Heel pain has a way of changing how you move.
At first, you might notice discomfort during your first few steps in the morning. Then it begins bothering you after a long walk, a round of golf or a pickleball game. Before long, you may find yourself changing the way you walk to avoid putting pressure on the painful heel.
For active adults in Mesa and throughout Arizona’s East Valley, plantar fasciitis can interfere with everything from walking and hiking to golf, pickleball, running and everyday exercise.
But persistent heel pain isn’t always just about the bottom of your foot. Limited ankle mobility, calf tightness, foot and ankle strength, gait mechanics and the way your entire lower body moves can influence the stresses placed on the plantar fascia.
As a preferred chiropractic clinic in the Mesa area, Elite Sports Medicine Arizona takes a whole-body approach to musculoskeletal problems, using chiropractic care, manual therapy, corrective exercise and rehabilitation to address pain as well as movement restrictions that may be contributing to it.
What Is Plantar Fasciitis?
The plantar fascia is a strong band of connective tissue running along the bottom of the foot from the heel toward the toes. It helps support the arch of the foot and plays an important role when you walk, run and push off the ground.
Plantar fasciitis is one of the most commonly recognized causes of plantar heel pain.
According to the 2023 Clinical Practice Guideline from the Academy of Orthopaedic Physical Therapy and American Academy of Sports Physical Therapy, plantar fasciitis typically causes pain along the inside-bottom portion of the heel. Symptoms are often most noticeable during the first weight-bearing steps after waking up or following a period of inactivity.
Pain may initially improve as you move around, only to return following prolonged standing, walking or exercise.
The guideline reports that plantar fasciitis accounts for approximately 15% of foot pathology in the general population and occurs most commonly among adults ages 40 to 60. It can affect both athletes and non-athletes, with a higher reported incidence among runners.
Why Does Plantar Fasciitis Hurt So Much in the Morning?
“Why does my heel hurt when I first get out of bed?” is one of the classic plantar fasciitis questions.
After you’ve been sleeping or sitting for an extended period, the plantar fascia and surrounding tissues haven’t been experiencing normal weight-bearing loads.
Then you stand.
Those first few steps suddenly place load through the foot and plantar fascia, which can produce the characteristic sharp or aching heel pain.
The same thing can happen after sitting at your desk, driving for an extended period or relaxing after exercise.
Morning heel pain doesn’t automatically prove you have plantar fasciitis, but pain with the first steps after inactivity is one of the characteristic findings clinicians consider when evaluating plantar heel pain.
Why Plantar Fasciitis May Be More Than a Foot Problem
Your foot doesn’t function independently from the rest of your body.
Every time you walk, forces travel through the foot and ankle and continue through the knee, hip and pelvis. Movement in one area can influence what happens elsewhere in this kinetic chain.
That’s why persistent plantar fasciitis deserves more than simply asking, “Where does it hurt?”
A more comprehensive evaluation may also consider:
- Ankle range of motion
- Calf flexibility
- Foot and ankle strength
- Balance
- Walking and running mechanics
- Hip mobility and strength
- Previous ankle or lower-extremity injuries
- Recent changes in exercise or weight-bearing activity
The 2023 plantar fasciitis clinical practice guideline specifically identifies limited ankle dorsiflexion, or reduced ability to bring the foot upward toward the shin, as a risk factor clinicians should assess.
That gives us an important clue: sometimes improving what happens at the heel requires looking above it.
How Can Limited Ankle Mobility Contribute to Heel Pain?
Your ankle needs to move through an adequate range of motion every time you walk.
As your body moves forward over your planted foot, the ankle must dorsiflex. If that movement is restricted, the body still has to find a way forward.
Compensation may occur through the foot, knee, hip or elsewhere in the movement chain.
The plantar fasciitis clinical practice guideline includes limited ankle dorsiflexion among the examination findings associated with plantar fasciitis and recommends evaluating ankle range of motion in people experiencing plantar heel pain.
