Plantar Fasciitis: What It Is, Why It Happens, and How We Treat It

If you've ever stepped out of bed in the morning and felt a sharp, stabbing pain in your heel the moment your foot hit the floor, there's a good chance you've already had a run-in with plantar fasciitis. It's probably the most common thing we see at Kootenay Pedorthic Clinic, and this time of year, when people in Nelson and the Kootenays are getting back outside, ramping up their activity, and logging a lot more steps than they were a few months ago — we tend to see a lot more of it walk through the door.

The good news is that it's very treatable. The frustrating part, for a lot of people, is that they put up with it for months before doing anything about it. This post is for anyone who's been limping through their mornings and wondering what's actually going on.

What Is Plantar Fasciitis?

The plantar fascia is a thick band of connective tissue that runs along the bottom of your foot, connecting your heel bone ( calcaneus ) to the base of your toes. Its job is to support the arch and absorb some of the load that goes through your foot with every step.

When that tissue is repeatedly stressed beyond what it can handle, it becomes irritated and inflamed. That's plantar fasciitis. The "itis" part just means inflammation, and it usually settles right at the point where the fascia attaches to the heel bone, which is why most people feel it in the heel, although the pain can also travel into the arch.

What Does It Actually Feel Like?

The classic sign is that sharp, stabbing heel pain with your first few steps in the morning, or after you've been sitting for a while and then stand up. The tissue tightens when you're off your feet, so that first load of the day tends to be the worst. A lot of people describe it as stepping on a rock or a tack, or as a burning sensation through the bottom of the heel.

For many people, it eases up after walking around for ten or fifteen minutes, which is why it's easy to dismiss early on. But it often comes back after long periods on your feet, at the end of a workday, or after a long walk or hike. If you're noticing that pattern, it's worth paying attention to.

Why Does It Happen?

There's rarely one single cause. Plantar fasciitis tends to develop when a combination of factors puts more load on the fascia than it can comfortably manage over time. Some of the things we look at during an assessment:

Foot structure - High arches and flat feet both change the way load is distributed through the foot, and both can contribute to plantar fasciitis in different ways.

Footwear - Shoes that lack proper support, have worn-out cushioning, or simply don't match the shape of your foot are a very common factor. This includes people who switch into sandals or go barefoot more as the weather warms up.

Activity changes - A sudden increase in how much you're walking, running, or standing, especially if it happens quickly, is one of the most common ways to trigger plantar fasciitis. This is why we see more of it in spring and summer.

Tight calves and Achilles - The calf muscles and Achilles tendon connect directly to the heel, and when they're tight, they increase the tension pulling on the plantar fascia. Calf tightness is one of the most consistently overlooked contributors.

Time on your feet - People who spend long days standing on hard surfaces, whether at work or otherwise, are at higher risk.

How We Treat Plantar Fasciitis

The first thing we do is figure out what's actually driving it for you specifically. Two people can come in with the same diagnosis and have completely different underlying causes, so the treatment plan needs to reflect that.

Here's what treatment typically looks like at Kootenay Pedorthic Clinic:

Custom orthotics - For most people with plantar fasciitis, a well-designed custom orthotic makes a significant difference. The goal is to support the arch, reduce the strain on the fascia, and redistribute load more evenly across the foot. Because our orthotics are built from a physical cast of your foot and designed around your specific biomechanics, they address the structural factors contributing to your particular case and your specific foot mechanics.

Footwear assessment - Orthotics work best in footwear that's actually supportive. Part of what we do is look at what you're wearing day-to-day and whether it's making things better or worse. In some cases, a footwear change alone makes a noticeable difference.

Stretching guidance - Gentle, consistent stretching of the calf and plantar fascia is one of the most effective things you can do between appointments. We'll walk you through what to do and, just as importantly, what to avoid while things are still inflamed.

Orthotic modifications and adjustments - Sometimes targeted modifications to your footwear or existing orthotics can provide meaningful relief while a longer-term plan is in place.

What Happens If You Ignore It?

Plantar fasciitis doesn't tend to get better on its own when the underlying causes are still there. Without addressing what's driving it, most people find that it becomes a chronic issue that flares up regularly and limits what they're able to do.

The earlier you address it, the easier it is to treat. Most people who come in when symptoms are relatively new respond well and quickly. People who've been dealing with it for a year or two often need more time and a more involved approach.

When to Come In

If you've had heel pain for more than a few weeks, or if it's affecting how you move through your day, it's worth coming in for an assessment. You don't need a referral to see us, and we're happy to answer questions before you book if you're not sure whether we're the right fit.

We see people from Nelson, Kaslo, Castlegar, Trail, Rossland, and across the Kootenays, and plantar fasciitis treatment is one of the things we do most often. If your mornings start with that familiar heel pain, we can help - please reach out to us and ask us how we can help. https://www.kootenaypedorthic.ca/contact