That stabbing pain in your heel when you take your first steps in the morning? You're likely experiencing —the most common cause of affecting over 2 million Americans each year. Here in Orlando, we see this condition constantly, especially among theme park workes, runners, and anyone who spends long hours on their feet.
This comprehensive guide will teach you everything you need to know about : what causes it, how to recognize the symptoms, which treatments actually work, and when it's time to see a doctor in Orlando.
Key Takeaways
- affects 1 in 10 people and is the #1 cause of
- The hallmark symptom is with your first morning steps
- Over 90% of cases improg> with proper conservative treatment y treatment leads to faster recovery—most resolve in 6-12 months
- Advanced treatments like shockwave therapy help stubborn cases
What Is ?
The plantar fascia is a thick, fibrous band of connective tissue that runs along the bottom of your foot, connecting your heel bone (calcaneus) to your toes. Think of it as your foot's natural shock absorber and arch support—it absorbs impact with each step and helps maintain the shape of your arch.
(pronounced PLAN-ter fash-ee-EYE-tis) occurs when this band becomes inflamed, irritated, or develops tiny tears. The condition was traditionally called "inflammation of the plantar fascia," but research now shows it's more accurately described as degeneration—the tissue breaks down from repetitive stress without adequate time to heal.
Understanding the Anatomy
Your plantar fascia originates at the medial tubercle of the calcaneus (the inside-bottom of your heel bone) and fans out toward your toes. It plays several critical roles:
- Shock absorption — Cushions impact forces during walking and running
- Arch support — Maintains the structural integrity of your foot's arch
- Propulsion — Helps push off during the gait cycle through the "windlass mechanism"
- Energy storage — Stores and releases energy like a spring
When you stand or walk, your body weight transfers through this tissue. The plantar fascia can handle tremendous stress—but when that stress becomes excessive or unrelenting, problems develop.
How Common Is ?
is remarkably common:
- 10% of people will experience at some point
- It accounts for 11-15% of all foot symptoms requiring professional care
- Peak incidence occurs between ages 40-60, though we see it in all age groups
- Affects both sedentary and athletic populations
- Slightly more common in women
In Orlando specifically, we see elevated rates among hospitality workers, healthcare professionals, and anyone who works standing jobs in our region's dominant tourism and service industries.
Recognizing Symptoms
Knowing the symptoms of helps you identify the condition early—which matters because early treatment leads to faster recovery.
The Classic Symptom: Morning
The hallmark symptom is sharp, stabbing pain at the bottom of the heel with your first steps in the morningents often describe it as:
- "Like stepping on a nail"
- "Walking on broken glass"
- "A bruised heel"
- "Sharp knife stabs with each step"
Why does this happen? During sleep, your plantar fascia tightens in a shortened position. When you stand up, you suddenly stretch the contracted tissue, causing pain. As you walk around and the fascia warms up and loosens, the pain typically decreases.
Other Common Symptoms
Beyond morning pain, watch for these symptoms:
- Pain after sitting — "Post-static dyskinesia" causes pain when you stand after periods of rest
- Pain that worsens throughout the day — Especially after prolonged standing
- Pain at the base of the heel — Usually on the inside (medial) edge
- Pain radiating into the arch — The fascia extends beyond just the heel
- Increased pain after exercise — Not usually during activity
- Pain when climbing stairs — Or standing on tiptoes
- Tenderness to touch — Pressing on the inside of your heel
- Limping — Unconsciously altering your gait to avoid pain
What Makes Pain Worse?
- Walking barefoot on hard surfaces
- Wearing flat shoes or flip-flops (see our flip-flop injury guide)
- Standing for extended periods
- High-impact activities (running, jumping)
- Sudden increases in physical activity
- Walking on uneven terrain
- Carrying extra weight
vs.
Many people confuse with . Here's the key distinction:
- = inflammation/degeneration of the soft tissue (plantar fascia)
- = a bony growth (osteophyte) on the heel bone
often develop as a result of chronic —the body deposits calcium at the point of stress. However, many people have without pain, and theelf usually isn't what hurts. Treatment targets the , not the spur.
Causes and Risk Factors for
Understanding what causes helps you both treat the current episode and prevent recurrence.
