(866) 552-4866 Chris* was eager to resume marathon training. However, promotions at work and a growing family meant he had to take more time off from training than he had planned. Thankfully, he found a marathon that worked for his schedule and began making up for lost time. Everything was going great, too. That is, until constant heel pain began to wreak havoc on his training with only three months before race day. Taking a few days off—maybe even a full week—was one thing. But when he realized the heel pain wasn't improving and would likely sideline him for quite a while, he immediately blamed plantar fasciitis. The question is: Was he right?
The odds that Chris is suffering from symptoms of plantar fasciitis are high. After all, he is an avid runner, and plantar fasciitis is a common overuse injury that affects roughly 2 million people in the United States each year. That said, plantar fasciitis is not the only cause of chronic heel pain. Assuming every case of heel pain is plantar fasciitis can lead to misdiagnosis, delayed treatment, and an even longer road to recovery—especially for active people like Chris. Identifying the true source, whether it is indeed plantar fasciitis or something else such as bursitis or an Achilles injury, is critically important to resolve the issue for good.
Are These Heel Pain Symptoms Holding You Back?
- Dull, sharp, or shooting pain in the heel
- Pain in the arch of the foot
- Pain at the back of the heel or lower calf
- General stiffness, especially in the morning
- A tight Achilles tendon
- Swelling around the heel
- Visible redness or warmth
- Pain triggered by long periods of standing
- Pain that worsens with movement
- A constant ache
- Tenderness to the touch
- Limited range of motion
- Possible bruising and discoloration
Is your heel pain caused by plantar fasciitis or something else? Request an appointment with a StrideCare podiatrist today. Our expansive network ensures you receive the support you need from a qualified foot doctor near you.
Heel Pain Is a Symptom: What's Causing It?
While chronic foot numbness and balance problems can affect people of any age, they are a greater concern for older adults. In fact, approximately one-third of older adults experience symptoms ranging from benign foot pain and stiffness to aching, numb, or inflamed feet, reduced flexibility, arthritis, balance problems, and more.
Plantar fasciitis is a common cause of heel pain. The condition is characterized by painful inflammation and small tears in the thick band of tissue that runs across the bottom of the foot, connecting the heel bone to the toes. Those affected by it are generally on their feet too much, walking barefoot, or engaging in repetitive or high-impact movements such as running and jumping. But there are other causes of plantar fasciitis:
- How you walk — The fascia is a thick band that supports the arch of your foot and absorbs an incredible amount of shock as you walk or run. If you walk with a limp or with your feet naturally rolling inward or outward, it can strain the fascia, making it feel like you are walking on a bruise.
- Your foot's shape — Something else that creates extra tension on your foot muscles and causes plantar fasciitis is flat feet. The same is true for higher-than-normal arches, differences in foot function, and differences in ankle strength.
- Poorly fitted shoes — The opposite of going barefoot is relying on shoes that are too big, too small, or have limited cushioning where it counts. All of these create less stability for the foot overall and add unnecessary stress.
- Obesity — Our feet already absorb an incredible amount of shock and support our weight. If you are carrying extra weight, you are putting more stress on the bottom of your foot and heel with each step.
People with plantar fasciitis typically describe it as a feeling of soreness and tenderness directly under or at the back of the heel. The pain they experience can also happen suddenly or develop over time. For instance, Chris was logging a good four or five miles per day in the early stages of his training and felt fine, but as he ramped up the intensity and mileage, the constant pounding led to heel pain.
The good news is that most bouts of plantar fasciitis and its laundry list of symptoms can be resolved with conservative treatment rather than surgery. This is especially true if you work with a podiatrist and are properly diagnosed.
What Else Can Cause Heel Pain?
According to a study by the American Podiatric Medical Association, 77% of Americans have experienced foot and heel pain, but only a third seek expert care. In these situations, it is easy to self-diagnose and assume the most common culprit—plantar fasciitis. However, several other conditions can cause chronic heel pain, many of which present with similar symptoms and require different treatments.
