If your heel pain seems to get worse just as the weather improves, it’s not a coincidence. Every summer here at Sundial we see a rise in patients coming in with sharp, stabbing heel pain that often started, or got noticeably worse, once flip-flops came out and the daily step count went up.
Longer days on the seafront, holidays that involve far more walking than usual and a switch from supportive trainers to sandals all put extra strain on a small band of tissue under the foot that most people never think about until it starts to hurt. The good news is that plantar fasciitis is well understood, usually responds well to simple changes and rarely needs anything drastic to resolve.
In this article, we will explain what is actually happening in the foot, why summer habits make it worse, the self-help steps worth trying first and the warning signs that mean it is time to get it looked at. An assessment at Sundial Clinics can help you get back to walking the seafront, playing golf or running without wincing at every step.
What Is Plantar Fasciitis?
Understanding the Plantar Fascia
The plantar fascia is a thick, flat band of connective tissue that runs along the sole of the foot, from the heel to the base of the toes. It acts a bit like a bowstring, supporting the arch and absorbing shock every time your foot hits the ground. It is designed to cope with a huge amount of repeated loading, but like any tissue, it has its limits.
How Plantar Fasciitis Develops
Plantar fasciitis develops when the fascia is repeatedly overloaded, faster than it can adapt and recover. Small amounts of strain build up around the point where the fascia attaches to the heel bone, leading to irritation, stiffness and the characteristic sharp pain many people describe as feeling like standing on a stone or a drawing pin first thing in the morning. It is one of the most common causes of heel pain, affecting around one in ten people at some point in their lives. It is most common between the ages of 40 and 60.
Why Heel Pain Can Be Worse in Summer
- Wearing Less Supportive Footwear: flip-flops, unstructured sandals and barefoot walking around the house or garden all remove the arch support and cushioning that trainers or supportive shoes normally provide. Without that support, the plantar fascia has to work harder with every step, which can be enough to tip an otherwise manageable foot into a painful one.
- Increased Activity Levels: summer tends to mean more walking. Holidays, sightseeing, festivals and simply spending more time outdoors all add up to a much higher daily step count than the rest of the year. A sudden jump in activity, particularly without a corresponding increase in footwear support or recovery time, is a classic trigger for plantar fasciitis. Research into risk factors for the condition has found that people who spend most of their working day on their feet have a significantly higher risk of developing it than those who do not. A matched case-control study of risk factors found that people who spent the majority of their workday weight-bearing had a meaningfully increased risk of plantar fasciitis, alongside reduced ankle flexibility and higher body weight.
- Walking on Hard Surfaces: beach promenades, seafront pavements, pebbly shores and sun-baked patios are all firmer and less forgiving than the indoor surfaces most feet are used to. Hard, flat surfaces increase the load transmitted straight through the heel with every step, which can aggravate an already sensitive plantar fascia.
- Changes to Your Daily Routine: holidays and family visits often mean far more time spent standing and walking than during a typical working week at home, especially for those who normally work from a desk. The combination of a less active baseline routine for most of the year, followed by a sudden surge of standing and walking in summer, is often exactly the pattern that brings plantar fasciitis on.
Common Symptoms of Plantar Fasciitis
- Pain with the first steps in the morning: a sharp, stabbing pain in the heel as soon as weight is put on the foot after getting out of bed, which is one of the most recognisable features of the condition.
- Heel pain after rest: the same sharp pain returning after sitting for a while, for example after a long car journey or a rest on a bench during a walk.
- Pain after prolonged standing or walking: a dull ache that builds up later in the day, particularly after long periods on your feet, such as a day of sightseeing or standing at a barbecue.
- Tenderness around the heel: the area just in front of the heel bone, on the sole of the foot, is often tender to firm touch or pressure.
Who Is Most at Risk?
- Runners and Walkers. Anyone who covers a lot of distance on foot, whether training for a run or simply enjoying long coastal walks, places repeated load through the plantar fascia and is more susceptible if that load increases quickly.
- People Who Spend Long Hours Standing. Retail, hospitality, teaching and trades all involve long periods on your feet, often on hard flooring, which increases cumulative strain on the fascia over time.