Primary Causes
develops when stress on the plantar fascia exceeds its ability to repair. This happens through:
- Repetitive strain — Constant microtears from prolonged standing, walking, or running
- Excessive loading — Forces that overwhelm the tissue's capacity
- Biomechanical abnormalities — Foot structures that distribute weight unevenly
- Sudden changes — Rapid increases in activity level
Major Risk Factors
Age (40-60 years)
peaks in middle age. The plantar fascia becomes less flexible with age, and the heel's natural fat pad thins, reducing shock absorption.
Foot Mechanics
- () — Cause the faretch more with each step
- High arches (pes cavus) — Concentrate force on the heel and forefoot
- Overpronation — Excessive inward rolling adds rotational stress
- Leg length discrepancy — Uneven loading between feet
Occupation
Jobs requiring prolonged standing or walking significantly increase risk. In Orlando, we commonly see in:
- Theme park employees (Disney, Universal, SeaWorld cast members)
- Healthcare workers (nurses, surgical staff, technicians)
- Hospitality workers (hotel staff, restaurant servers)
- Retail workers
- Teachers
- Factory and warehouse workers
See our detailed guides for Disney cast members and hospitality workers.
Body Weight
Excess weight dramatically increases plantar fascia stress. With each step, your foot absorbs 2-3x your body weight. Even modest weight gain can trigger symptoms.
Exercise Patterns
- Runners — Especially those who increase mileage too quickly
- Dancers — Ballet and aerobic dance stress the fascia
- Athletes — Basketball, tennis, and other sports with jumping/pivoting
- Weekend warriors — Sudden activity after prolonged inactivity
Check our Orlando running trails guide for smart training tips.
Improper Footwear
- Worn-out athletic shoes
- Flat shoes without arch support
- Flip-flops (extremely common in Florida)
- High heels (chronic use shortens the Achilles)
- Non-supportive "fashion" shoes
Tight Calf Muscles
Limited ankle dorsiflexion (ability to flex your foot upward) forces compensatory strain on the plantar fascia. Tight calves are one of the most modifiable risk factors.
Home Treatments for
The good news: over 90% of cases improve with conservative, non-surgical treatment. Here's what you can do at home.
Rest and Activity Modification
Reduce activities that trigger pain—but don't stop moving entirely. Avoid:
- Running or jumping (temporarily)
- Walking barefoot on hard surfaces
- Standing for extended periods
Replace high-impact exercise with swimming, cycling, or upper-body workouts while healing.
Stretching (Essential)
Daily stretching is the cornerstone of treatment. Stretch:
Plantar Fascia Stretch:
- Sit and cross affected foot over opposite knee
- Pull toes back toward shin until you feel a stretch in the arch
- Hold 10-30 seconds
- Repeat 3-5 times, especially before getting out of bed
Calf Stretches:
- Stand facing a wall, hands on wall
- Step back with affected leg, keeping heel on ground
- Lean forward to stretch calf
- Hold 30 seconds; repeat 3 times
- Do with knee straight (gastrocnemius) AND bent (soleus)
Learn more stretches in our daily foot stretches guide.
Ice Therapy
Apply ice to the heel for 15-20 minutes, 2-3 times daily—especially after activity. A frozen water bottle rolled under the arch provides both cold therapy and massage.
Proper Footwear
- Wear supportive shoes immediately upon waking—no barefoot walking
- Choose shoes with good arch support, cushioned soles, and slight heel elevation
- Replace athletic shoes every 300-500 miles
- Avoid flat shoes, flip-flops, and going barefoot
See our best shoes for standing all day and running shoe selection guide.
Over-the-Counter Arch Supports
Quality OTC insoles can provide immediate relief. Look for:
- Firm (not soft) arch support
- Deep heel cup for stability
- Good cushioning
Brands like Superfeet, Powerstep, and Spenco offer decent temporary options—though custom orthotics work better for long-term management.
Night Splints
Night splints hold your foot in a flexed position while sleeping, preventing the plantar fascia from tightening overnight. This can dramatically reduce morning pain. Available over-the-counter at pharmacies.
