Pain and Performance Clinic

Plantar Fasciopathy

Suffering from morning heel pain?

This can be a very sore, very frustrating condition usually effecting men in their 40s/50. No one treatment works really with this but a lot of little things need to be done. Pelvic control, core strengthening, loosening out calves and hamstrings, using a heel pad, correct foot-ware and losing some weight are all part of recovery.

Heel Pain

What is it?

A mechanical over- load problem caused by poor movement mechanics.(Not Inflammatory condition)
  • Example 1- Anterior Pelvic Tilt = increased load on calf, increased calf muscle tone and reduced ankle dorsiflexion. This can lead to excessive foot pronation.
  • Example 2- Over striding. Forces aren’t well distributed and increased eccentric load on Tibialis Posterior , Gastroc and Soleus. These combined with increased activity produces pain in the Plantar Fascia.
These combined with increased activity produces pain in the Plantar Fascia.


  • Pain after rest- morning pain, prolonged sitting
  • Can be pain on prolonged standing/walking
  • ‘Bruised’ type pain
  • Eases out after a few steps/minutes


  • Range of motion testing- especially ankle dorsiflexion
  • Accurate palpation
  • Standing posture
  • Walking assessment-pelvic lateral movement and rotation
    • heel strike
    • toe off. Where is this happening – callus formation?


  • Single leg stance
  • Neural Testing (Medial Calcaneal Nerve, Lateral Plantar Nerve)
  • MRI or Ultrasound if you query a tear (X- Ray no use)


Correct Walking technique

If over-striding , shorten the stride- landing on the front part of the heel with a slight knee bend. Best to use a simple cue – ‘walk quietly’, ‘lift knees slightly higher’, ‘land softly’.

 Home Exercise Programme

(Indicated If pain eases within 20 minutes in morning) 15 minutes daily x 6 weeks.
  • Calf Stretch 20 seconds x 3 reps
  • Plantar Fascia stretch 1 minute x 2 reps
  • Strengthening- ‘Don’t fall over’ exercise x 30 reps
(Repeat the above 3 times. )

Constant taping

Watch out for: Pain at night or if pain gets worse during the day they may have a bone or periosteal response. (Pain limited to less than 30 minutes)


Questions, bookings or feedback? Contact me by any of the channels below. I’ll respond ASAP!

P: 087 652 9287


A: Pain & Performance Clinic, 12 Trinity Court, Fonthill Business Park, Dublin 22

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