- Those with Flat Feet or High Arches. Both very flat and very high-arched feet change how load is distributed across the plantar fascia, which can make it more vulnerable to irritation.
- People Carrying Extra Weight Body weight has a direct relationship with load through the feet with every step. A landmark case-control study found that individuals with a body mass index over 30 had a substantially higher risk of developing plantar fasciitis compared with those with a lower BMI, and a later systematic review and meta-analysis confirmed that a higher body mass index was the strongest and most consistent clinical risk factor identified across the available research, particularly in people who were not athletes. This is simply useful information to understand risk, not a suggestion that weight is the only or main cause for any individual reader.
What You Can Do at Home
Choose Supportive Footwear
Swap flip-flops and unstructured sandals for shoes with a firm sole, a supportive footbed and a slight heel cushion, even around the house and garden.
This is one of the simplest and most effective changes most people can make.
Whilst most flip-flops are unsupportive and often aggravate plantar fasciitis,
one brand has shown its flip-flops can help.
Archies flip-flops have a supportive arch support, soft heel cushion and a toe bar to help them stay on. We recommend them.
Stretch Your Calves and Plantar Fascia.
Gentle stretching of the calf and the plantar fascia itself is one of the best-supported self-help measures available. A well-known trial of patients with long-standing plantar fasciitis found that people given instructions for a plantar fascia-specific stretching protocol showed substantially better outcomes than those given a standard Achilles tendon-stretching protocol, when followed for three times a day, with the first stretch performed before taking the first steps of the morning. At two-year follow-up, the improvements were largely maintained, though it is worth being realistic that full resolution for chronic cases often takes several months of consistent effort rather than a quick fix.
- Try this simple plantar fascia stretch, ideally seated on the edge of the bed before you stand up in the morning:
- Cross the affected foot over the opposite knee.
- Hold the base of the toes and gently pull them back towards the shin until you feel a stretch along the arch of the foot.
- Hold for 10 seconds and repeat 10 times.
- Follow with a simple calf stretch against a wall or step, holding for 20 to 30 seconds on each side.
Gradually Increase Activity.
If you know a big walking day is coming, whether a seafront stroll, a round of golf, or a day exploring, build up your usual activity level gradually over the preceding weeks rather than suddenly increasing your step count on the day itself.
Apply Ice After Activity.
A simple ice pack or rolling a cold water bottle under the sole of the foot for 10 to 15 minutes after activity, can help settle discomfort, particularly after a long day on your feet.
Avoid Walking Barefoot on Hard Floors.
Tiled kitchens, conservatories and stone patio floors offer no cushioning at all. Keeping a supportive pair of shoes on around the house during a flare-up can make a noticeable difference.
When Should You Seek Professional Help?
Most cases of plantar fasciitis improve with the self-help measures above, given time. However, it is sensible to seek a professional assessment if you notice:
- Persistent heel pain that has lasted more than two to three weeks despite trying supportive footwear, stretching, and reduced barefoot walking
- Pain that limits daily activities, such as struggling to walk the dog or get through a working day on your feet
- Symptoms that do not improve with self-care or that seem to be getting gradually worse rather than settling
- Sudden, severe heel pain following a specific incident, such as a jump or a fall, which could suggest a different injury and warrants medical assessment rather than self-treatment
The Importance of an Accurate Diagnosis
Most heel pain is plantar fasciitis, but not all of it is. Heel pain can also arise from a stress fracture, nerve irritation, fat pad changes or referred pain from elsewhere, and these need a different approach entirely. Getting an accurate diagnosis before starting a treatment plan means you are not guessing so any advice you are given actually fits what is going on in your foot.
How Physiotherapy Can Help
- Assessment and Diagnosis: a thorough assessment looks at your walking pattern, footwear, activity history and the specific location and behaviour of your pain to confirm plantar fasciitis and rule out other causes of heel pain.
- Personalised Exercise Programme: rather than a generic handout, a tailored programme takes into account your current fitness, your goals (whether that is getting back to running, gardening or simply walking pain-free) and how your foot responds as you progress.
- Strengthening and Mobility Exercises: alongside stretching, calf and foot strengthening exercises help the fascia and surrounding structures cope better with load over time, reducing the likelihood of the problem recurring.
