Heel pain is one of the most common problems we see in clinic, and plantar fasciitis is the diagnosis most people recognise. For many, it begins subtly: a sharp or aching pain under the heel first thing in the morning, easing as you move, then returning after periods of rest or at the end of a long day. Over time it can become persistent, frustrating, and limiting.
What is often misunderstood is that plantar fasciitis is rarely just an inflamed bit of tissue that needs resting. In most chronic cases, it is the end result of how forces are being transmitted through the foot with every step you take.
What is Plantar Fasciitis?
The plantar fascia is a thick band of connective tissue that runs from the heel bone to the toes. Its role is to support the arch and help the foot act like a spring during walking and running. Each step places load through this structure. When that load is well distributed, the tissue adapts and remains healthy. When it is not, microscopic strain accumulates at the heel attachment. Over time, this leads to pain, degeneration and loss of tissue resilience.
Why does plantar pain happen?
For many people, the issue is not the fascia itself but the way the foot and lower limb move. A foot that collapses excessively, twists too much, or fails to stabilise at the right moment increases strain through the plantar fascia.
This can be influenced by:
- Foot structure and mobility
- How quickly the foot rolls inwards after heel strike
- How effectively the arch recoils during push-off
- Calf and Achilles tightness
- Hip and pelvic control
- Walking and running style
- Occupational demands such as long hours on hard surfaces
Two people can have identical symptoms but very different mechanical drivers.
This is why plantar fasciitis often becomes chronic. Rest alone does not change how load is applied. Stretching may help temporarily. Ice and anti-inflammatories can reduce pain, but they do not alter the mechanics that caused the problem in the first place.
Why do orthotics help with Plantar Fasciitis pain?
A common misconception is that orthotics are simply “arch supports”. In reality, a properly designed orthosis is a precision device used to influence how forces move through the foot and up the kinetic chain.
The goal is not to prop the arch up artificially. It is to:
- Reduce excessive strain through the plantar fascia
- Improve how the foot accepts and transfers load
- Encourage more efficient timing of foot motion
- Support the foot when it is most vulnerable during stance
- Reduce repetitive microtrauma at the heel
How RS Podiatry can help with Plantar Fasciitis
In clinic, this begins with a detailed biomechanical assessment and gait analysis. We look at how your foot behaves under load, not just how it looks when you are standing still. Modern tools such as pressure mapping and 3D gait systems allow us to understand where forces are peaking, how long they are applied, and how your body compensates.
From this, an orthosis can be designed that subtly reshapes how your foot interacts with the ground. In the case of plantar fasciitis, this often means:
- Offloading the stressed portion of the heel
- Reducing excessive arch flattening
- Improving midfoot stability
- Enhancing the foot’s ability to “spring” efficiently
- Decreasing strain on the plantar fascia with each step
This is fundamentally different from generic insoles. We have a blog comparing custom and off-the-shelf orthotics, take a read.
Off-the-shelf products are built for an “average” foot. They do not know how you move, where you overload, or what tissues are failing. Some people may feel temporary comfort from them. Others may feel no change. In certain cases, they can even shift load into new problem areas.
Why see a podiatrist for Plantar Fasciitis
When you see a podiatrist, you are not paying for a piece of plastic. You are paying for:
- Clinical assessment
- Understanding of pathology
- Interpretation of your movement patterns
- Identification of the true driver of your pain
- A device designed specifically for your foot and your life
This is why orthotics can sometimes resolve symptoms that have been present for months, even years, and why in some cases they remove the need for more invasive interventions such as shockwave therapy.
Plantar fasciitis is not simply a sore heel. It is a load management problem. When the load is corrected, the tissue can settle, heal and regain resilience.
Kerren’s chronic heel pain
Kerren is a former Premier League referee and now works for the Premier League as the PGMOL Referees Select Group Manager, overseeing and developing the very best officials in the game. During his career, he rubbed shoulders with legends such as Sir Alex Ferguson and Arsène Wenger and officiated matches featuring some of the greatest players ever to grace the Premier League.
Like many who have spent decades on their feet at the highest level, Kerren began to experience chronic heel pain that was increasingly limiting. When he first attended the clinic, he was open-minded but understandably sceptical about whether orthoses, particularly 3D-printed Phits orthoses, could genuinely make a meaningful difference.
Following a full biomechanical assessment and gait analysis, we designed bespoke Phits orthoses tailored precisely to his foot structure, movement patterns, and loading demands. Within a relatively short time, his symptoms resolved. At review around two months later, Kerren reported being free from heel pain, comfortably managing long days on his feet. Crucially, this meant we did not need to progress to more advanced treatments such as shockwave therapy, often required in persistent or long-standing cases.
Kerren’s experience is a powerful reminder that even long-standing, activity-limiting heel pain can often be resolved when the underlying mechanical drivers are properly understood and addressed, allowing people to return to their day-to-day roles with comfort, confidence, and ease.
Kerren’s experience reflects this perfectly. His heel pain did not require escalation to advanced therapies. By understanding how his foot was functioning and correcting the mechanical drivers, his symptoms resolved within a short period.
The aim is always the same: not just to settle pain, but to restore a system that works efficiently again.
That is what podiatry should do.