Anti-Inflammatory Measures
- NSAIDs (ibuprofen, naproxen) can reduce pain and inflammation short-term
- Topical anti-inflammatories (Voltaren gel) offer targeted relief
- Follow package directions; don't exceed recommended doses
Massage
Roll a tennis ball, golf ball, or frozen water bottle under your arch for 2-3 minutes at a time. This helps break up adhesions and increase blood flow.
Professional Treatments We Offer
When home treatments aren't enough—or for faster results—professional treatment option:
Custom Orthotics
Custom orthotics are medical-grade shoe inserts designed specifically for your feet. Unlike store-bought insoles, they're created from molds or scans of your feet and address your unique biomechanics.
Benefits:
- Redistribute pressure away from the heel
- Correct overpronation or other gait abnormalities
- Provide consistent, long-lasting support
- Can be made for work shoes, athletic shoes, and dress shoes
Shockwave Therapy (ESWT)
Extracorporeal Shockwave Therapy uses acoustic waves to stimulate healing in damaged tissue. It's a breakthrough treatment for chronic that hasn't responded to other measures.
How it works:
- Sound waves create controlled microtrauma
- Stimulates blood flow and collagen production
- Triggers the body's natural healing response
- Non-invasive, performed in-office
We've seen remarkable results with shockwave therapy at our Orlando and Lake Mary locations—often helping patients who've struggled for months or years.
MLS Laser Therapy
MLS Laser Therapy uses specific wavelengths of light to reduce inflammation and accelerate tissue repair. It's painless, has no side effects, and typically requires 6-10 sessions.
Physical Therapy
A physical therapist can provide:
- Targeted stretching and strengthening exercises
- Manual therapy techniques
- Gait analysis and correction
- Ultrasound or iontophoresis treatment
Corticosteroid Injections
Steroid injections deliver powerful anti-inflammatory medication directly to the affected area. They can provide rapid relief for severe cases—but we use them selectively because:
- Effects are temporary (weeks to months)
- Repeated injections can weaken the fascia
- Risk of fat pad atrophy with multiple injections
Injections work best as part of a comprehensive treatment plan, not as standalone therapy.
PRP Therapy
Platelet-Rich Plasma (PRP) therapy uses your own blood's healing factors to repair damaged tissue. Blood is drawn, processed to concentrate platelets, and injected into the plantar fascia.
PRP shows promise for chronic cases and may provide longer-lasting relief than steroids.
Surgery (Rarely Needed)
Less than 5% of patients require surgery. We consider it only after 6-12 months of failed conservative treatment.
Surgical options include:
- Plantar fascia release — Partially cutting the fascia to release tension
- Gastrocnemius recession — Lengthening the calf muscle
- Minimally invasive techniques — Smaller incisions, faster recovery
When to See a Doctor
While mild may improve with home carould see a podiatrist if:
- Pain persists more than 2 weeks despite rest and home treatment
- Pain is severe or began suddenly after an injury
- Pain affects your ability to walk or work normally
- You notice swelling, redness, or warmth in the heel
- You have diabetes or circulation problems
- You have numbness or tingling in your foot
- Home treatments aren't helping
Why early treatment matters: The longer goes untreated, the harder it becomes to resolve. Chronic cases can lead to:
- Compensatory injuries in the knee, hip, or back (from altered gait)
- Persistent that becomes resistant tot
- Long-term activity limitations
At Central Florida Foot & Ankle Institute, we offer comprehensive treatment in Orlando. Our board-certified podiatrists will:
- Perform a thorough examination
- Take X-rays if needed to rule out fractures or spurs
- Diagnose the underlying cause
- Create a personalized treatment plan
- Monitor your progress and adjust as needed
Prevention: How to Keep from Coming Back
Once you've recovered, prevention is critical—recurrence is common without lifestyle modifications.
