Plantar Fasciitis & Heel Pain Treatment in Norwest & Dural
The Short Version
Plantar fasciitis is the classic first step out of bed pain in the heel. It is a loading problem, not an inflammation problem, despite the name. The treatment with the best evidence behind it is progressive heavy strength work for the foot and calf, not rest, not stretching alone, and not an orthotic on its own. It is slow. Three to six months is typical and people who are told it will take two weeks give up in week three. Done properly it resolves, and it stays resolved.
The Heel Pain We See Most
The most common version is someone who has had it for four or five months, has tried a night splint, a golf ball, two pairs of shoes and a cortisone injection, and is now walking differently to avoid it. The heel pain is bad first thing, eases after ten minutes, and comes back hard at the end of the day. Nobody has ever given them a strength program. The second version is a runner six weeks into a volume increase who thinks they can wait it out. They usually can, but it will take twice as long as it needs to.
Do You Need a Scan?
Almost never. Plantar fasciitis is a clinical diagnosis made from where it hurts, when it hurts and what makes it worse. An ultrasound will usually show a thickened fascia, which confirms what the history already told us and does not change the plan. We would send you for imaging if the pain came on suddenly with a snap or a pop, which raises the possibility of a tear, if there is night pain, unexplained weight loss or a history of cancer, if you have numbness or pins and needles in the foot, which points at a nerve rather than the fascia, if you are a runner with pain that gets worse with every step rather than warming up, which can indicate a stress fracture, or if you have had six months of genuine rehab with no change. A heel spur on an X ray is a feature rather than the cause. Spurs turn up in plenty of feet with no heel pain at all, they tend to show up in heels that have been under strain for years, and removing one does not reliably fix anything.
Whether you need imaging is something we work out with you at the appointment, based on where it hurts and what we find when we examine you. Your practitioner will talk you through whether a scan would change anything, and organise it if it would.
What Is Actually Driving It
Plantar fasciitis is almost never about your arch. These are the six things that actually determine whether it settles.
A jump in load your foot was not prepared for
Calf and foot strength
Bodyweight and standing hours
Footwear that changed recently
A sudden jump in walking or running volume
Calf and foot strength that never got built
How We Actually Treat It
Almost everyone arrives having tried the same four things: a night splint, rolling it on a ball, new shoes, and stretching. Some have had a cortisone injection. Almost nobody has been given a strength program, which is the one thing with the best evidence behind it.
The core of it is heavy, slow loading for the calf and foot. Stretching, rolling and massage do not do this job. Progressive strength work, done every second day, built up over months. It’s unglamorous and it’s slow and it’s what works.
Loading gets you there faster. Compared against stretching and inserts alone, a proper strength program produces substantially better foot function within about three months. Given this condition routinely drags on for six to twelve months, getting there faster is the whole point.
The things that don’t do much. A heel spur on an X ray isn’t the cause and removing it doesn’t reliably fix anything. Spurs turn up in plenty of pain free feet. Cortisone gives short term relief and doesn’t change the trajectory. An orthotic on its own rarely resolves it, although it can help alongside the loading.
What Recovery Actually Looks Like
Weeks one to four. Loading starts, and it often doesn’t feel like much is changing. Morning pain is usually the last thing to shift, so don’t judge progress on your first few steps out of bed.
Months one to three. This is where most people notice real change. The first step in the morning gets shorter and less sharp, and the end of day ache eases.
Months three to six. Getting back to full loading, and continuing the strength work past the point where it stops hurting. This is where people stop and where it comes back.
Three to six months is the honest timeframe. Anyone telling you two weeks is either treating something else or hasn’t been counting.
What to Tell Us When You Book
Most heel pain is plantar fasciitis and most of it follows the same pattern. A few things aren’t, and they don’t respond to the same plan, so it’s worth telling us at the time of booking if any of these fit.
Tell us if it started suddenly, with a snap or a pop rather than building up over weeks. That raises the possibility of a tear rather than a gradual overload, and it changes the first few weeks.
Tell us if there’s numbness, pins and needles or burning in the foot. That points at a nerve rather than the fascia, and chasing it as fasciitis wastes months.
Tell us if it gets worse with every step rather than warming up over the first ten minutes, particularly if you run and you’ve recently put the distance up. That pattern can mean a bone stress injury, which needs less loading rather than more.
Tell us if there’s night pain unrelated to activity, unexplained weight loss, or a history of cancer. Uncommon, but we’d rather know at the start.