This is one reason extremity joint adjustments and other approaches addressing lower-extremity joint mobility may be considered as part of an individualized treatment program when clinically appropriate.
The goal isn’t simply to manipulate a painful foot. It’s to identify mobility restrictions that may be affecting how the foot functions when you stand, walk and exercise.
Can the Way You Walk Affect Plantar Fasciitis?
Potentially.
Walking is a coordinated sequence involving the foot, ankle, knee, hip and pelvis. When pain develops in the heel, people also commonly begin altering their gait without realizing it.
You may shorten your stride, shift weight toward the outside of the foot, spend less time on the painful side or push off differently.
That may make the heel temporarily more comfortable, but repeatedly walking differently can place additional demands on other parts of the body.
Someone who begins limping because of heel pain may eventually notice discomfort in the opposite leg, knee, hip or lower back.
At Elite Sports Medicine Arizona, assessing movement patterns can help identify whether restricted mobility, weakness or compensatory movement should be addressed alongside the painful heel.
Why Are Active Arizona Adults Susceptible to Plantar Fasciitis?
Arizona makes it easy to stay active throughout much of the year.
Mesa and the surrounding East Valley offer golf, hiking, pickleball, tennis, walking, running and countless other opportunities for outdoor activity.
That’s excellent for overall health, but sudden increases in weight-bearing activity can overload tissues that aren’t adequately conditioned for the new demand.
The plantar fasciitis clinical practice guideline identifies running and work-related weight-bearing activity among recognized risk factors. It also notes that heel pain may be associated with a recent increase in weight-bearing activity.
That might mean increasing your running mileage, suddenly playing pickleball five days a week, walking 18 holes instead of using a golf cart, starting a new hiking routine or returning to exercise after months of inactivity.
Often the problem isn’t that the activity itself is bad.
It’s that the workload increased faster than the body was prepared to handle it.
Is Plantar Fasciitis Common Among Runners?
Yes. Although plantar fasciitis affects both athletic and non-athletic populations, the 2023 clinical practice guideline notes that incidence has been reported to be higher among runners.
Running repeatedly loads the foot and plantar fascia. Training volume, changes in terrain, footwear, calf and ankle mobility, strength and recovery can all affect how the lower extremity responds to that repetitive loading.
For runners experiencing recurring heel pain, simply resting until the pain disappears and immediately returning to the same training volume may not address contributing factors.
A progressive return to activity combined with appropriate mobility and strengthening can be important.
Can Tight Calves Contribute to Plantar Fasciitis?
Calf flexibility and ankle mobility are closely connected.
The gastrocnemius and soleus muscles make up much of the calf and connect into the Achilles tendon. Restrictions through this region can influence ankle dorsiflexion and lower-extremity mechanics.
That’s one reason current clinical guidelines recommend both plantar fascia-specific stretching and gastrocnemius/soleus stretching for people with plantar fasciitis.
Stretching alone, however, isn’t necessarily the entire solution.
If limited joint mobility, muscle weakness or movement mechanics are also contributing to the problem, those issues may need to be addressed as well.
How Can Manual Therapy Help Plantar Fasciitis?
There is good evidence supporting manual therapy as part of plantar fasciitis treatment.
The 2023 clinical practice guideline recommends that clinicians use manual therapy directed at the joints and soft tissues of the lower extremity to address relevant joint and flexibility restrictions, decrease pain and improve function in people with plantar heel pain.
That’s particularly relevant to the whole-body approach used at Elite Sports Medicine Arizona.
Depending on the patient’s examination findings, manual therapy may address appropriate joints and soft tissues throughout the lower extremity rather than concentrating exclusively on the painful heel.
Treatment should be based on the specific restrictions identified during examination rather than assuming every case of plantar fasciitis has the same cause.
Does Strengthening Help Plantar Fasciitis?
Strengthening can be an important component of rehabilitation.
