Plantar fasciitis

Plantar fasciitis is overload of the plantar fascia under the foot, most often felt as sharp heel pain with the first steps in the morning or after sitting.

What it feels like

Sharp or bruised-feeling pain under the heel with the first steps out of bed is the classic story.

Pain may ease with walking, then return after long standing, longer runs, or the end of a workday on hard floors.

Some people feel tightness along the arch as well as the heel.

What is going on

The plantar fascia supports the arch and absorbs load with each step. Sudden training spikes, hard surfaces, and limited ankle dorsiflexion raise stress at the heel origin.

A heel spur on x-ray is common and does not by itself prove the diagnosis.

Nerve entrapment and fat-pad contusion can mimic plantar heel pain and are considered when the story is atypical.

How we evaluate

History of first-step pain and tenderness at the medial heel origin usually make the diagnosis.

We assess calf flexibility, foot posture, footwear, and training load.

Imaging is selective for trauma, refractory pain, or unclear differentials.

What we may offer

Load management, footwear changes, and progressive fascia and calf loading through physical therapy help most people.

Night splints or taping can support selected cases. Corticosteroid injection may help stubborn flares; PRP is discussed for some persistent plantar fasciopathy.

True surgical release is uncommon and reserved for carefully selected refractory cases.

Do heel spurs cause the pain?

Spurs are common findings. The irritated plantar fascia is usually the pain generator, not the spur alone.

Should I stop walking?

Usually we reduce irritating volume and keep you moving with better load dosing rather than full shutdown.

How long does plantar fasciitis last?

Many cases improve over weeks to a few months with consistent load management. Chronic cases need a more structured plan.

Can PRP help plantar fasciitis?

It may be discussed after rehab fundamentals for persistent cases. Expectations are reviewed in clinic.