice
Guidance on shoes for work, exercise and around the house that suit your feet.
Taping and padding
Used in the short term to reduce load on the irritated tissue while other parts of your plan take effect.
Custom orthotics
Made from a 3D scan of your feet and an individual prescription, where your assessment shows they are appropriate for you.
Foot mobilisation therapy (FMT)
A hands-on therapy where gentle, precise pressure is used to move the joints of the foot and reduce joint restriction.
MLS laser therapy
A non-invasive treatment using light energy, used alongside other care where it is suitable for you. Results vary from person to person.
Heel pain often takes time to settle, and the plan is adjusted as you progress. Your podiatrist will talk you through the options, expected benefits and any risks before you decide.
Who you will see
Experienced in sports podiatry
Alana Underwood is the principal podiatrist at Sports and Structural Podiatry. She holds a Bachelor of Health Science (Podiatry) and a Master of Sports Medicine (Honours), and has a special interest in sports podiatry and biomechanics.
When to book
Book in if your heel pain has lasted more than a couple of weeks, keeps coming back, or is changing the way you walk.
If your heel pain followed a fall or a sudden injury, if the heel is swollen, hot or red, or if you have diabetes and notice a change in your feet, book an assessment promptly.
FAQs
Frequently asked questions
Why is my heel pain worse in the morning?
With plantar fasciopathy, the tissue under the foot stiffens overnight or after sitting. The first steps load it before it has warmed up, which is why those steps are often the most painful.
Do I need an X-ray?
Not always. Most heel pain can be assessed from your history and an examination. If imaging is needed, we will explain why and arrange a referral.
Does a heel spur mean I need surgery?
No. Many people have a heel spur with no pain at all, and heel pain is usually managed without surgery.
Will I need orthotics?
Not necessarily. Many people improve with load changes, exercise and footwear advice. Custom orthotics are only recommended when your assessment shows they are appropriate for you.
Do I need a referral?
No. You can book directly with us. If your GP has referred you, please bring the referral to your appointment.
Can I claim on my health fund?
If your private health insurance includes extras cover for podiatry, you may be able to claim part of the cost. Check with your fund for your level of cover.
Book an assessment
Shop 202, Building 2, Ground Floor, 2 Emporio Place, Maroochydore QLD 4558
Book an AppointmentCall (07) 5479 1211