Heel pain that won’t quit? A surprising fix for plantar fasciitis

“Plantar fasciitis is one of the most common—and stubborn—causes of heel pain, and we see it all the time in our practice,” says Dr. Tyler Stewart, an Atlantic Health foot and ankle orthopedic surgeon. But he also says there’s a surprisingly simple explanation for it—and a simple fix.

“It’s not your shoes. It’s not the shape of your foot. It’s all because of a tight calf muscle. That’s the root of the problem,” he says.

What is plantar fasciitis?

Plantar fasciitis is inflammation of the plantar fascia—a thick ligament that runs along the bottom of your foot and supports your arch. The inflammation typically occurs where the fascia connects to the heel bone, causing persistent and sometimes severe pain in the heel.

The pain is usually sharp and stabbing. It worsens after prolonged standing, walking or exercise. It’s also especially painful first thing in the morning or after long periods of sitting.

What causes plantar fasciitis?

While obesity, poor footwear or overuse can all play a role, Dr. Stewart explains the root cause is from a tight calf muscle, clinically known as gastrocnemius contracture.

“If your calf muscle is tight, that tension pulls on the Achilles tendon, which pulls on the heel, which tightens the plantar fascia. That’s where the inflammation starts,” says Dr. Stewart.

How to treat plantar fasciitis

Dr. Stewart’s approach is straightforward and effective. “I tell patients stretch your calf and come back in two months—and most don’t come back. It works that well,” he says.

Here’s his prescription for daily calf stretches:

1. Stand on a step with your heels hanging off the edge
2. Keep your knees straight and let your heels drop down
3. Hold the stretch for 30 to 60 seconds
4. Repeat three or four times daily

“Let gravity do the work,” he says, noting that a physical therapist can help with proper techniques and mobility. He also recommends anti-inflammatories to reduce pain and inflammation.

But if heel pain persists, here are a few other recommendations that can bring relief:

1. Heel cups or extra padding in the shoes
2. Ice rolling using a frozen water bottle under the foot
3. Custom orthotics for very flat or high-arched feet
4. A night splint to keep the foot flexed overnight

Additionally, shockwave therapy, platelet-rich plasma injections (PRP) or, as a last resort, a calf-lengthening procedure that Dr. Stewart performs can also help release a tight gastrocnemius tendon.

An ounce of prevention

To prevent plantar fasciitis, stretch your calves daily—especially before and after sports—wear supportive footwear and avoid walking barefoot on hard floors for long periods of time. If you start to feel heel pain, get off your feet and rest.

“By the time most people get to my office, they’ve been in pain for months,” says Dr. Stewart. “With proper stretching, most cases resolve on their own very quickly.”