If it is not plantar fasciitis, your heel pain could be:
An Achilles injury
For the sake of this conversation, we will rule out an Achilles tendon rupture because it is typically a sudden, severe injury that causes immediate pain, swelling, and difficulty walking. This makes it far less likely to be confused with more gradual, overuse-related heel pain. That said, Achilles tendinitis is not something to overlook. The Achilles tendon connects the calf muscle to the heel bone and plays a critical role in walking, running, and jumping. When it becomes irritated or inflamed—often due to overuse or a sudden increase in activity—it can lead to persistent pain.
Where it differs from plantar fasciitis is in its location. Achilles tendinitis is usually felt on the back of the heel or lower calf rather than the bottom of the heel. There are also specific symptoms, including, but not limited to, the following:
- Pain at the back of the heel or lower calf
- Pain that worsens during or after activity
- Reduced explosive strength or push-off power
- A thickened or "rope-like" feeling in the tendon
- Tenderness when squeezing the tendon
- Morning stiffness that eases with movement
- Difficulty walking or standing on your tiptoes
- Limited range of motion
- Reduced function
Heel Bursitis
Throughout our bodies are these small, fluid-filled sacs that cushion our bones, tendons, and muscles near the joints. Unfortunately, repetitive motion or pressure can cause these small sacs to become inflamed.
When this happens, we experience heel pain that is often mistaken for plantar fasciitis and Achilles tendinitis. That said, the source of the problem is very different: plantar fasciitis affects the thick band of tissue on the bottom of the foot, while Achilles pain is caused by the tendon itself. Because of its location, heel bursitis is most felt when pressure is applied by shoes or when there is repetitive friction. This can make certain shoes uncomfortable right away and may lead to visible signs such as swelling, redness, or warmth in the affected area.
Stress Fractures
Stress fractures are tiny cracks in the heel bone caused by repetitive force or overuse—something runners like Chris may be especially prone to when increasing mileage too quickly. This type of injury often causes deep, persistent pain that worsens with activity and doesn't improve with typical at-home remedies like rest or stretching. Over time, the pain may become more constant and severe.
Symptoms are also slightly different, including:
- Localized pain that you can often point to the exact spot
- Pain that worsens with weight-bearing activities
- Pain that persists, even at rest
- Possible mild swelling
- No relief from stretching, unlike plantar fasciitis or Achilles tightness
- Deep, sharp, or aching pain directly in the heel bone
Consulting with a foot doctor can address a wide range of heel pain problems. If you would like to discuss your treatment options, please schedule an appointment with StrideCare's expert podiatric physicians.
When To See a Podiatrist for Heel Pain
Far too many people delay seeking help from a podiatrist. They think their symptoms are not that bad, and, in some cases, it may not be. That said, early intervention can't hurt—especially if you are not sure what the exact cause is.
You need to consider seeing a podiatrist if:
- Your heel pain doesn't improve with rest or home remedies
- The symptoms are worsening
- You see visible deformities
- You are limited in mobility, which impacts daily activity
A professional evaluation at StrideCare can confirm the situation and guide the next steps in treatment, which could include a comprehensive foot examination, physical therapy, custom orthotics and protective footwear, possible surgery, and additional education on proper foot care.
Need Help With Heel Pain? StrideCare Is Here for You
Plantar fasciitis is a common heel and foot condition that almost anyone can experience during their lifetime. But it is not the only possible source of heel pain. If you want to reclaim your life and uncover the correct diagnosis, take the time to find the right podiatrist for your unique foot care needs. With over 50 StrideCare clinic locations, finding an experienced, qualified podiatrist near you is easier than ever. A consultation with one of our podiatrists can determine the type, severity, and location of your foot pain issues.
Our podiatry team at StrideCare is committed to providing you with the most comprehensive foot care—including conservative and surgical treatment options. This is equally true for significant foot conditions all the way down to the tiniest of toes. Healthy, pain-free feet make all the difference in our lives, and it is our job to ensure you stay on your feet today, tomorrow, and moving forward.
Please contact us at 866-552-4866 or complete the appointment form to schedule a consultation. At StrideCare, we are here to help, all while providing compassionate patient care.
This information is not a substitute for professional medical advice. Before starting any new treatment or questions regarding a medical condition, always seek the advice of your doctor or other qualified health provider.
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*Patient names and/or photos may be changed to protect patient confidentiality.