Heel pain is one of the top reasons people walk through our clinic doors here at Foot Focus. It’s frustrating, persistent, and often gets in the way of walking, exercising, or just going about your day comfortably.
But here’s the thing—not all heel pain is the same. In fact, there are several types, and the right approach depends entirely on what’s causing it.
So in this post, we’re breaking down the 7 most common causes of heel pain we see, and how we support each one. If you’ve been wondering why that discomfort isn’t going away, this might help you get closer to the answer.
1. Plantar Fasciitis
This one’s probably the most well-known—and the most misunderstood.
What it feels like: Sharp pain first thing in the morning or after sitting down for a while. Often eases a bit as you move but flares again later in the day.
What causes it: Irritation of the thick band of tissue (the plantar fascia) that supports your arch.
How we help: We use a combination of hands-on techniques, load management, strengthening exercises, footwear guidance, and where needed, custom orthotics. The key is identifying what’s overloading the tissue in the first place.
2. Fat Pad Atrophy or Bruising
The heel has a built-in cushion that can wear down with age or impact.
What it feels like: A dull, aching feeling in the centre of the heel—often described as walking on a pebble or bone.
What causes it: Natural ageing, repetitive impact, or hard-soled shoes without support.
How we help: Padding, insole support, and gentle offloading strategies to protect the heel during everyday movement. We also assess whether your walking or standing style is adding unnecessary stress.
3. Achilles Tendinopathy
This affects the back of the heel—specifically the tendon that connects your calf to your heel bone.
What it feels like: Stiffness in the back of the heel or ankle, especially in the morning or during/after activity.
What causes it: Overuse, tight calves, or a sudden increase in walking or running without enough strength.
How we help: We tailor a progressive loading plan (not just stretching!) that safely rebuilds the tendon’s capacity. Shockwave therapy and footwear tweaks can also be part of the plan when needed.
4. Heel Bursitis
There are small fluid-filled sacs (bursa) at the back of the heel that can become inflamed.
What it feels like: A deep, aching pain at the back of the heel, sometimes with redness or swelling.
What causes it: Repetitive friction, poor footwear, or biomechanical issues.
How we help: Reducing irritation is the priority here—so we’ll look at footwear, heel lifts, and in some cases hands-on treatment to calm the inflammation. Once things settle, we look at prevention.
5. Nerve Entrapment (e.g., Baxter’s Nerve)
Sometimes the discomfort isn’t coming from muscles or tendons at all—it’s a nerve being compressed.
What it feels like: Burning, tingling, or numbness in the heel or arch. Sometimes confused with plantar fasciitis.
What causes it: Tight tissues, inflammation, or structural issues pressing on the nerve.
How we help: A full biomechanical assessment helps us pinpoint the cause. From there, we use manual therapy, footwear advice, and soft tissue work to take pressure off the nerve.
6. Sever’s Disease (in kids and teens)
This one affects active children during growth spurts.
What it feels like: Sore, achy heels after sport or activity. Most common in kids aged 8–14.
What causes it: The growth plate in the heel gets irritated by tight muscles or repetitive activity.
How we help: We focus on gentle offloading, footwear recommendations, and advice on pacing activities—not telling them to stop moving, but helping them move better.
7. Stress Fracture
While rare, stress fractures can happen in the heel bone—especially with sudden increases in activity.
What it feels like: Deep, persistent discomfort that gets worse with impact. Often one-sided and worsens with activity.
What causes it: Repetitive overload—common in runners, military recruits, or those starting a new fitness routine.
How we help: If we suspect a fracture, we’ll arrange imaging and provide the right offloading strategy to allow healing. Once healed, we guide return to activity safely and gradually to avoid recurrence.
Why Getting the Right Diagnosis Matters
You can see from the list above—heel pain isn’t one-size-fits-all. That’s why generic advice (rest, ice, painkillers) might help short-term but rarely fixes the problem long-term.
At Foot Focus, we take the time to assess:
✔️ Your walking pattern
✔️ Footwear choices
✔️ Activity levels
✔️ Strength and movement habits
✔️ Where the discomfort actually starts (and why)
From there, we build a plan that makes sense for you. Not a cookie-cutter approach, and definitely not one that relies on just treating the symptoms.
A Quick Note About Our Workshops
If you’ve been keeping an eye on our updates, you might’ve seen we’ve been running Free Heel Pain Education Workshops at our Finglas clinic.
They’ve been a brilliant way to bring the local community together and help people understand what’s going on with their feet before things get worse.
We talk through common causes of heel discomfort, show some practical tips you can start at home, and share what really works vs. what doesn’t.
💬 The feedback has been fantastic – and yes, we’ll be running more! So if you missed out on the last one, keep an eye on our socials or ask at the clinic and we’ll let you know when the next one is happening.
Final Thoughts from Mark & Stephen
Whether it’s a dull ache that’s getting on your nerves or something sharper that’s stopping you in your tracks – you don’t have to just live with heel pain.
Understanding what’s really going on is the first step. After that, it’s about taking simple, sensible steps to feel more confident on your feet again.
We’re here to help you figure it out—no fuss, no pressure, just the right support at the right time.
If you’ve been meaning to get things checked, or you’re curious about the workshops, give us a ring or pop into the clinic. We’d love to help you take the first step (pun absolutely intended).