Heel Pain & Plantar Fasciitis · Podiatry on the Gold Coast
Heel pain that won’t budge with stretching or rest.
Plantar fasciitis is the most common cause — but not the only one. Eighty per cent of cases settle inside three months with the right plan. We start with the right diagnosis, not a generic stretching handout.
Heel pain isn’t one thing.
Most people who walk in with sore heels assume it’s plantar fasciitis. About two-thirds of the time, they’re right. But the other third has a different cause — and treating plantar fasciitis when it’s actually insertional Achilles tendinopathy, a fat-pad bruise, a stress fracture, or nerve entrapment won’t go anywhere.
The first job is identifying which tissue is actually angry. That’s palpation, gait assessment, sometimes imaging, and the specific pattern of when and where it hurts. From there the treatment plan is built backwards from the diagnosis — not assumed from the location.
A “heel spur” on X-ray is rarely the cause — lots of pain-free heels have spurs. The pain comes from the soft tissue around it, not the bony bump itself.
What might be causing it
Six common causes of heel pain.
Same painful heel, six very different diagnoses. The treatment plan only works once we know which one you actually have.
01
Plantar fasciitis
First-step pain in the morning, eases as you warm up, then worsens again by evening. Classic plantar fasciitis. Settles with the right combination of load management, calf and fascia work, taping, and often orthotics. Shockwave for the stubborn cases.
02
Insertional Achilles tendinopathy
Pain at the back of the heel where the Achilles attaches. Hurts walking up stairs, jumping, or pushing off. Different tissue, different program — calf eccentrics, heel-raise modification, sometimes shockwave.
03
Heel fat-pad pain
Aching deep in the centre of the heel, especially after long days on hard floors or in thin-soled shoes. Often missed because everyone defaults to plantar fasciitis. Treatment is heel cups, cushioning and footwear changes — not stretching.
04
Calcaneal stress fracture
Heel pain that’s been climbing for weeks in a runner or a walker who’s ramped up mileage. Hurts on impact. Needs imaging and a structured deload before anything else. Pushing through a stress fracture turns weeks of recovery into months.
05
Sever’s disease (children)
Heel pain in 8–14 year-olds during a growth spurt, especially in active kids. The growth plate at the back of the heel is irritated. Settles with activity modification and good footwear — usually resolves by the time growth slows.
06
Nerve entrapment (Baxter’s nerve)
Burning, electric or numb sensation in the heel rather than a sharp ache. Often misdiagnosed as plantar fasciitis. Different management — nerve gliding, sometimes injection or surgery for the stubborn cases.
How we work heel pain at our clinic
Diagnose. Target. Review.
01
Diagnose first.
Full history, palpation across the heel and Achilles, gait screen, and footwear review. If anything points to a stress fracture or atypical cause, we’ll send you for imaging the same day. Most cases we can diagnose in the first session.
02
A plan that targets the real cause.
For plantar fasciitis: load management, calf and fascia mobility, taping or temporary orthotics, sometimes shockwave. For Achilles: graded loading. For fat-pad pain: cushioning and footwear. Different problem, different plan.
03
Review at four to six weeks.
We expect noticeable improvement by week four. If you’re not progressing, we re-examine — either the diagnosis needs revising or the load isn’t right yet. We don’t keep doing the same thing if it isn’t working.
The honest comparison
Three approaches to heel pain.
01
Ace — targeted diagnosis and progressive plan.
We work out which heel-pain pattern you have, build a plan around that, and review whether it’s working. Most plantar fasciitis settles in three months. Stubborn cases get shockwave, which we run in-house.
02
Generic “stretch and ice” advice.
If your only management has been stretches from a YouTube video and rolling on a frozen water bottle, you’ve done the surface layer. Underneath, the loading pattern that caused the heel pain hasn’t changed.
03
Cortisone injections first.
Cortisone reduces pain in the short term but weakens the fascia and risks fat-pad atrophy with repeat use. We use it occasionally as a circuit-breaker for severe cases — not as the first or main treatment.
Is this you?
If this sounds like you, book in.
01
First steps in the morning are agony.
Classic plantar fasciitis presentation. The longer this has gone on, the longer it takes to settle — but it does settle once the right plan is in place.
02
You’ve had heel pain for more than three months.
Past the acute window. Most chronic cases need more than stretching — structured loading, taping, sometimes shockwave. Worth getting a proper diagnosis if you haven’t already.
03
It hurts to stand at work or run on weekends.
Workers on hard floors and recreational runners are the two biggest cohorts we treat. Both need a load-management plan that fits the real schedule, not a textbook one.
Questions we get asked
Common heel-pain questions.
01 How long does plantar fasciitis take to resolve?
Most cases settle inside three months with the right management. Acute cases — caught early, treated properly — can resolve in six weeks. Chronic cases (more than a year) can take six to nine months and often benefit from shockwave.
02 Do I need orthotics?
Sometimes. If your foot type or biomechanics are driving the heel pain, orthotics genuinely shift things. If they’re not, orthotics on top of soft tissue work won’t add much. We’ll tell you up front whether they’re worth it for your case.
03 Should I keep running?
Usually yes — just less. Complete rest tends to backfire (the tissue weakens, the pain comes back the moment you load it again). We typically reduce mileage, modify pace, and add specific loading work rather than stopping outright.
04 Will I need imaging?
Most heel pain doesn’t need it. We’ll send you for an ultrasound or X-ray if the picture is atypical, the pain has progressed quickly, or we suspect a stress fracture or nerve issue.
05 Does shockwave work for plantar fasciitis?
Yes — for chronic cases (three-plus months) where conservative care hasn’t fully shifted it. We run shockwave in-house and pair it with the loading work that’s already in progress. See our shockwave page for the full picture.
06 Is it covered by private health?
Yes — podiatry consults and any orthotics are claimable under your podiatry extras. We HICAPS on the spot with every major fund.
HICAPS on the spot with every major fund — plus DVA, NDIS & WorkCover.
Get the diagnosis right. Then fix it.
