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Plantar Fasciitis

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Plantar fasciitis is one of the most common causes of heel pain. It occurs when the plantar fascia — the thick band of tissue supporting the arch — becomes irritated or inflamed. Pain is typically worst with the first steps in the morning or after periods of rest.

Symptoms

• Sharp or stabbing pain at the base of the heel
• Pain on standing after periods of rest
• Discomfort that improves with activity but worsens with prolonged walking
• Tenderness in the heel or arch

Causes

• Repetitive strain from walking, running, or prolonged standing
• Tight calf muscles or Achilles tendon
• Poorly cushioned or unsupportive footwear
• Being overweight or recent weight gain
• Flat feet or high arches

Non-Surgical Treatment

• Well-cushioned, supportive footwear
• Stretching exercises for the calf and plantar fascia
• Ice therapy to reduce pain and inflammation
• Anti-inflammatory medication (e.g. ibuprofen)
• Orthotics or insoles to offload heel pressure
• Night splints to gently stretch the fascia during sleep
• Ultrasound-guided steroid injections for persistent cases
• Extracorporeal Shockwave Therapy (ESWT) — often effective in chronic cases

Surgery — Gastrocnemius Recession

Surgery is considered only after several months of failed conservative treatment. The most common procedure is a proximal medial gastrocnemius recession — a small release of the calf muscle behind the knee to reduce tension on the plantar fascia. Performed as a day case through a small incision.

Recovery

Timeframe	What to Expect
0–2 weeks	Rest, foot elevated. Protective dressing or boot.
2 weeks	Wound review. Sutures trimmed. Transition to light footwear.
2–4 weeks	Walking in supportive trainers. Gentle stretching.
4–6 weeks	Increased walking and daily activity.
6–12 weeks	Return to most normal activity.
12 weeks+	Running and impact activities may resume if pain-free.