Condition library
Plantar fasciitis: why does my heel hurt when I first get up?
Plantar fasciitis (also called plantar heel pain) is pain under the heel, typically sharpest with the first steps in the morning or after sitting, which eases a little as you move and then aches again after standing or walking a lot. It's caused by overload of the thick band of tissue (the plantar fascia) that runs from the heel to the toes. It's common in runners, people who stand all day, and people who have recently increased their walking or weight. Most cases improve with the right loading and footwear changes; long-standing cases often respond to radial shockwave therapy, which is one of shockwave's better-researched uses. Glasgow Sport & Spine Clinic in Glasgow (G40) offers assessment, hands-on treatment, exercise rehab and shockwave for heel pain.
Common causes
- a sudden increase in walking, running or standing
- long hours standing on hard floors
- tight calves or reduced ankle movement
- unsupportive footwear, or switching footwear suddenly
- weight gain
See your GP or call NHS 111 if:
- heel pain began after a fall, jump or injury and you can't bear weight normally (possible fracture)
- the heel is red, hot or swollen, or you feel unwell
- you have numbness, tingling or burning in the foot
- pain is severe at night or at rest
- you have diabetes and new foot pain, a wound or a change in sensation
How it's assessed
Assessment confirms the source of the heel pain — the plantar fascia, the fat pad, nerves in the heel, or referral from the back — and looks at calf, ankle, hip and footwear factors that keep it going.
How it's treated at Glasgow Sport & Spine Clinic
- a progressive strengthening programme for the foot and calf
- advice on footwear and short-term load changes
- ART and IASTM to the calf and foot
- dry needling (acupuncture)
- kinesiology taping, and advice on plantar fascia support socks, which patients have given very positive feedback on
- radial shockwave therapy — typically considered for longer-standing heel pain. Sessions are at least three days apart. Many people notice a clear improvement within about three sessions, though this varies with how long the pain has been present and whether there are changes where the fascia attaches to the heel bone (enthesopathy or a heel spur), which can mean a slower response.
Frequently asked questions
- How long does plantar fasciitis last?
- Many cases settle within several months, but it can last a year or longer without the right management.
- Should I stretch my calves?
- Calf and foot stretching helps some people; strengthening tends to be more important for longer-term recovery.
- Do I need insoles?
- Some people benefit from supportive insoles in the short term. They are part of the plan for some people, not a cure on their own.
- Is a heel spur causing my pain?
- Heel spurs are common in people with no heel pain, so a spur on an X-ray isn't necessarily the cause. Where there are long-standing changes at the heel attachment, though, recovery can take longer, and this is factored into the treatment plan.
About the practitioner
Guy Murray, BA, BOst (Hons), HDip NMT, is the sole practitioner at Glasgow Sport & Spine Clinic, Suite 1.4, Redtree Business Suites, 33 Dalmarnock Rd, Glasgow G40 4LA. He has treated musculoskeletal pain and sports injuries in Glasgow since 2008, for patients ranging from office workers and older adults to professional athletes. He was the first practitioner in Scotland to be certified in full-body Active Release Technique (2011) and the first in the UK to complete the Postural Restoration Institute core courses, and trained directly under Leon Chaitow. Treatment sessions combine assessment, hands-on treatment and a home rehab plan.
Appointments: 07584 284854 · guy@glasgowsportandspine.co.uk · Monday–Friday, 10:00–18:30 · Book an appointment · Treatments and prices
This page is general information, not a diagnosis. If you are worried about your symptoms, see your GP or call NHS 111.