Heel pain is a common foot problem that can make walking, standing, running and everyday activities uncomfortable. Pain may develop gradually following changes in activity or exercise, although it can also occur after an injury.

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There are several possible causes of heel pain, including plantar fasciitis (plantar heel pain), Achilles tendon problems, bursitis and stress injuries. Identifying the cause of your symptoms is important for choosing the right treatment.

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What Are the Common Causes of Heel Pain?

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1. Plantar Fasciitis / Plantar Heel Pain

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Plantar fasciitis is one of the most common conditions associated with pain underneath the heel.

The plantar fascia is a strong band of connective tissue running along the bottom of the foot. Symptoms often develop when the tissue becomes sensitive to load.

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Typical symptoms may include:

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• Pain underneath or around the heel

• Pain with the first few steps in the morning

• Pain when walking after sitting or resting

• Increased pain after prolonged standing or walking

• Heel pain following running or exercise

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A heel spur may be visible on an X-ray, but the presence of a heel spur does not necessarily mean it is the cause of your pain.

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2. Achilles Tendinopathy

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The Achilles tendon connects your calf muscles to the heel bone.

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Achilles tendinopathy can cause pain and stiffness around

the back of the heel or lower Achilles tendon, particularly during walking,

running, jumping or other activities that place

increased load through the tendon.

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3. Heel Bursitis

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Bursae are small fluid-filled sacs

that help reduce friction between tissues.

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Irritation around a bursa at the back of the heel

can cause local pain, tenderness and sometimes swelling,

particularly when wearing certain shoes.

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4. Stress Injuries & Fractures

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Repetitive loading from running, jumping or sudden increases in physical activity can sometimes result in a stress reaction or stress fracture of the heel bone.​ Unlike some other causes of heel pain, stress injuries may require medical assessment and a temporary reduction in weight-bearing activity.

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5. Other Causes of Heel Pain

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Heel pain may also be associated with:

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• Foot or ankle sprains

• Nerve irritation

• Inflammatory conditions

• Arthritis

• Growth-related heel pain in children and adolescents

• Referred pain from another area

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Because different conditions can produce similar symptoms, persistent heel pain should be properly assessed.

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How Can Physiotherapy Help Heel Pain?

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Treatment for heel pain depends on the underlying cause, your activity level and how long you have experienced symptoms.

Physiotherapy for heel pain may include:

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• Calf and plantar fascia exercises

• Progressive strengthening

• Foot and ankle mobility exercises

• Activity and load management

• Advice about footwear

• Running or walking assessment where appropriate

• Manual therapy

• Taping when appropriate

• A personalised home exercise program

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For plantar heel pain and Achilles tendon problems, rehabilitation often focuses on gradually improving the ability of the foot, calf and tendon to tolerate load.

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Should I Rest If I Have Heel Pain?

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Complete rest is not always necessary.

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In many cases, temporarily reducing activities that significantly aggravate your symptoms while maintaining comfortable physical activity can be more helpful.

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For example, a runner experiencing heel pain may temporarily adjust running distance or intensity while completing a progressive strengthening program.

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Your physiotherapist can help determine an appropriate level of activity based on your symptoms.

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What Shoes Are Best for Heel Pain?

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There is no single type of shoe that is best for everyone with heel pain.

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Comfortable, well-fitting footwear may help reduce symptoms, and some people may temporarily benefit from additional cushioning, heel supports, taping or orthotics depending on their condition.

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Rather than assuming you must never walk barefoot, footwear advice should be individualised according to your symptoms, activities and assessment findings.

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When Should I See a Physiotherapist for Heel Pain?

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Consider having your heel assessed if:

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• Pain persists or repeatedly returns

• Your first steps in the morning are consistently painful

• Walking or standing is becoming difficult

• Heel pain limits running, sport or exercise

• Symptoms are getting progressively worse

• Pain developed after significantly increasing your activity or training

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Seek prompt medical assessment if you are unable to bear weight following an injury, have significant swelling or deformity, or experience severe or unexplained heel pain.

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Heel Pain & Plantar Fasciitis Physiotherapy in Castle Hill & Chatswood

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Our physiotherapists provide assessment and treatment for heel pain and plantar fasciitis in Castle Hill and Chatswood.

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We assess factors such as your foot and ankle movement, calf strength, activity levels, footwear and physical demands to help identify factors contributing to your symptoms.

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Depending on your condition, treatment may include exercise rehabilitation, strengthening, manual therapy, activity modification, footwear advice and an individualised home exercise program.

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Contact our Castle Hill or Chatswood physiotherapy clinic to book an assessment for heel pain or plantar fasciitis.