What it is

Plantar fasciitis is a very common condition seen at Spinal and Sports Care, affecting one in ten people at some point in their adult lives.

Plantar fasciitis is irritation of the thick band under the foot where it attaches to the heel. Pain is sharp with the first steps after sleeping or sitting, then eases as the tissue warms. Long days on hard floors, sudden increases in walking or running, and reduced ankle flexibility are common drivers of pain and discomfort. Left alone, pain limits activity and weight control. With tissue-specific loading and footwear support, symptoms settle and function returns.

Plantar fasciitis is slightly more prevalent in females than in males. However, it affects both sexes, with approximately 1 in 10 people experiencing it at some point in their lives. The peak age is between 40 and 60 years. Factors contributing to this higher prevalence in women include naturally flatter foot postures, more flexible ligaments, potential weight gain from hormonal changes during perimenopause and menopause, and lifestyle factors like wearing high heels or spending long periods standing.

What happens when it occurs

Repeated tensile and compressive loads at the heel attachment irritate the fascia, reducing load tolerance.

Common causes and risk factors

  • Overuse: Activities like running, jumping, and dancing can strain the plantar fascia
  • Age. Plantar fasciitis is most common in people between the ages of 40 and 60.
  • Higher body mass and prolonged standing
  • Biomechanical factors such as high or low foot arches
  • Reduced ankle dorsiflexion, calf tightness
  • Training spikes, worn, unsupportive footwear or poor footwear selection
  • Age-related weakness of the arch in the foot
  • A tight achilles tendon can also put added stress on the plantar fascia.
  • Occupations that require standing on your feet for long work hours or on hard surfaces.

Who is most affected?

Adults in standing occupations, runners ramping up mileage, and people with reduced ankle mobility. It is common in prolonged weight-bearing activities (standing/walking/running).

Typical symptoms

  • Sharp or stabbing pain on the underside of the heel
  • A sensation that the fascia is “pulling” away from the bone
  • Medial heel tenderness and pain
  • Start-up pain after rest, especially in the morning when rising from bed
  • Pain with prolonged standing and walking or after activity

When to seek care

If first-step pain persists beyond two weeks, despite rest or self-care, or interrupts sleep or work. If pain prevents you from physical activity or is severe and worsening. You notice numbness, tingling, or signs of nerve involvement. There is swelling, redness, or suspicion of other conditions like stress fractures.

How we diagnose

Mostly via clinical examination and medical history. The provider will press on the bottom of your foot near the heel to locate tenderness, ask about symptom patterns, and assess foot structure and flexibility. Imaging (X-ray, ultrasound, MRI) is reserved for atypical presentations and used if the diagnosis is unclear or to rule out other causes (stress fracture, nerve issues).

Management

Although this can be an extremely painful condition, it is generally self-limiting and most cases resolve over 6-18 months. Treatment will be aimed at reducing your pain, keeping you fit and active and aiming to speed up recovery. Treatment measures include:

  • Active Rest: reduces pain and prevents aggravation
  • Ice: Rolling your foot over ice can be very effective in reducing pain
  • Medications: NSAIDs (non-steroidal anti-inflammatory drugs) may be prescribed to help reduce pain and inflammation
  • Exercise: calf and foot strengthening exercises
  • Physical therapy
  • Supportive shoes and orthotics may also be recommended to reduce the pain while walking or standing. Heel lifts may assist is some cases.
  • Night splints can be suggested to help stretch the plantar fascia while sleeping.
  • Your practitioner may consider adjunctive treatments such as extracorporeal shock wave therapy (ESWT), which is available at Spinal and Sports Care.

Surgical treatment and corticosteroid injections are rarely, if ever, considered.

Rehabilitation milestones

Phase 1, weeks 0–2: pain-modulated loading, fascia stretch, taping for long days.

Phase 2, weeks 2–6: heavy slow calf raises, seated to standing progressions.

Phase 3, weeks 6–12: walk-jog return, step-down control, standing tolerance targets.

Phase 4, weeks 12–16: full return to running or long work shifts.

Readiness to progress

  • Next-morning pain ≤2 out of 10
  • Calf strength symmetry ≥90%
  • Walk-jog session completed without flare

Prevention

  • Gradual increases in walking or running
  • Supportive footwear
  • Calf strength and ankle mobility

Heel Spurs vs Plantar Fasciitis: Understanding the Difference

Heel spurs and plantar fasciitis are closely linked yet distinct conditions that cause heel pain.

A heel spur (calcaneal spur) is a small bony growth that develops on the underside of the heel bone, often where the plantar fascia attaches. It typically develops gradually over time due to chronic stress on the heel, such as repeated running or prolonged standing. Many people with heel spurs never experience pain, and the spur itself is not always the cause of discomfort.

Plantar fasciitis, on the other hand, is inflammation or degeneration of the plantar fascia, the thick band of tissue running along the bottom of the foot. The pain from plantar fasciitis comes from irritation of this tissue, especially near its attachment at the heel.

Heel spurs may be present in people with plantar fasciitis, but they are more of a side effect than the source of pain. In short, plantar fasciitis causes heel pain; heel spurs may also be present, but they are not always the primary cause.

Australia snapshot

  • About one in ten people experience plantar heel pain at some point
  • At any time, around 3 to 5% of adults report heel pain consistent with plantar fasciitis
  • Standing occupations and running make up the bulk of cases

Latest insights

Load the fascia and calf rather than resting completely.

Taping or orthoses help in the early stages, while strength work drives long-term change.

Frequently Asked Questions

Several factors can contribute, including repetitive strain (such as running or walking on hard surfaces), poor footwear or lack of support, tight calf muscles or Achilles tendons, foot structure (flat feet or high arches), sudden increases in activity, obesity, or weight gain.

Many people notice improvement within weeks to months. Full recovery may take up to 9–12 months in some cases. However, timeframes depend on the grade and your starting capacity. Mild injuries often settle within weeks when loading is matched to tolerance. Moderate injuries take longer as strength and control are rebuilt. Severe injuries or those with instability need a longer block and closer supervision. Progress is criteria-based.

Yes, if pain during activity stays at or below 3 out of 10 and does not worsen the next morning. Reduce volume and intensity, maintain a tidy technique, and avoid movements that exacerbate symptoms.

Cut the next session’s volume by 20 to 30 per cent, keep strength work, and retest the following day. Progress again when baseline settles. You may be able to keep doing low-impact activities (like swimming, cycling) that don’t aggravate your foot. However, high-impact, repetitive load-bearing exercises (such as running and jumping) should be modified or paused until symptoms improve.

Imaging helps when red flags are present, progress stalls after two weeks, or instability or a tear is suspected. Your clinician will advise on whether an X-ray, ultrasound, or MRI is most useful.

They can. Night splints hold the foot in a slightly flexed (dorsiflexed) position while sleeping, keeping the plantar fascia gently stretched and reducing morning “first-step” pain.

Yes. Though it more often affects one foot, both feet can be affected simultaneously.

Yes. Though it more often affects one foot, No. A heel spur is a bony growth on the heel that sometimes forms at the attachment of the plantar fascia. Many people with plantar fasciitis have heel spurs, but the spur is not always painful or the root cause of pain.feet can be affected simultaneously.

They can unload sensitive tissue early. Keep them while strength and control improve, then review fit and need.

Yes. Shoes with poor arch support, minimal cushioning, or worn-out soles increase stress on the plantar fascia. Switching to supportive, cushioned footwear is a common recommendation.