Why Does My Heel Hurt?
Understanding the Root Causes of Plantar Fasciitis—and How Treating the Whole Body Can Help
If you’ve ever stepped out of bed and felt a sharp pain in your heel, especially with those first few steps, you may be experiencing plantar fascia pain, often labeled as plantar fasciitis. While this condition is common, especially among active people and those who spend long hours on their feet, the reasons it develops are often more complex than they seem at first glance.
What Is the Plantar Fascia?
The plantar fascia is a strong, fibrous band of connective tissue that runs from your heel to the base of your toes. It supports the arch of your foot and helps manage the forces involved in walking, standing, and movement. When this tissue becomes overstressed, painful symptoms can develop—typically along the inside of the arch and the front of the heel.
Although the term “plantar fasciitis” implies inflammation, recent research shows that most cases are actually driven by degeneration, not swelling. Over time, the tissue becomes weakened and disorganized, and blood flow to the area may be reduced. Some experts now prefer the terms plantar fasciosis or plantar fascia pain to reflect this more accurate understanding.
What Does It Feel Like?
A sharp or stabbing pain with the first steps in the morning or after sitting
Tenderness near the front of the heel and along the arch
A slow, gradual onset that doesn’t always follow a specific injury
Pain that sometimes becomes chronic if underlying factors aren’t addressed
Why Does It Happen?
There’s rarely a single cause. Instead, plantar fascia pain usually arises from a combination of tissue stress, structural imbalances, and reduced healing capacity.
Mechanical Stress and Foot Function
Certain foot shapes or movement patterns can make the fascia more vulnerable. Flat feet or collapsing arches may overstretch the tissue, while high arches can lead to concentrated pressure on the heel and forefoot. Limited ankle flexibility—often due to tight calves or past injuries—can increase strain during walking. Hard floors, unsupportive shoes, and prolonged standing can make the problem worse.
Whole-Body Tension Patterns
The plantar fascia doesn’t operate in isolation. It is part of a long connective tissue system that links the foot to the calf, hamstrings, pelvis, spine, and even the ribcage and head. Tension or dysfunction anywhere in this chain can shift excess load to the fascia. A rotated pelvis, restricted ribcage, or poor circulation in the leg may all contribute to why the pain starts—or why it won’t go away.
Standard Approaches to Treatment
Conventional treatments often focus on the local tissue. These may include:
Stretching the calf muscles and plantar fascia
Using night splints to prevent tissue tightening overnight
Custom orthotics to support the arch or reduce tension during walking
Deep tissue massage or scraping tools to loosen the fascia
Physical therapy exercises to build strength and mobility
While these methods can help reduce symptoms, they don’t always resolve the root causes—especially when the issue has become chronic or is part of a broader body pattern.
How Fascial Counterstrain Takes a Different Approach
By the time pain reaches your awareness, it often means that multiple layers of tissue and reflex patterns are involved. Fascial Counterstrain is a gentle, hands-on technique that helps uncover and treat the deeper sources of strain—not just in the foot, but throughout the body.
A Counterstrain evaluation looks beyond the plantar fascia itself. It includes:
Fascia and ligament restrictions in the foot and ankle
Subtle torsions or bony tensions in the heel and arch
Imbalances in muscle chains that link the lower body to the spine and ribcage
Impaired lymphatic or venous drainage that may be slowing healing
Autonomic reflexes that may be keeping the body in a protective holding pattern
Treatment involves gently positioning the body or guiding specific structures to ease these reflexes. This allows tissues to soften, circulation to improve, and irritated nerves to quiet down. Many people notice immediate relief with walking or standing after treatment. For chronic cases, the healing process may take time as tissues remodel and regain full strength—but the progress tends to be steady and lasting.
Plantar fascia pain is rarely just a problem in the foot. It’s often a sign that the body’s larger tension and support systems are out of balance. By working with the body as a whole—rather than just treating the site of pain—longer-lasting relief and real recovery become much more possible.