Daily Habits
- Stretch every day — Even 5 minutes of calf and foot stretches makes a difference
- Never walk barefoot — Especially on hard surfaces like tile or hardwood
- Wear supportive shoes — Even around the house
- Replace shoes regularly — Athletic shoes lose cushioning; replace every 300-500 miles
- Maintain healthy weight — Every pound matters for your feet
Exercise Smart
- Increase activity gradually — Follow the 10% rule (no more than 10% increase per week)
- Warm up properly — Before any exercise or physical activity
- Cross-train — Mix high-impact with low-impact activities
- Listen to your feet — Pain is a signal to back off
Workplace Considerations
For Orlando's many standing workers:
- Use anti-fatigue mats when standing in one place
- Take breaks to sit when possible
- Stretch on breaks — Even quick calf stretches help
- Wear proper work shoes — Prioritize function over fashion
- Consider custom orthotics — Especially for work shoes
See our theme park worker foot care guide and at work article for detailed workplace strategies.
Recovery Timeline: What to Expect
recovery varies, but here's a general timeline:
Mild Cases (Recent Onset)
- 0-2 weeks: Begin treatment, modify activities
- 2-6 weeks: Gradual improvement with consistent stretching and proper footwear
- 6-8 weeks: Significant symptom relief; can resume normal activities cautiously
Moderate Cases
- 0-4 weeks: Initial treatment phase, may need professional intervention
- 1-3 months: Steady improvement with comprehensive treatment
- 3-6 months: Most patients achieve significant or complete relief
Chronic/Severe Cases
- 6-12 months: May require advanced treatments (shockwave, PRP)
- 12+ months: Surgery considered only if all else fails
Important: Even after symptoms resolve, continue prevention measures. Many patients feel better, return to old habits, and experience recurrence.
Frequently Asked Questions About
What does feel like?
typically causes a sharp, stabbing pain in the bottom of the heel, especially with your first steps in the morning. The pain often improves as you walk but may return after prolonged standing or sitting. Some describe it as feeling like walking on a pebble or broken glass.
How long does take to heal?
With proper treatment, most cases of improve significantly within 6-12 months. Mild cases may resolve in 6-8 weeks with conservative care. Chronic or severe cases may take longer. Early treatment typically leads to faster recovery.
Can go away on its own?
While mild may improve with rest, most cases require active treatment including stretching, proper footwear, and activity modification. Without treatment, often becomes chronic and can lead to compensatory injuries in the knee, hip, and back.
Should I walk with ?
Walking is generally okay with , but you should avoid walking barefoot on hard surfaces, wear supportive shoes, and limit excessive walking when pain is severe. Gentle walking can actually help promote healing by increasing blood flow, but overwalking can worsen the condition.
What is the fastest way to cure ?
The fastest approach combines multiple treatments: daily stretching (especially before getting out of bed), ice therapy, supportive footwear, over-the-counter arch supports, and activity modification. For persistent cases, professional treatments like custom orthotics, shockwave therapy, or PRP injections can accelerate healing.
When should I see a doctor for ?
See a podiatrist if persists for more than twespite home treatment, if pain is severe or sudden, if you notice swelling or redness, if you have diabetes, or if pain interferes with daily activities. Early professional intervention leads to better outcomes.
Is the same as a ?
No, they're related but different conditions. is inflammation of thefascia ligament. are bony growths that can develop from chronic . Many people have without pain, and treatment usually resolves symptoms even when spurs are present.
Are flip-flops bad for ?
Yes, traditional flip-flops are one of the worst footwear choices for . They lack arch support, heel cushioning, and stability. If you must wear sandals, choose ones with built-in arch support, a contoured footbed, and secure heel straps.
Related Articles
- vs. : Understanding the Difference
- Shockwave Therapy for : A Non-Surgical Solution
- Custom Orthotics: Are They Worth It?
- Daily Foot Stretches for Pain Relief
- After Standing All Day: Causes and Solutions
- Best Shoes for Standing All Day
Get Expert Treatment in Orlando
At Central Florida Foot & Ankle Institute, Dr. Carli Hoover and Dr. Sean Griffin provide expert, compassionate treatment using the latest evidence-based techniques. Whether you need custom orthotics, shockwave therapy, or a comprehensive treatment plan, your Orlando podiatrist team is here to help you get back on your feet pain-free.
With convenient locations in Orlando, Kissimmee, Lake Mary, and Oviedo, world-class podiatric care is always close to home.
Don't let control your life. The sooner you start treatment, the sooner you'll find relief.