Plantar fasciitis is a common cause of pain under the heel, often most noticeable with the first steps after rest. Symptoms are influenced by the amount of standing, walking or running and by the capacity of the foot and calf to tolerate that load.

Key points

  • First-step pain after rest is a common clinical pattern.
  • A sudden increase in walking, standing or running can aggravate symptoms.
  • Calf and foot strengthening can help rebuild load tolerance.
  • Shockwave may be considered for selected persistent cases after assessment.

What a physiotherapy assessment can add

A physiotherapist can examine the location of pain, ankle mobility, calf strength, footwear and daily loading while screening for other causes of heel pain.

Practical next steps

Adjust the most aggravating activities temporarily, keep tolerable movement and progress strengthening over time rather than repeatedly stretching or pressing the painful area aggressively.

When to seek medical care

Significant trauma, marked swelling, numbness, fever, skin breakdown or inability to bear weight should be assessed appropriately.