Heel Pain: Why It Happens (and Why Rest Alone Rarely Fixes It)
Heel pain has a habit of creeping in quietly. At first, it’s just a sharp twinge when you step out of bed. Then it lingers after walks or workouts. Before long, you’re adjusting how you stand, walk, or exercise just to avoid the pain.
At Body Zest in Banstead, Surrey, heel pain is one of the most common issues we treat, and it’s also one of the most misunderstood.
The Most Common Causes of Heel Pain
Heel pain is a symptom, not a diagnosis. Understanding the cause is what allows it to resolve properly.
Plantar fasciitis is the most common culprit. The plantar fascia supports the arch of your foot, and when it’s repeatedly overloaded, pain develops under the heel, often worst first thing in the morning.
Other common causes include Achilles tendinopathy, which causes pain at the back of the heel, fat pad irritation, which feels more like a deep bruise, and less commonly, nerve or joint-related pain referred from elsewhere in the leg or lower back.
Heel spurs are often blamed, but in reality they’re usually a by-product of long-term tension rather than the source of pain itself.
Why Heel Pain Often Becomes Persistent
Many people try rest, ice, stretching, or new shoes. Sometimes this helps temporarily, but the pain often returns as soon as activity increases again.
That’s because heel pain usually needs progressive loading, not complete rest. Tissues like the plantar fascia and Achilles tendon recover when they’re exposed to the right amount of stress, in the right way.
This is where rehabilitation plays a crucial role.
The Role of Rehabilitation in Heel Pain Recovery
Rehab exercises are not about forcing through pain. They’re about helping the foot tolerate load again and reducing strain on the heel during everyday movement.
At Body Zest, we commonly use exercises like:
Plantar Fascia Loading
A controlled heel raise with a small towel placed under the toes increases tension through the plantar fascia in a safe way. Slowly lifting and lowering the heel helps the tissue adapt rather than remain irritated.
Calf Strengthening
Both straight-knee and bent-knee calf raises are important. The calf muscles absorb a huge amount of force when you walk. Weak or under-conditioned calves push extra load into the heel, worsening symptoms.
Foot Strength Exercises
Simple movements such as gently drawing the ball of the foot towards the heel (without curling the toes) improve arch control and reduce repetitive strain on the plantar fascia.
Achilles Tendon Loading
For pain at the back of the heel, slow controlled heel drops help improve tendon strength and pain tolerance. The slow lowering phase is particularly important for tendon health.
Ankle Mobility Work
Restricted ankle movement often forces the heel to compensate. Gentle knee-to-wall drills or controlled lunges help improve ankle mobility and reduce stress through the heel.
Balance and Load Control
Single-leg standing, controlled step-downs, and eventually light impact work help restore normal movement patterns and confidence, reducing flare-ups in the long term.
The exact combination and progression of exercises depends on the type of heel pain, how long it’s been present, and your activity levels.
Other Effective Treatments for Heel Pain
Rehabilitation works best when combined with the right hands-on care.
Podiatry
Podiatry focuses on foot mechanics, footwear advice, walking patterns, and load management. Insoles may be helpful in some cases, but they’re used to support rehab, not replace it.
Osteopathy
Heel pain rarely exists in isolation. Osteopathy looks at how the foot interacts with the ankle, knee, hip, and lower back. Improving movement elsewhere can significantly reduce ongoing heel stress.
Shockwave Therapy
For stubborn or long-standing heel pain, extracorporeal shockwave therapy (ESWT) can be very effective. Shockwave therapy stimulates blood flow, encourages tissue healing, and helps reset chronic pain patterns, particularly in plantar fasciitis and Achilles tendinopathy.
When Should Heel Pain Be Assessed?
If heel pain lasts longer than a few weeks, keeps returning, or affects your walking or exercise, it’s worth getting it assessed.
Early treatment usually means:
-Faster recovery
-Less time off activity
-Lower risk of recurrence
Heel Pain Is Fixable With the Right Approach
Heel pain is not something you just have to live with. When the cause is understood and the right combination of rehabilitation, manual treatment, and load management is applied, outcomes are usually very good.
At Body Zest, we take the time to assess why your heel is under strain and guide you through the steps needed to fix it properly.
📍 Body Zest – Osteopathy & Podiatry in Banstead, Surrey
Helping you walk, move, and exercise comfortably again
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FAQ: Heel Pain
What is the most common cause of heel pain?
Plantar fasciitis is the most common cause of heel pain, particularly pain felt first thing in the morning.
Does heel pain go away on its own?
Some mild cases settle, but many become persistent without proper treatment and rehab.
Is shockwave therapy effective for heel pain?
Shockwave therapy has strong evidence for treating chronic plantar fasciitis and Achilles-related heel pain.
Should I stretch or strengthen for heel pain?
Most cases respond better to progressive strengthening rather than stretching alone.