Plantar Fasciitis & Heel Pain | North Vancouver

Usually no. Cortisone can settle pain short-term but doesn't change the underlying tissue, and repeated injections can weaken the fascia. We reserve injection referrals for stubborn cases that haven't responded to conservative care such as heavy slow calf loading, manual therapy, and shockwave, since those address the calf, foot mechanics, and fascia together rather than masking pain alone.

Not necessarily. Some people benefit long-term, others use them as a bridge while the tissue heals and then phase them out. Orthotics help when foot mechanics are overloading the inside of the heel, but they are one piece alongside calf loading and manual therapy, not the whole plan. We're happy to fit you with them if they're indicated, and equally happy to say so if they're not.

Usually yes, at reduced volume and on a smarter schedule. Complete rest often makes plantar fasciitis worse, not better, since the fascia and calf both need controlled load to adapt. We'll set running parameters and pair them with footwear and load-management coaching that let the tissue calm down without de-conditioning you.

It helps for a few minutes, then wears off. Pain modulation, not tissue healing. Heavy slow calf loading is the exercise approach with the strongest long-term evidence for this recovery, and that loading work is what actually changes the underlying tissue over weeks. Roll the bottle if it feels good between sessions, but don't expect it to be the whole answer.

That morning stabbing pain is the classic pattern of plantar fasciitis, easing as you walk and then often returning later in the day after standing or training. It happens because the tissue under the heel is usually degenerative rather than actively inflamed, which is also why anti-inflammatories only help for a few days before the effect wears off.

Plantar fasciitis is rarely one thing. It's usually a combination of a calf that doesn't lengthen well under load, foot mechanics that overload the inside of the heel, and a fascia that's stopped tolerating its normal job. That's why treatment addresses the calf and ankle with manual therapy alongside the fascia itself, not the heel in isolation.

Acute plantar fasciitis often settles inside 4 to 6 weeks with the right loading program. Chronic cases, meaning pain that has lasted over 6 months, usually need 3 to 5 shockwave sessions added on top, but most people still see meaningful improvement inside 8 weeks. Heavy slow calf loading is the exercise approach with the strongest long-term evidence for this recovery.