Common causes include sudden increases in activity (new running programme, long days on your feet), tight calf muscles, flat feet or very high arches, unsupportive footwear, standing on hard floors for long periods and being overweight. Most cases are a combination of two or three of these factors loading the fascia beyond what it can recover from.

The hallmark symptom is sharp pain in the bottom of the heel that's at its worst on your first steps in the morning or after sitting still for a while. The pain often eases after a few minutes of walking but returns later in the day, particularly after standing or walking for long periods. Some people also feel tightness or aching along the arch.

Your podiatrist diagnoses plantar fasciitis through a clinical examination. We take a detailed history of your symptoms, look at how you stand and walk, palpate the heel and arch to identify the pain pattern and assess your calf flexibility and foot biomechanics. In most cases imaging is not needed to make the diagnosis.

We combine the treatments shown to work best for plantar fasciitis:

• Shockwave therapy to stimulate healing in the plantar fascia
• Custom orthotics to offload the painful area and correct any biomechanical issues
• Manual therapy and targeted stretching for the calves and plantar fascia
• Footwear advice and activity modification
• A clear at-home rehab programme

The specific mix is tailored to your case at your first appointment.

Most patients begin to feel improvement within 3 to 6 weeks of starting treatment. A typical programme involves 4 to 6 sessions spaced a couple of weeks apart, plus ongoing self-care between sessions. Chronic cases that have been around for many months can take longer. Your podiatrist will give you a realistic timeline at your first appointment.

Usually no. Plantar fasciitis is diagnosed clinically and most patients get better without ever needing imaging. We may recommend an ultrasound scan if your symptoms are unusual or if you're not responding to treatment as expected. X-rays are useful only if we suspect a stress fracture or significant heel spur.

The main aggravating factors are: walking barefoot on hard floors first thing in the morning, wearing unsupportive shoes (flip flops, ballet flats, worn-out trainers), sudden increases in activity, long periods of standing without breaks and ignoring the early signs by trying to push through. Tight calves left untreated can also keep the problem going.

Several things help most patients:

• Stretch your calves and plantar fascia daily, especially before getting out of bed
• Roll the bottom of your foot over a frozen water bottle for 10 to 15 minutes after activity
• Wear supportive shoes around the house, not bare feet on hard floors
• Avoid walking long distances in unsupportive footwear
• Reduce high-impact activity temporarily while the fascia heals

Yes, it can. Around 1 in 4 people who have had plantar fasciitis will get it again, usually when the same risk factors return (increased activity, change of footwear, weight gain, tight calves). The good news is that once you know what triggered it for you, you can usually prevent recurrence with a few simple ongoing habits. We'll cover this at your treatment review.

Plantar fasciitis is not dangerous and doesn't damage the foot long-term. However, untreated plantar fasciitis can persist for months or even years and can change how you walk, which sometimes leads to knee, hip or back problems. Seek treatment early rather than trying to push through. If you have heel pain accompanied by numbness, severe swelling, fever or pain that's worse at night, see your GP to rule out other causes.

Most patients notice some improvement within 2 to 4 weeks of starting treatment, with significant improvement by 6 to 8 weeks. The morning pain usually eases first. Full recovery (back to running or long walks pain-free) typically takes 8 to 12 weeks. Chronic cases that have been around for many months can take longer but still respond well to the right treatment combination.