Have you ever stepped out of bed in the morning and felt like you were walking on a bed of nails? You’re not alone. Plantar heel pain is one of the most common issues I see in clinic, and let me tell you – it can stop even the toughest Aussie in their tracks.
Growing up running barefoot on the sandy beaches of the Mornington Peninsula, I never imagined that something as simple as walking could one day cause people so much grief. Yet, in my years as a podiatrist, I’ve treated everyone from young Auskick players to retired surf lifesavers, all hobbling into my rooms with that telltale “stone bruise” feeling under their heel.
Let’s explore plantar heel pain, why it can feel downright nasty, and what we can do to get you back on your feet pain-free.
What is Plantar Heel Pain?
Plantar heel pain refers to discomfort right underneath the heel – the part that cops a pounding with every step you take. It often flares up first thing in the morning, when you step out of bed, or after sitting still for a while – like after a long drive along the Hume or watching the kids’ footy from the sidelines.
In a nutshell:
| Symptom | Description |
| Location | Bottom of the heel (sometimes arch pain too) |
| Onset | First steps after rest |
| Sensation | Feels like a bruised stone under the foot |
| Progression | Can have good and bad days, giving a false sense of improvement |
What Does It Feel Like?
Patients often describe it like walking on a rock hidden inside their shoe. Others reckon it’s more like a burning or stabbing pain under the heel. Some days it disappears – giving a glimmer of hope – only to sneak back in after standing in line at Bunnings for 20 minutes.
Quick Tip
If your heel pain kicked in suddenly – say during a netball game or sprinting for the tram – you might have actually torn your plantar fascia rather than slowly irritated it over time. (Yes, I’ve seen it happen even to weekend warriors!)
Common Causes of Plantar Heel Pain
In my experience, it’s rarely just one cause – usually it’s a cocktail of bad luck, overdoing it, and little niggles that get ignored. Here’s what we know:
- Poor Foot Biomechanics: Flat feet, high arches, or wonky walking patterns (like rolling inwards) put extra stress on the heel.
- Excessive Pressure: Carrying a bit of extra weight (even that sneaky COVID lockdown weight!) increases the load on your feet.
- Injury and Trauma: Falls, sporting injuries or even a misstep on uneven footpaths.
- Limited Ankle Mobility: If your ankles don’t bend properly (dorsiflexion restriction), your poor plantar fascia cops the strain.
- Weak Foot Muscles: Especially the small stabilisers that we take for granted.
- Overtraining: Runners who ramp up their training too fast, especially after a lazy winter.
- Hard or Uneven Surfaces: Think concrete warehouse floors or rocky bush tracks.
- Unsupportive Footwear: Ballet flats, thongs (yes, even our trusty Aussie thongs), and worn-out runners.
- Tight Calf Muscles: Calves tighter than a drum pull on the plantar fascia.
- Systemic Conditions: Things like reactive arthritis can show up first as heel pain.
- High BMI: (Body Mass Index) – just more load with every step.
Why Getting the Right Diagnosis Matters
One thing I’ve learned the hard way: not all heel pain is plantar fasciitis.
It could be a plantar fascia tear, a stress fracture, or even referred pain from the lower back. (Yep, your back can mess with your feet too.)
How we get it right at Well Heeled Podiatry:
- Thorough biomechanical assessment
- Ultrasound imaging ,if needed (bulk-billed in some cases)
- Ruling out other nasty culprits like fractures or nerve entrapments
I always say, “If you don’t know exactly what you’re treating, you’re wasting your time — and money.”
Who Suffers From Heel Pain?
Heel pain doesn’t play favourites — I’ve treated schoolkids, dancers, farmers, FIFO workers, and retirees who just want to enjoy their morning walk around the lake without limping. That said, some groups do cop it more often.
Groups More Likely to Experience Heel Pain
| Group | Why They’re At Risk |
| Athletes and Runners | Repetitive pounding on hard surfaces. Plus, pushing through pain when they should rest. |
| Overweight Individuals | Extra load = extra strain on the plantar fascia and heel bone. |
| Pregnant Women | Hormones loosen ligaments + extra baby weight = unhappy feet. |
| Older Adults | Fat pad under the heel thins naturally with age (not fair, I know!). |
| People with Flat Feet or High Arches | Poor load distribution. Either the arch collapses too much, or there’s not enough shock absorption. |
| Workers on Their Feet All Day | Nurses, retail workers, tradies — standing for hours wears out the heel’s natural shock absorbers. |
| Individuals with Tight Achilles Tendons | The Achilles pulls harder on the heel bone if it’s too tight. |
| Wearing Poor Footwear | Fashion over function? Those “cute” but unsupportive shoes come back to bite. |
A True-Blue Aussie Example
I once treated a primary school teacher from Altona who loved her job but stood on hard floors five days a week. She thought her heel pain was just “a normal part of getting older.” It wasn’t.
After a few simple changes — better shoes, a bit of calf stretching, and custom orthotics — she was back kicking the footy with her grandkids on weekends. No surgery needed. Just the right plan at the right time.
Important Note:
If you’re in one of these groups and start to notice heel pain, don’t wait for it to get unbearable. Early treatment can save you months of limping around and missing out on life.
Additional Key Points About Heel Pain
1. Plantar Fasciitis: The Big Culprit
This is the number one cause I see.
Plantar fasciitis is inflammation of the tough band of tissue (plantar fascia) that runs from your heel to your toes. It’s the unsung hero that supports your arch — until it gets overloaded.
