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Foot & ankle

Plantar fasciitis and heel pain

Sharp heel pain on the first steps in the morning, easing as you move, returning after sitting.

What it typically feels like

  • Sharp heel pain on the first few steps out of bed
  • Easing after ten minutes of walking
  • Returning after sitting for a while, then easing again
  • Tenderness on the inside of the heel

The first-steps-in-the-morning pattern is so characteristic that it is often recognisable from the description alone. The plantar fascia — the thick band of tissue along the sole — tightens overnight, and the first steps stretch it sharply.

What usually causes it

  • A sudden increase in standing, walking or running.
  • Tight calves. The calf and the plantar fascia are connected through the heel, and a tight calf pulls on the fascia with every step. This is very often where the actual problem sits.
  • Standing all day on hard floors, in unsupportive shoes.
  • Weight change or a change in footwear.

Why calf work matters

People treat the sore heel and wonder why it does not settle. Treating the calf frequently changes the heel pain more than treating the heel does, because the tension pulling on the fascia originates further up the chain.

What treatment involves

Soft tissue work through the calf and the sole of the foot, releasing the trigger points that refer into the heel, and restoring ankle movement. Then strengthening for the foot and calf, and practical changes — footwear, and how much standing you are doing.

How long it takes

Weeks rather than days, and it improves gradually rather than suddenly. It responds well to consistent work, and badly to being ignored until it becomes a limp — at which point the other leg starts complaining too.

What is actually in the foot & ankle

Twenty-six bones and a thick band of tissue along the sole, forming an arch that has to be rigid enough to push off and springy enough to absorb landing, thousands of times a day.

Plantar fascia
The dense band from the heel bone to the base of the toes, supporting the arch. It tightens overnight, which is exactly why the first steps in the morning are the worst.
Talocrural joint
The main ankle hinge, between the shin bones and the talus. It needs to bend forward properly for you to squat, run or even walk downstairs comfortably.
Lateral ankle ligaments
The band on the outside of the ankle that gives way when the ankle rolls inwards. The most frequently injured ligament complex in the body.
Calf and heel connection
The calf attaches to the heel bone, and the plantar fascia leaves the other side of the same bone. Tension in one pulls on the other, which is why heel pain is so often a calf problem.

Why it goes wrong

The heel is where the pain is felt and the calf is very often where the cause sits, which is why treatment aimed only at the sore heel tends to stall. Ankle sprains are the other common story here, and the trouble is not usually the original injury but the stiffness and loss of balance left behind when it is treated too casually — that is what leads to rolling it repeatedly.

3D anatomy See the structures involved on the interactive model

The honest next step

This page describes what is common, not what you have. The only way to know is to have it assessed — and your first session includes a full assessment, so you leave knowing what is actually going on.

Book an assessment Call 07922 884 788