What is plantar fasciitis?
Plantar fasciitis is pain under the heel, caused by an irritated band of tissue that runs along the sole from the heel to the toes. This band, the plantar fascia, supports the arch of the foot each time you step.
When it is overloaded, it becomes sore and tight. Load is a big part of the problem, which is why simply resting rarely fixes it for long.
What does it feel like?
The typical story is a sharp pain under the heel when you take the first steps after getting out of bed, or after sitting for a while. It eases as you walk, then returns after a long stand or a long walk.
You may feel it at the inside front of the heel, and it can be tender when pressed there. Climbing stairs or walking barefoot on tile can make it worse.
Pain behind the heel, along the back, points to the Achilles tendon instead. Our page on Achilles tendon pain explains that one.
Why does it happen in Ipoh?
Three daily habits keep the heel sore. The first is walking barefoot or in thin slippers on hard tiles at home, which most Ipoh terrace houses have, with no cushion under the heel.
The second is standing for long hours, as in a hawker stall, a kitchen, a shop counter or a classroom. The heel takes the same pressure all day.
The third is a sudden start. Someone who has been inactive and begins brisk morning walks at Polo Ground or a hill climb at Bukit Kledang can overload the sole within days.
Extra body weight, tight calves and a recent change to harder shoes add to the load. Our guide to wearing slippers and heel pain goes deeper.
What do we check at the first visit?
We ask when the pain happens, what changed before it began, and how long you stand each day. Then we look at the foot and the leg above it.
- The exact spot of the pain, and where it is tender.
- The movement of the big toe and the ankle.
- Calf tightness and strength, using heel raises.
- The shape of the arch, standing and sitting.
- How you walk, and what your shoes look like when worn.
- Your work, hobbies and floors at home.
If the findings suggest a stress fracture, a nerve problem or another cause, we tell you and help you see a doctor.
What helps plantar fasciitis?
Strengthening the calf and foot, and spreading the load more evenly, are what bring lasting relief. Rest alone, or a quick gadget, rarely does it.
A plan can follow these steps.
- Reduce the heaviest triggers, such as barefoot walking on tile and long unbroken standing.
- Add a cushioned insole or a supportive pair of shoes to share the load, if it helps.
- Start calf and foot strengthening, such as slow heel raises with the toes raised on a towel roll.
- Add gentle stretching of the calf and sole, if the physiotherapist finds tightness.
- Build walking and standing back up in steps.
Recovery varies, and the heel is slow to settle, so we review progress every visit. Our guide on footwear for plantar fasciitis helps you choose, and the glossary explains orthotics if you were told to try them.
What can I do this week?
Simple changes can reduce the morning stab.
- Put on shoes or supportive sandals before your feet touch the tile.
- Place a firm mat at the kitchen sink or stall where you stand.
- Roll a bottle gently under the foot after sitting, as a warm-up.
- Do slow calf raises, two sets, on a low step, holding the rail.
- Split long walks into shorter walks on softer ground.
If the pain gets worse during an exercise, ease off and tell your physiotherapist.
When should I see a doctor first?
Go to a doctor if the heel is red, hot and swollen, or if you have fever with heel pain. Go too if the pain began after a fall or a hard landing and you cannot put weight on the foot.
See a doctor if you have numbness or burning in the foot, pain that wakes you at night, or long-standing diabetes with a foot that looks different. Hospital Raja Permaisuri Bainun, Fatimah Hospital and Pantai Hospital Ipoh can see you for these.
How do home sessions in Ipoh work?
A physiotherapist comes to your house, looks at the floors you walk on and the shoes by your door, and tests your feet and calves. Foot loading needs only a step, a towel and a chair.
Visits are available across Ipoh now, and our Canning Garden centre is opening soon. Prices are quoted on WhatsApp after a short description. See how home physiotherapy works, and read about flat feet if your arch is low.