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Plantar fasciitis is one of the most common, yet most stubborn, musculoskeletal conditions we treat. It is characterised by a sharp, stabbing pain in the heel or the arch of the foot. The pain is typically at its worst during the first few steps in the morning or after sitting for a long period. It feels like walking on broken glass or a hot poker.
For many sufferers, this condition becomes a chronic nightmare that lasts for months or even years. You may have tried the frozen water bottles, the night splints, the expensive custom insoles, and the endless calf stretches. You may have even had a steroid injection that provided temporary relief, only for the pain to return with a vengeance.
At Breakthrough Pain & Performance, we approach heel pain differently. We understand that while the pain is in the foot, the cause is rarely just a tight band of tissue. It is often a complex interplay between nerve entrapment, poor foot mechanics, and a brain that has forgotten how to stabilise the arch. By treating the neurology of the foot, we can resolve even the most stubborn cases of “plantar fasciitis.”
A significant percentage of people diagnosed with Plantar Fasciitis do not have inflammation of the fascia at all. They have Baxter’s Neuritis.
Baxter’s nerve is the first branch of the lateral plantar nerve. It runs directly beneath the heel bone, sandwiched between the heavy muscles of the foot and the hard bone. If the muscles of the foot or calf are tight due to neurological guarding, they can strangle this nerve.
The symptoms are almost identical to fasciitis: heel pain. However, the treatment is completely different. If you have nerve entrapment, stretching the fascia (pulling the toes back) actually stretches the nerve. Nerves hate being stretched. This explains why so many people do their prescribed stretches and get worse.
We differentiate between the two conditions using specific neurological tension tests. If it is the nerve, we use Neural Flossing techniques to glide the nerve freely through the tunnel. We release the muscular compression using P-DTR (Proprioceptive – Deep Tendon Reflex). By freeing the nerve, the “heel pain” often vanishes instantly, revealing that the fascia was never the problem.
The Plantar Fascia is not just a passive rope. It is part of a dynamic system called the Windlass Mechanism. When your big toe bends back (dorsiflexes) as you push off to walk, it pulls the fascia tight. This raises the arch of the foot, turning it from a flexible shock absorber into a rigid lever for propulsion.
In many patients, this mechanism is broken. Often, the big toe joint is stiff (Hallux Limitus). Or, the brain has inhibited the muscles that control the toe.
If the Windlass Mechanism fails, the foot remains floppy and unstable during push-off. This places immense strain on the fascia insertion point at the heel. It is like trying to tow a car with a bungee cord instead of a steel cable.
We treat the mechanism. We mobilise the big toe joint. We wake up the Flexor Hallucis Longus muscle. By restoring the timing of the Windlass Mechanism, we allow the fascia to function correctly, removing the strain that causes the pain.
Your foot is designed to be a sensory organ. It has thousands of nerve endings that tell the brain about the texture, slope, and hardness of the ground.
Modern footwear acts as a sensory deprivation chamber. Thick, cushioned soles block this information. When the brain cannot “feel” the ground, it panics. It stiffens the foot and calf muscles to create artificial stability. It is like walking on ice; you stiffen up to avoid slipping.
This chronic rigidity prevents the foot from absorbing shock naturally. The impact forces travel straight into the heel bone and fascia. We use Sensory Integration training. We use textured surfaces (like spikey balls or mats) and vibration to wake up the dormant sensors in the sole. By restoring the “sight” of the foot, the brain allows the muscles to relax, restoring natural shock absorption.
Sometimes, heel pain has nothing to do with the foot. The S1 nerve root in your lower back supplies the sensation to the heel and the bottom of the foot.
If you have a stiff lower back or a minor disc bulge at L5/S1, it can irritate this nerve root. This irritation sends pain signals down the nerve that the brain interprets as coming from the heel. This is Referred Pain.
You might have zero back pain, but your heel hurts. We trace the nerve all the way up. If we find that mobilising your lower back reduces your heel pain, we know the driver is spinal. Treating the foot in this case would be useless. We treat the spine to fix the foot.
Orthotics (insoles) can be helpful in the short term to offload painful tissue. However, long-term use can weaken the foot. They act as a crutch. If you prop up the arch artificially, the muscles that should support the arch (Posterior Tibialis, foot intrinsics) go to sleep.
The brain learns that it does not need to stabilise the foot because the plastic support is doing it. When you take the insole out, the pain returns immediately.
Our goal is to build a foot that is strong enough to support itself. We use neurological strengthening to wake up the arch muscles. We wean you off the supports as your intrinsic strength improves. We want you to have functional, resilient feet, not feet that depend on equipment.
1. The Diagnosis: Is it the fascia, the nerve, or the spine? We find out.
2. The Release: We use P-DTR to switch off the protective spasms in the calf and foot.
3. The Mobilisation: We restore range of motion to the big toe and ankle.
4. The Strengthening: We build the “foot core.” We teach you exercises like “short foot” to build a natural arch.
This clinic is for you if:
We get to the root of the problem so you can walk freely again.
