Manhattan Podiatry Group • Biomechanical Evaluation, Conservative Care & Advanced Heel Therapies
Plantar fasciitis, also called plantar fasciopathy, is a common cause of pain beneath the heel. It involves irritation and degenerative changes in the plantar fascia, the strong band of connective tissue running from the heel toward the toes to help support the arch.
Its hallmark symptom is sharp or stabbing pain with the first steps in the morning or after sitting for a long period. Discomfort may ease as you move, then return after prolonged standing, walking, or exercise. Similar symptoms can also arise from nerve irritation, stress fractures, or other conditions, so an accurate diagnosis matters.
At Manhattan Podiatry Group, Dr. Mark Sharobeem, DPM, assesses foot mechanics, activity demands, footwear, and potential contributing factors to develop an individualized heel pain treatment plan. Care may include stretching, orthotic support, night splinting, and selected advanced therapies.
Visit our practice at 55 Broadway, Suite 602, in Manhattan's Financial District. Heel pain that persists, worsens, or interferes with normal walking deserves professional evaluation.
Pain often concentrates beneath or toward the inside of the heel. It can feel especially sharp when getting out of bed, climbing out of a chair, or resuming movement after rest. Prolonged standing can bring the pain back later in the day.
Running mileage changes, jobs involving long periods on hard floors, tight calves, and changes in training load can stress the fascia. Foot structure and how weight moves through the foot may influence symptoms and help guide appropriate supportive care.
Not every sore heel is plantar fasciitis. Heel fat-pad pain, nerve entrapment, Achilles disorders, and stress fractures can overlap. Sudden severe pain, significant swelling, numbness, or an inability to bear weight calls for prompt assessment.
A thorough evaluation begins with the timing and location of pain, a physical examination, and a review of footwear, activity, calf flexibility, and walking mechanics. Imaging is not always needed for classic plantar fasciitis, but an X-ray, ultrasound, or MRI may be considered for unusual symptoms, persistent pain, or suspected alternative diagnoses.
Most patients begin with conservative treatment: plantar fascia and calf stretches, temporary activity adjustments, footwear changes, heel cushioning or orthotic devices, and ice for symptom relief. Physical therapy or a night splint may help when first-step pain or stiffness continues. Treatment is adjusted to your activity and response over time.
For symptoms that persist despite an adequate course of conservative care, options may include extracorporeal shockwave therapy (EPAT/ESWT), injections, or other selected interventions. PRP has mixed evidence and is not a guaranteed solution; more invasive procedures, including radiofrequency microtenotomy or surgery, are considered only in appropriate refractory cases after discussing potential benefits, risks, and alternatives.
Heel pain management works best when the treatment addresses why the fascia is overloaded. The right plan may combine flexibility work, supportive footwear, gradual activity progression, and reassessment if progress stalls. Most patients improve without surgery, although recovery can take several months.
* New heel pain following injury, inability to bear weight, progressive numbness, or signs of infection should be evaluated promptly rather than treated as routine plantar fasciitis.
Plantar fasciitis is associated with repeated loading of the plantar fascia. Changes in walking or running activity, prolonged standing, limited ankle flexibility, and footwear may contribute. The condition involves tissue irritation and degeneration, not simply inflammation.
The plantar fascia can feel stiff after rest. Your first steps load the tissue again, producing the characteristic sharp pain. Symptoms often ease briefly with movement but may recur after a long day on your feet.
Not usually. Heel spurs are common findings on X-rays and can occur without pain. A spur alone does not confirm plantar fasciitis, and many people with plantar fasciitis do not need treatment directed at a spur.
Supportive shoes and over-the-counter inserts may be enough for some people. Custom orthotics can be considered based on foot mechanics and response to initial treatment. Night splints may reduce morning pain in selected patients, particularly alongside a stretching program.
Many people improve gradually over weeks to months with consistent conservative care. Persistent symptoms may require reassessment to confirm the diagnosis, address contributing factors, and discuss additional options.
Shockwave therapy may help some people with chronic plantar fasciitis after conservative treatment has not worked. Evidence for platelet-rich plasma (PRP) is mixed and results vary. A podiatrist can explain candidacy, expected benefits, risks, and costs.
Get prompt medical attention if heel pain follows a significant injury, you cannot bear weight, or the foot becomes severely swollen, red, hot, numb, or accompanied by fever. These findings may point to a condition other than routine plantar fasciitis.
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Contact Manhattan Podiatry Group for personalized heel pain evaluation and plantar fasciitis treatment options with Dr. Mark Sharobeem, DPM.