The 2023 clinical practice guideline recommends therapeutic exercise that includes resistance training for the muscles of the foot and ankle.
That’s an important distinction because plantar fasciitis treatment is sometimes viewed primarily as stretching.
Mobility matters, but your foot and ankle also need sufficient strength and endurance to tolerate repeated loading.
At Elite Sports Medicine Arizona, therapeutic exercise and corrective movement can be incorporated into a rehabilitation program based on the patient’s specific deficits and activity goals.
An active adult trying to return to hiking may need a different progression than a runner training for a race or a retiree who simply wants to walk comfortably around the neighborhood.
Can Chiropractic Care Help with Plantar Fasciitis?
Chiropractic care for plantar fasciitis shouldn’t simply mean treating the heel.
As a preferred chiropractic clinic in the Mesa area, Elite Sports Medicine Arizona evaluates how the foot and ankle interact with the rest of the lower extremity.
Depending on the patient’s findings, conservative treatment may incorporate joint mobility work, extremity adjustments, manual therapy, stretching, therapeutic exercise, strengthening and movement retraining.
This approach is consistent with current plantar fasciitis guidelines emphasizing lower-extremity joint and flexibility restrictions, ankle mobility, foot and ankle strengthening and functional movement.
The objective is not to promise a quick fix. It’s to identify modifiable factors that may be contributing to pain and help the foot tolerate normal activity again.
Do Orthotics Cure Plantar Fasciitis?
Not necessarily.
The 2023 clinical practice guideline specifically recommends against using either prefabricated or custom orthotics as an isolated treatment for short-term pain relief in plantar fasciitis.
However, the guideline states that orthoses may be used in combination with other treatments to reduce pain and improve function.
That’s another reason a comprehensive approach matters.
An insert may alter how forces are distributed through the foot, but it doesn’t necessarily restore restricted ankle movement, improve muscle strength or address other movement deficits.
For some patients, orthotics can be useful. They simply shouldn’t automatically become the entire treatment plan.
Do Heel Spurs Cause Plantar Fasciitis?
Heel spurs and plantar fasciitis are often discussed together, but the relationship isn’t as simple as “there’s a spur, therefore that’s what’s causing the pain.”
Plantar heel pain can have several possible causes. The 2023 clinical guideline notes that plantar heel pain may encompass plantar fasciitis as well as heel fat pad syndrome, heel spur syndrome, nerve irritation and calcaneal stress fracture.
That makes an accurate evaluation important, especially when symptoms don’t follow the typical plantar fasciitis pattern or fail to improve as expected.
Treating every painful heel as plantar fasciitis risks overlooking another cause.
When Is Heel Pain Not Plantar Fasciitis?
Persistent heel pain deserves evaluation because not every painful heel is plantar fasciitis.
Other possibilities can include a stress fracture, nerve irritation, heel fat-pad problems, Achilles-related conditions and other musculoskeletal or systemic causes.
You should be particularly cautious if pain followed significant trauma, you cannot comfortably bear weight, there is substantial swelling or bruising, symptoms include significant numbness or tingling, or the pain isn’t behaving like typical plantar fasciitis.
If symptoms aren’t responding to appropriate conservative treatment, the diagnosis may also need to be reconsidered.
Should You Keep Exercising with Plantar Fasciitis?
The answer depends on the severity of the symptoms and the activity.
Complete inactivity isn’t necessarily required, but repeatedly performing an activity that significantly aggravates the heel can make recovery more difficult.
Activity modification may allow you to remain active while reducing excessive stress on the plantar fascia.
A runner might temporarily reduce mileage. A hiker might choose flatter terrain. A pickleball player may need to decrease playing frequency while strength and mobility improve.
The eventual goal is generally not permanent avoidance.
It’s rebuilding enough mobility, strength and load tolerance to safely return to the activities you enjoy.
How Can You Reduce the Risk of Plantar Fasciitis Coming Back?
Preventing recurrence means looking beyond whether today’s heel pain has disappeared.
