Plantar Fasciitis & Heel Spur

Heel spur is the everyday name for pain under your heel, where the thick band of tissue under your foot attaches to the heel bone. Doctors call it plantar fasciitis. The pain comes from that overloaded band, the plantar fascia.

The word heel spur refers to a bony outgrowth on an X-ray. People without any pain have that outgrowth too, and in most cases it does not explain your symptoms.

You feel the pain under or on the inner side of your heel, sharpest with your first steps after getting up or after sitting for a while. Long spells of standing or walking bring it back. It often starts in one foot.

Your physiotherapist makes the diagnosis from your history and an examination of your foot, ankle and calf. Tenderness on the inner side of your heel that you recognise as your pain fits plantar fasciitis. We also check for a stress fracture, a trapped nerve or an Achilles problem.

An X-ray of the heel spur says little about your pain. If the diagnosis is in doubt or recovery is slow, we look at the fascia with ultrasound.

Exercise therapy is the foundation, for at least twelve weeks: daily stretches for your plantar fascia and calf, or progressive strength exercises every other day. You train under supervision in our own gym. Standing, walking and sport may cause pain up to about 3 on a scale of 10.

If your heel still hurts too much after twelve weeks of good exercise, your physiotherapist can add shockwave to your programme. It is part of your regular physiotherapy appointment and costs nothing extra.

Recovery takes months. With consistent exercise you can expect less pain and better function within twelve weeks, although many people still have some symptoms at that point. For most people the complaint settles within a year; for some it takes longer.

We adjust your programme to how your foot responds.