How do I tell if my heel/arch pain is Plantar Fasciitis or something else?

I just started having some pain in my arch area, back towards the heel on my left foot about 2 weeks ago. It happened to come on during a tempo run in a shoe that was "running out" of mileage. I have zero idea if the problem is shoe related or not, but when I look up the symptoms of Plantar Fasciitis, what I have seems a little different.

1) Most information out there says that PF seems to "loosen up" and the pain goes away on a run. My pain stays with me the entire run, and sometimes gets worse the longer I go.

2) Some information says that the person typically gets a very sharp shooting pain upon waking up in the morning, that then eases up as the foot muscles move around and loosen up.  I don't have shooting pain, and it seems to vary from day to day how sore it is in the morning.

A few things that I do know right now:
1) It seems to be more sore on the days after I run vs taking a rest day
2) There is a small "lump" in the arch back towards the heel that sticks out a little bit, which is definitely tender to the touch
3) Icing seems to help, but a lot of times only temporarily
4) My shoes are all neutral style shoes, so my only option for adding some support is to buy some insoles. I am planning to look at some Superfeet, but have not had a chance to try them on locally yet to get the right type & size
5) The foot will be sore to varying degrees all throughout the day. I work in an office job where I sit most of the day, but get up and walk around for a lot of tasks throughout the day.
6) If I do a calf stretch on the sore foot, I can definitely feel it pulling/hurting/stretching the sore arch.
7) I rolled out my calves this morning with a foam roller and did not find any tender spots.



  • Doesn't sound like PF if there is a noticeable tender "lump." When I had PF it was always worse in the morning and pain would lessen as I loosened up. Pain usually directly under heel, sometimes radiating up the inner side of the heel. Never any swelling or lump.

    Maybe you strained something in the arch on that run?
  • It still can be plantar fasciitis, but  just an atypical one.
    My best guess is that the small lump is a trigger point ... Google 'trigger point treatment'
  • Depending on where exactly the pain is (is it more in the heel or just in front of the heel? Or is it more in the midfoot/arch?) it could be any of several things. I agree with Pete that it doesn't sound like PF based on the behaviour of your symptoms. As a physio and runner, my first thought would be a insertional tibialis posterior tendinopathy although fat pad irritation and potentially navicular/calcaneal stress reaction could be considered.  

    My recommendation would be (if it hasn't been improving) to see a physiotherapist/physical therapist with an interest or extra training in running biomechanics and injuries
  • I forgot to follow up on this post after seeing my sports doctor about a week ago. He took xrays and checked me over and said it is a type of PF. He said it is a bit confusing since it does't really present itself as "typical" PF, but it is PF nonetheless.  He gave me some calf stretching exercises & also some foot strengthening work. My main concern was whether or not I would be able to continue with high volume training for my 50K, and he said I would be fine as long as it doesn't get worse.  He also recommended that I try a "plantar fascia sleeve" which I ordered from running warehouse and should be arriving today.  On the high side, I was able to do 24 miles on some pretty tough trails this past Saturday and the PF was totally tolerable. I even gambled and ran in my (very low cushioned) Merrell Mix Master 2s, and the foot seemed "ok".  Thanks for all the help and advice everyone!
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