If restricted ankle mobility, insufficient foot and ankle strength, a sudden training increase or another modifiable factor contributed to the original problem, those issues may still exist after symptoms settle down.
A long-term strategy may include maintaining ankle and calf mobility, strengthening the foot and ankle, increasing exercise volume gradually, wearing footwear appropriate for your activity and continuing exercises that address identified weaknesses.
Elite Sports Medicine Arizona’s approach to physical medicine and rehabilitation emphasizes restoring function and helping patients return to normal activities rather than focusing solely on short-term symptom relief.
For an active patient, success isn’t simply being able to walk out of the clinic without pain.
It’s being able to return to the trail, golf course, pickleball court, gym or daily routine with greater confidence.
When Should You Seek Treatment for Plantar Fasciitis?
Occasional foot soreness after an unusually active day may resolve with rest and normal recovery.
Consider having persistent heel pain evaluated if it repeatedly hurts during your first steps in the morning, returns after periods of sitting, worsens with prolonged standing or walking, interferes with exercise, changes the way you walk or continues despite modifying your activity.
Earlier evaluation can also help determine whether the symptoms actually fit plantar fasciitis or whether another condition may be responsible.
Take a Whole-Body Approach to Heel Pain in Mesa
Your heel may be where you feel the pain, but it isn’t necessarily the only place worth evaluating.
Ankle mobility, calf flexibility, foot and ankle strength, gait mechanics, activity level and movement throughout the lower extremity can all be relevant when plantar fasciitis becomes persistent or recurrent.
As a preferred chiropractic clinic in the Mesa area, Elite Sports Medicine Arizona combines chiropractic care, extremity joint treatment, manual therapy, corrective exercise and rehabilitation to help active adults address musculoskeletal pain and return to the activities they enjoy.
If heel pain is interfering with walking, running, hiking, golf, pickleball or everyday life, contact Elite Sports Medicine Arizona to schedule an evaluation in Mesa.
The goal isn’t simply to quiet the heel temporarily. It’s to understand why it hurts, restore function and help your lower body better tolerate the demands you place on it.
Frequently Asked Questions
What is the most common symptom of plantar fasciitis?
Pain along the bottom-inside portion of the heel is typical. It is often most noticeable during the first steps after waking or after sitting for an extended period and may worsen following prolonged weight-bearing.
Can limited ankle mobility cause plantar fasciitis?
Limited ankle dorsiflexion is a recognized risk factor associated with plantar fasciitis. It may alter lower-extremity mechanics and should be assessed when evaluating persistent plantar heel pain.
Can the way I walk make plantar fasciitis worse?
Gait and lower-extremity mechanics can influence how forces move through the foot. Heel pain itself may also cause you to alter your walking pattern, potentially creating compensations elsewhere.
Can a Mesa chiropractor help with plantar fasciitis?
For appropriate musculoskeletal cases, chiropractic care can be part of a conservative treatment plan addressing lower-extremity joint mobility and movement. Elite Sports Medicine Arizona may combine this with manual therapy, stretching, corrective exercise and strengthening based on examination findings.
Should I stretch or strengthen for plantar fasciitis?
Both may be appropriate. Current clinical guidelines recommend plantar fascia and calf stretching as well as resistance exercise for the muscles of the foot and ankle.
Do I need custom orthotics for plantar fasciitis?
Not necessarily. Current clinical guidelines recommend against using orthotics alone as the sole treatment for short-term plantar fasciitis pain. Orthoses may be useful for some patients when combined with other treatments.
Why does plantar fasciitis keep coming back?
Recurrence can have multiple contributing factors. If activity load, ankle mobility, strength or other movement deficits aren’t addressed, the conditions that contributed to the original problem may remain.
Is heel pain always plantar fasciitis?
No. Heel pain can also result from other conditions, including stress fractures, nerve irritation, heel fat-pad problems and Achilles-related disorders. Persistent or atypical symptoms should be properly evaluated.
