Plantar Fasciitis: Why Your Heel Hurts in the Morning (and How to Fix It)
That stabbing first-step pain in your heel is almost always plantar fasciitis. Here's what causes it, what makes it worse, and the treatments that actually work.
If your first few steps out of bed feel like stepping on a drawing pin in your heel, you're almost certainly dealing with plantar fasciitis — the most common cause of heel pain we see in clinic.
The plantar fascia is a thick band of tissue that runs along the sole of your foot, from your heel bone to the base of your toes. When it's repeatedly overloaded, tiny tears form and the tissue becomes inflamed and stiff.
How to tell if it's plantar fasciitis
- Sharp pain under the heel with your first steps in the morning
- Pain that eases after walking a few minutes, then returns later in the day
- Tenderness when you press the inside of your heel
- Worse after long periods of standing or after exercise — not during
What causes it
It's almost always a loading problem rather than an injury. Common triggers include a sudden increase in walking or running, unsupportive footwear (flat shoes, worn-out trainers, bare feet on hard floors), tight calves, and the way your foot mechanically loads — flat feet and high arches both predispose.
Treatments that actually work
1. Calf and fascia stretching
Daily calf stretches against a wall plus a frozen-bottle roll under the arch (5 minutes, twice a day) gives most people meaningful relief within 2–3 weeks.
2. Supportive footwear from the moment you get up
Don't walk on hard floors barefoot. Have a pair of supportive slippers or sandals by the bed. During the day, wear shoes with a cushioned heel and some arch support.
3. Custom orthoses for stubborn cases
If the fascia is being repeatedly overloaded by your foot mechanics, no amount of stretching will fully resolve it. A biomechanical assessment identifies the cause and a custom or semi-bespoke orthotic offloads the painful area.
4. Shockwave and steroid injection — last resort
For cases lasting more than 6 months, shockwave therapy or a guided steroid injection can break the cycle. Most people never need this.
When to see a podiatrist
If heel pain has lasted more than two weeks despite stretching and better footwear, get assessed. The longer plantar fasciitis is left untreated, the longer it typically takes to settle.
Need this looked at in person?
Book a £70 30-minute appointment at our Aylesbury clinic — assessment, diagnosis and a personalised treatment plan.