Symptoms:
- Sharp stabbing pain with the first steps in the morning
- Eases as you move but returns after standing or long periods
- Tenderness under the heel, sometimes extending into the arch
Main Causes:
- Strain injury causing micro-tears in the fascia
- Tight calves pulling extra hard
- Being on your feet all day without support
- High-impact activities like distance running
How We Treat It:
- Rest (I know, easier said than done)
- Ice and anti-inflammatory strategies
- Specific stretches (I’ll show you the magic ones in clinic!)
- Shockwave therapy (a real game-changer for stubborn cases)
- Orthotics to unload the fascia
2. Heel Spurs: The “Silent Passenger”
Now, here’s a fun fact: Heel spurs and plantar fasciitis often go hand-in-hand, but the spur itself isn’t always the bad guy.
What is it?
- A small, sharp calcium deposit growing off the heel bone.
- Looks scary on an X-ray but might not be causing the pain.
Symptoms (if they cause trouble):
- Tenderness especially when standing or walking
- Sometimes swelling or heat in the heel area
Main Causes:
- Chronic strain on foot muscles and ligaments
- Stretching of the plantar fascia
- Poor biomechanics over years
Treatment is very similar to plantar fasciitis:
- Physical therapy
- Supportive shoes and orthotics
- Anti-inflammatories
- Surgery is rare — usually last resort
Solutions and Treatments for Plantar Heel Pain
When it comes to fixing plantar heel pain, there’s no one-size-fits-all magic bullet. Every foot (and every life) is a bit different. But here’s the good news: with the right combination of small changes, most people turn things around faster than they think.
As I tell my patients, “You don’t have to live with heel pain. You just need the right plan.”
1. Footwear Adjustments: Your First Line of Defence
Honestly, I can’t stress this enough — good shoes are like good tyres for a car. Ignore them and the whole system suffers.
Must-Have Shoe Features:
- Strong arch support
- Deep heel cup
- Cushioned sole
- Slightly raised heel (around 10-12mm)
Avoid:
- Flat shoes (think ballet flats, thongs)
- Worn-out runners
- Hard, unsupportive soles
My Local Tips for Melbourne Buyers:
- Try Athletes Foot (they do gait assessments in store)
- Active Feet stores stock podiatry-approved brands
- Asics, Brooks, and Hoka often do the trick for runners
2. Physical Therapies: Move Smart, Not Hard
Movement is medicine — but only the right movement.
Heel Pain Recovery Timeline
| Timeframe | Focus |
| Weeks 1-2 | Rest, ice, gentle calf stretches |
| Weeks 3-4 | Add foot strengthening (e.g., towel scrunches) |
| Weeks 5-6 | Balance work, slow return to activity |
| Beyond | Preventative maintenance — keep stretching and strengthening |
Essential Exercises:
- Calf stretch: Wall push (straight and bent knee versions)
- Plantar fascia stretch: Rolling foot gently over a frozen water bottle
- Towel scrunches: Strengthen those tiny foot muscles
Pro Tip:
A simple 5-minute stretch routine morning and night can speed up recovery by months.
3. Orthotic Solutions: A Hidden Weapon
Not everyone needs custom orthotics — but when you do, they’re a game-changer.
Options:
- Prefabricated orthotics: Good for mild cases (around $60-$100)
- Custom-made orthotics: Best for stubborn or biomechanical cases (fitted specifically to your foot)
A Real Story:
One tradie from Point Cook came to me after trying “chemist orthotics” — no luck.
After switching to custom-moulded orthotics tailored to his flat feet and heavy lifting work, he was back on site, pain-free, within six weeks.
4. Medical Interventions: When Pain Won’t Budge
Sometimes you need a little extra firepower.
Medical Options
| Treatment | What It Does |
| Anti-inflammatory meds | Reduce swelling and pain |
| Corticosteroid injections | Temporary pain relief in severe cases |
| Shock Wave Therapy | Stimulates tissue repair without surgery |
| Ultrasound imaging | Confirms diagnosis (plantar tear vs fasciitis) |
Shockwave therapy is becoming one of my favourite non-invasive options for chronic heel pain.
It’s quick, safe, and results often show after just 3–5 sessions.
5. Lifestyle Adjustments: Small Changes, Big Results
You can’t out-stretch a bad lifestyle.
Here’s what matters most:
Weight Management:
- Dropping just 5kg can remove 20kg of pressure per step off your feet!
Rest and Ice:
- 15-20 minutes of icing after long periods on your feet
- Take short sit-down breaks during the day if possible
Surface Matters:
- Use cushioned mats if standing on concrete floors (e.g., kitchen, workstations)
- Soft grass or rubberised surfaces for walking instead of concrete paths
6. Surgical Options: Rare, but Sometimes Necessary
If after 6–12 months of good conservative care you’re still hobbling, surgery might be discussed.
Thankfully, that’s less than 5% of my patients.
Possible Procedures:
- Plantar fascia release
- Removal of bone spurs (if truly symptomatic)
Recovery Tip:
- Post-surgery rehab is just as important as the surgery itself.
- Plan for physio, gradual weight-bearing, and a patient mindset.
If there’s one thing I want you to know: heel pain doesn’t need to be your new normal.
Early intervention, good shoes, targeted therapy — it’s not complicated, but it takes commitment. At Well Heeled Podiatry, we see heel pain improve every single week, even in cases that have been dragging on for months or years.
Sometimes, all it takes is the right help at the right time. And if you’re stuck, confused, or just fed up with hobbling around the house — come and see us.
We’ll get you back on your feet.