- Advice on Footwear and Activity Modification: practical, specific guidance on footwear choices and how to structure your activity, particularly useful before a holiday or a change in routine, such as starting a new walking habit. Here at Sundial we sell Superfeet supportive insoles and our practitioners can advise you on the best type and fit.
A 2021 best practice guide, drawn from a systematic review of the evidence alongside expert clinical reasoning, concluded that management of plantar heel pain should be built around patient education, load management and targeted exercise as the foundation of care, with other interventions considered only if this initial approach is not sufficient. This reflects exactly the approach taken at Sundial Clinics: understand what is driving your particular symptoms, start with the simplest effective measures and only consider anything more involved if it is genuinely needed.
Preventing Future Flare-Ups
Summer Foot Care Tips
- Pack supportive shoes for holidays. However tempting it is to live in sandals on a trip away, packing at least one pair of supportive, cushioned shoes for longer walking days is one of the simplest ways to avoid a flare-up ruining a holiday.
- Warm up before long walks. A few minutes of calf and foot stretching before a long day of sightseeing or a coastal walk helps prepare the fascia for the load ahead.
- Take regular breaks during sightseeing. Building in short seated breaks during a long day on your feet reduces cumulative strain.
- Replace worn-out trainers. Trainers lose their cushioning and support over time, often well before they look worn out on the outside. If your regular walking shoes are more than a year or two old, or have done significant mileage, it may be worth replacing them.
Frequently Asked Questions
Is plantar fasciitis permanent? No. The great majority of people make a full recovery with appropriate self-care and, where needed, professional guidance, though it can take time and does need consistent effort rather than a single quick fix.
Can I still exercise with plantar fasciitis? Often yes, though it usually needs adjusting rather than stopping altogether. Low-impact activities such as swimming or cycling are generally well tolerated. Our physiotherapists can advise on how and when to keep up your usual activities, including walking and running, as symptoms allow.
Are flip-flops bad for plantar fasciitis? Flip-flops and other unstructured, flat sandals offer very little arch support or cushioning, which can aggravate symptoms in people who are already prone to plantar fasciitis or currently experiencing it. They are not inherently harmful for everyone, but they are worth avoiding during a flare-up or if you are at higher risk.
How long does recovery usually take? Timelines vary, but many people see a good improvement within a matter of weeks to a few months of consistent stretching, footwear changes, and activity management. More established, longer-standing cases can take longer, often several months, which is why an accurate early assessment and a realistic plan matter.
Key Takeaways
Heel pain that flares up in summer is common, understandable given the change in footwear and activity, and usually very manageable. Simple changes such as more supportive shoes, targeted stretching, and a gradual approach to increased activity resolve most cases in time.
Do not ignore heel pain that persists, worsens or is starting to limit the things you enjoy about summer. If your symptoms are not settling or you would simply like a clear picture of what is going on and a sensible plan going forward, the team at Sundial Clinics is here to help with a thorough assessment and honest advice about what will help most.
Sources
- DiGiovanni BF, Nawoczenski DA, Malay DP, et al. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis: a prospective clinical trial with two-year follow-up. J Bone Joint Surg Am. 2006;88(8):1775-1781.
- Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg Am. 2003;85(5):872-877.
- Van Leeuwen KDB, et al. (systematic review and meta-analysis) Higher body mass index is associated with plantar fasciopathy/”plantar fasciitis”: systematic review and meta-analysis.
- Morrissey D, Cotchett M, Said J’Bari A, et al. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. Br J Sports Med. 2021;55(19):1106-1118.
About Matthew Bennett, Chiropractor Brighton
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics Brighton, established in 1991. With over 35 years of clinical experience, Matthew qualified from the Anglo-European College of Chiropractic in 1987 and served as President of the British Chiropractic Association for four years. As a Fellow of the Royal College of Chiropractors and former team chiropractor for Brighton and Hove Albion FC and the British Alpine Ski Team, Matthew combines evidence-based chiropractic treatment with sports performance expertise. His authority in musculoskeletal health has been recognised through national media appearances, expert witness roles and contributions to professional publications. Matthew’s commitment to clinical excellence ensures patients receive the most effective chiropractic care in Brighton.