Here, Shane Brennan, our foot and ankle specialist physiotherapist, describes a recent case where he supported a patient through the successful resolution of persistent heel pain.
Client Bio
Patient Z is a 63 year old female retiring farmer who enjoys walking for exercise.
Background
Patient Z first presented to the foot and ankle clinic in late January 2025 with heel pain that had been present for several months. Her pain was particularly severe first thing in the morning and eased slightly with movement as the day progressed.
She reported difficulty walking barefoot and found it uncomfortable to walk in her wellington boots, which was having a noticeable impact on her daily activity levels.
The Challenge
On assessment, Patient Z was tender on palpation both at the back of the heel and underneath the heel. She demonstrated stiffness and weakness at the ankle, along with reduced single-leg balance on the affected side.
Contributing factors included reduced flexibility in the hamstring muscles and stiffness through the lumbar spine, both of which can influence lower limb loading and heel pain.
The Solution
Based on her assessment findings, I diagnosed plantar fasciitis.
Initial treatment focused on a combination of shockwave therapy, targeted strengthening, and exercises to improve ankle range of movement.
Shockwave treatment resulted in a rapid reduction in pain under the heel; however, she continued to experience some discomfort at the back of the heel. To address this, a 6mm heel raise was prescribed for use in both shoes, which resulted in a significant reduction in symptoms and improved her walking comfort.
The Results
Patient Z made steady progress with treatment. Within six weeks, her symptoms had significantly improved, and by ten weeks she had full resolution of pain.
She has since returned to walking comfortably for exercise and is able to manage daily activities without heel pain. I’m pleased to say that she has not had a recurrence of her symptoms.
Key Take-Home Points
- Heel pain often has multiple contributing factors, and effective treatment depends on addressing more than just the site of pain.
- Morning pain and pain when walking barefoot are common features of plantar fasciitis and should prompt early assessment.
- Treatments such as shockwave therapy can be very effective when combined with appropriate strengthening and mobility work.
- Simple interventions, such as temporary heel raises, can significantly reduce symptoms by altering load on the heel.
- A structured rehabilitation programme guided by a specialist physiotherapist can lead to full symptom resolution and safe return to activity.
Learn More
Visit Shaneâs website bio, or learn more about the foot and ankle clinic at Mid West Physiotherapy.
Online booking is available for this service; no doctorâs referral needed.