What is Plantar Fasciitis & Why Does it Hurt?
Heel pain can be incredibly frustrating. In fact, it’s one of the most common foot complaints we see in clinic. However, when someone is told they have plantar fasciitis, it often raises more questions than answers.
So, what exactly is plantar fasciitis — and why does it hurt so much, especially first thing in the morning?
In this blog, we’ll explain what plantar fasciitis is, why it develops and, importantly, what you can do about it.
What is Plantar Fasciitis?
The plantar fascia is a thick band of connective tissue that runs from your heel to your toes. Its job is to support the arch of your foot and help absorb load when you walk, run or stand.
Plantar fasciitis refers to irritation or overload of this tissue. However, despite the name, research now suggests that it is often less about inflammation and more about the tissue being overloaded over time.
In other words, it’s usually a load management issue rather than a sudden injury.
Why Does It Hurt?
Pain typically develops because the tissue has been exposed to more stress than it can currently tolerate. As a result, the plantar fascia becomes sensitive and painful when loaded.
Common contributing factors include:
A sudden increase in walking or running
Standing for long hours on hard surfaces
Reduced calf flexibility
Changes in footwear
A recent return to exercise
Increased bodyweight load
In addition, recovery factors such as poor sleep or inadequate rest can influence symptoms.
Pain is often worst in the morning. This is because the tissue tightens slightly overnight and is then suddenly stretched when you take your first steps. Consequently, those initial steps can feel sharp and uncomfortable.
What Are the Symptoms?
People with plantar fasciitis commonly describe:
Sharp pain under the heel
Pain with the first steps in the morning
Discomfort after long walks
Tenderness when pressing into the heel
Sometimes the pain improves as you move around. However, it may return later in the day if the foot has been heavily loaded.
Importantly, symptoms can vary from person to person. Some people experience mild discomfort, whereas others find it significantly limits activity.
Who Gets Plantar Fasciitis?
Plantar fasciitis can affect anyone. That said, it is more common in:
Runners
People who stand for long periods
Those returning to exercise after a break
Individuals aged between 40 and 60
Nevertheless, age alone is not the cause. More often, it’s a combination of load, recovery and tissue capacity.
How Can Physiotherapy Help?
Firstly, an accurate diagnosis is essential. Heel pain can sometimes be caused by other conditions, so understanding the true source of symptoms matters.
At Principle Physiotherapy in Chelmsford, we focus on:
A thorough assessment
Clear explanation of the condition
Load management advice
Progressive strengthening exercises for the calf and foot
Hands-on treatment where appropriate
A structured return to running or activity
Rather than simply masking symptoms, we aim to build long-term resilience in the tissue. Therefore, the goal is not just short-term relief, but sustainable improvement.
