Plantar Fasciitis (under-heel pain)

Heel pain that’s worse first thing in the morning? You’re probably dealing with plantar fasciitis - and it’s very treatable.  

We see plantar fasciitis more than almost any other condition. When it’s been going on for months and nothing has worked, focused shockwave therapy combined with a targeted rehabilitation plan is often the turning point. 

What is plantar fasciitis?

Plantar fasciitis is one of the most common causes of heel pain. It involves irritation or degeneration of the plantar fascia - a thick band of tissue that runs along the sole of the foot, from the heel bone to the toes, helping to support the arch. Despite the name, plantar fasciitis is often not a true inflammatory condition, particularly when symptoms have been present for several months. In longer-standing cases, the problem is more accurately related to tissue overload and reduced healing capacity. 

Common Symptoms

Symptoms vary, but often include:

• Pain under the heel or along the arch of the foot
   
• Pain that worsens with long periods on your feet

• Pain on the first few steps after rising from bed
   
• Initial discomfort that eases slightly with movement but worsens later in the day
   
• Tenderness when pressing into the inside of the heel

• Feeling like there is a marble in your shoe
   

Symptoms may affect one or both feet.

Who does it commonly affect?

Plantar fasciitis can affect anyone, but it is particularly common in:

• People who spend long periods standing or walking
   
• Runners and recreational athletes
   
• Individuals who have recently increased activity levels
   
• Those with reduced ankle mobility or altered foot mechanics
   
• People returning to activity after a period of rest
   

It can also occur gradually, without a single obvious injury.

How is plantar fasciitis usually treated?

Most cases improve with appropriate conservative care, but this often requires a combination of approaches rather than a single treatment.

Common elements include:

• Load management and activity modification (making the tendon work less in daily activities)
   
• Targeted stretching and strengthening exercises (rehabilitation exercise)
   
• Addressing calf, ankle, and foot mechanics
   
• Supportive footwear or temporary orthoses
   
• Manual therapy where appropriate
   

For persistent or long-standing symptoms that have not settled with time or basic care, focused shockwave therapy is commonly used to stimulate tissue healing and recovery. Focused shockwave therapy is much more comfortable than radial shockwave therapy, typically more effective and requires fewer sessions overall. To learn more about these therapies, please click on the in-text links.

Why our approach is different

At Tenby Health & West Wales Ultrasound, we focus on understanding the problem properly before deciding on treatment. Where clinically appropriate, we use diagnostic ultrasound to confirm the nature of the plantar fascia changes and rule out other causes of heel pain. This allows treatment to be targeted and appropriate, rather than applied on a trial-and-error basis.

For suitable cases, focused shockwave therapy is used because it can deliver energy accurately and deeply into the affected portion of the plantar fascia, helping to stimulate the body’s natural healing response. This is combined with:

• A structured clinical assessment
   
• Supervised rehabilitation sessions
   
• A clear, progressive exercise plan to address contributing factors
   

This integrated approach is designed to be effective, efficient, and evidence-informed, supporting recovery while reducing the need for unnecessary appointments.

 What to do next

If plantar fasciitis pain is affecting your daily life, the most important first step is a proper assessment.

Book a new patient consultation (£65) and we will assess your symptoms, confirm the diagnosis, and explain your options clearly - whether that's shockwave, rehabilitation, diagnostic ultrasound, or a combination. If shockwave is right for you, we will talk you through the package options at that appointment. Most people leave their first appointment knowing what's going on for the first time.

View our pricing and packages: tenbychiropractic.co.uk/pricing-and-cancellations