The one thing that isn’t a booking, it’s an emergency department: a heel or foot that’s hot, swollen and red with a fever.
What Else It Could Be
The pattern on this page is sharp pain under the heel, worst on the first few steps in the morning, easing after ten minutes, back again at the end of the day. That is plantar fasciitis, and it’s the great majority of heel pain. If yours doesn’t fit that pattern, one of these is more likely.
Fat pad irritation. Pain more in the middle of the heel, more like a bruise than a sharp pull, worse on hard surfaces and barefoot. Treated differently and often mistaken for fasciitis.
Bone stress injury of the heel. Pain that gets worse with every step rather than warming up, often in a runner who’s increased load. Needs offloading rather than more loading.
Nerve related heel pain. Burning, numbness or pins and needles rather than sharp mechanical pain. Points somewhere else entirely.
Achilles related pain. Behind the heel rather than underneath it. Different structure, different plan.
If what you’ve got doesn’t fit the classic pattern, telling us at the first appointment is more use than an ultrasound.
Related pages: Achilles Tendinopathy, Shin Splints.
Frequently Asked Questions
How long will this take? Three to six months is the honest answer, and it's why people give up. If someone has told you two weeks, they were being kind rather than accurate. It does resolve, and when it's done properly it tends to stay resolved.
Why is it worst first thing in the morning? Overnight the foot sits still and slightly pointed, the fascia settles short, and fluid builds up around irritated tissue. The first few steps load a heel that's swollen and cold, which is why they're the sharpest of the day and why it eases once you've moved and the swelling disperses. It's the most characteristic feature of the condition and usually the last thing to improve, so don't use it as your only measure of progress. End of day ache and how far you can walk usually shift well before the morning does.
Should I get a cortisone injection? It'll give you short term relief and it won't change where you end up. If you've had one and it's worn off, that's the expected pattern rather than bad luck. We'd rather put the same months into loading.
Do I need orthotics? Sometimes they help, particularly alongside a strength program, but on their own they rarely resolve it. This isn't a problem with your arch, which is what most people are told. It's a problem with what the tissue can tolerate.
Is the heel spur causing it? No, though it isn't nothing either. Spurs turn up in plenty of feet with no pain at all, so a spur on its own doesn't explain a sore heel. Where they do show up is in heels that have been irritated for a long time. The spur is a feature of a fascia that's been under strain for years rather than the reason it started, and once it's there it can add to the irritation. Removing it doesn't reliably fix anything, and the loading work is the same either way.
Do I need a referral to book? No. You can book directly with any of our chiropractors or physiotherapists. If you've got a GP care plan or you're claiming through a fund, bring the paperwork and we'll work with it.
Who Treats This at Strive
Heel pain is treated at both clinics by our physiotherapists and chiropractors. Because the treatment is a loading program rather than a series of appointments, most of the work happens between visits and the sessions exist to progress it.
Tammy Ong
Women’s Health Physiotherapist
Rehabilitation Pilates Instructor
Tammy helps women and active individuals recover from injury, improve movement, and return to the activities they love.
Warren Zhou
Chiropractor, competitive powerlifter, and trail runner who treats athletes from the gym floor to the platform to the start line.
Tegan Webster
Chiropractor
Providing evidence-based care to help patients achieve their health goals.
Richard Kan
Sports Chiropractor
Strength and Conditioning Coach
Helping athletes and active individuals recover, perform, and stay injury-free.
Rawan Haydar
Physiotherapist
Passionate about personalised care that supports recovery and long-term wellbeing.
Jess Larder
Physiotherapist
Passionate about rehabilitation, movement, and helping people achieve their goals.
Getting Here
We treat plantar fasciitis and heel pain at both our Norwest and Dural clinics.
Norwest
301/10 Century Circuit NORWEST NSW 2153
Inside Norwest Central Building Complex - 8 - 12 Century Circuit
Entry doors next to Zaatar and Zucchero Cafe
Operating Hours
Mon - Fri 8am - 6pm
Sat 8am - 12pm
Sun CLOSED
Ready to Sort Your Heel Pain Out?
We treat plantar fasciitis and heel pain for patients from across The Hills, including Dural, Round Corner, Kenthurst, Glenhaven, Castle Hill, Kellyville, Baulkham Hills, Cherrybrook and Bella Vista, at our Norwest and Dural clinics, and in Canberra at Giralang. Book online or call and we will get you assessed.