If your first few steps in the morning feel like you are walking on shards of glass, you are likely already searching for answers. That sharp, stabbing sensation in the heel is a hallmark of foot dysfunction, but there is a common misconception that every heel pain case is automatically plantar fasciitis. Without a proper assessment, these symptoms can become chronic and increasingly difficult to manage. Understanding the specific driver of your discomfort is the essential first step toward a lasting recovery.
At Richmond Blundell Physiotherapy & Sports Injury Clinic, we know that foot pain is rarely simple. Whether it is an irritated nerve, a bruised fat pad, or a struggling tendon, the root cause dictates the recovery path. To get back to walking, running, or just standing comfortably at work, you need to know exactly what your foot is trying to tell you.
What Is Plantar Fasciitis?
Plantar fasciitis refers to irritation of the plantar fascia, a thick band of connective tissue that runs from your heel to your toes. This structure supports your foot’s arch and helps absorb impact during walking, running, and standing.
When the plantar fascia becomes overloaded, small areas of irritation develop, leading to pain and stiffness. It is typically not a tear but rather a response to excessive stress on the tissue.
Common signs of plantar fasciitis include:
- Sharp pain under the heel, especially with the first steps in the morning
- Tenderness when pressing the bottom of the heel
- Pain that improves slightly with movement but returns after activity
Clinically, a test called the Windlass test may reproduce symptoms when the big toe is extended, helping confirm the diagnosis. Plantar fasciitis responds well to progressive loading, improved foot strength, and appropriate support.
Not All Heel Pain Is Plantar Fasciitis
Heel pain is a symptom, not a diagnosis. Several other conditions can cause similar discomfort, and each requires a different treatment strategy. At Richmond Blundell Physiotherapy & Sports Injury Clinic, clinicians commonly assess the following causes of heel pain:
Achilles Tendinopathy
Pain occurs at the back of the heel where the Achilles tendon attaches. Symptoms often worsen with running, jumping, or climbing stairs and typically respond to progressive calf strengthening.
Posterior Tibial Tendon Dysfunction
This condition causes pain along the inside of the ankle or arch and may lead to gradual flattening of the foot. Individuals often struggle with single leg heel raises or prolonged walking.
Nerve Irritation
Nerve related heel pain may present as burning, tingling, or radiating discomfort into the arch or sole of the foot. The area may also feel sensitive to touch or compression.
Fat Pad Irritation
This produces a deep, bruise like pain directly under the heel. It commonly worsens with prolonged standing or walking on hard surfaces due to reduced cushioning.
Because these conditions require different management strategies, an accurate diagnosis is essential. Guessing based on symptoms alone may delay recovery.
Why Does Plantar Fasciitis Develop?
Plantar fascia irritation usually develops when repetitive stress exceeds the tissue’s ability to recover. In most cases, several contributing factors are involved rather than a single cause.
Common risk factors include:
- Rapid increases in running or walking activity
- Prolonged standing on hard surfaces
- Tight calf muscles or reduced ankle mobility
- Returning to exercise after time off
- Underlying hip weakness that causes issues down the kinetic chain
Your foot is strong and adaptable, but every tissue has a limit. Addressing the underlying contributors helps prevent ongoing symptoms.
Plantar Fasciitis Treatment in Richmond, BC
Effective treatment focuses on more than temporary pain relief. The goal is to restore function, improve tissue capacity, and prevent recurrence.
Confirming the Diagnosis
A physiotherapy assessment typically evaluates foot mechanics, ankle mobility, calf strength, walking patterns, and load tolerance. Identifying the specific cause of heel pain guides the treatment plan.
Reducing Irritation
Early treatment may include activity modification, taping for short term support, and manual therapy to improve joint mobility. In some cases, shockwave therapy may be recommended to stimulate healing in chronic conditions.
Restoring Strength and Capacity
Long term improvement depends on progressive strengthening and controlled loading of the foot and calf muscles. Treatment programs often include intrinsic foot strengthening, calf raises, and gradual return to sport or activity. Rest alone rarely resolves plantar fasciitis. Strategic loading and progressive exercise are essential for lasting recovery.
How Long Does Recovery Take?
Most people experience meaningful improvement within six to twelve weeks when they follow a structured rehabilitation program consistently. Recovery timelines vary depending on symptom duration, activity levels, and contributing factors. Chronic cases may take longer, particularly if the condition has been present for several months.
When Should You See a Physiotherapist?
Early treatment often leads to faster recovery and prevents long term complications. You should consider seeking professional assessment if you experience:
- Heel pain lasting more than two weeks
- Persistent morning pain that does not improve
- Limping or changes in walking pattern
- Limited improvement despite stretching
- Pain interfering with work, sport, or daily activities
Final Thoughts: Do Not Guess Your Diagnosis
If you are experiencing heel pain, it is important not to assume the cause is plantar fasciitis. Many conditions can produce similar symptoms, and the right diagnosis leads to faster and more effective recovery.
At Richmond Blundell Physiotherapy & Sports Injury Clinic, treatment combines hands-on care, progressive strengthening, and personalized education to help you return to daily activities with confidence. Book an assessment with our Richmond physiotherapy team and take the first step toward comfortable movement again.