Plantar Fasciitis and tendonitis are two very different conditions that can be difficult to tell apart at first. Both involve acute foot pain, and both can have a big impact on your quality of life. Knowing the difference between the two can make a significant difference on your treatment, so the sooner you determine which condition you’re dealing with, the sooner you can get effective relief for your symptoms.
One of the biggest difference between Plantar Fasciitis vs. tendonitis is the location of the pain: The pain from Plantar Fasciitis is concentrated on the heel and underside of the foot, while the pain from tendonitis can manifest in many areas of the foot, depending on the type of tendonitis–except the underside of the foot. However, in the early stages of both conditions, this can be difficult to differentiate. Luckily, these two conditions differ in other ways too.
Keep reading to learn more about the differences between Plantar Fasciitis and tendonitis.
Is It Plantar Fasciitis?
When the thick tissue that connects your heel to the ball of your foot (the area responsible for your foot’s arch) becomes chronically inflamed to the point of pain, you have a condition known as Plantar Fasciitis.
Causes of Plantar Fasciitis
The primary cause of Plantar Fasciitis is unsupported or strained arches. It can be triggered or made worse by any of the following factors:
- Sudden weight gain (including weight gain from pregnancy) or chronic weight issues that put additional strain on the arches of your feet
- Long distance running, or running without proper foot support on hard or uneven surfaces
- Arches that are either high or flat
- Standing for long periods of time throughout the day
- Prolonged use of everyday footwear that doesn’t have proper arch support
Symptoms and Characteristics of Plantar Fasciitis
One of the most common telltale signs of Plantar Fasciitis is foot pain that is worst first thing in the morning (when the fascia is tight after a night of sleep) and improves somewhat throughout the day as the fascia stretches out. The following are other telltale signs of Plantar Fasciitis:
- Stiffness in the heel and aching arches
- Swelling and redness along the arch and heel
- Pain that is worse in the morning
- Symptoms improve somewhat with rest, stretching the fascia, and icing
- Sharp pain in the fascia and heel, which typically causes limping (especially in the morning)
Diagnosis
To diagnose Plantar Fasciitis, your doctor will carefully examine your heel and arch, and will probably take x-rays. If the area between your heel and the ball of your foot appears inflamed and thicker than normal, and if the x-rays reveal bone spurs (calcium deposits that develop in response to inflammation of the heel and fascia), a diagnosis of Plantar Fasciitis will likely be made.
Treatment
Treatment for Plantar Fasciitis is most effective when approached holistically to reduce inflammation and support your heels and arches:
- Regular, gentle stretching
- Regular icing of the heel and fascia
- Shoes that support the heel and fascia, and daily use of orthotics and/or Heel Seats
- Dietary changes (avoiding inflammatory foods and adding certain supplements)
- Anti-inflammatory medication to manage foot pain, including ibuprofen
Is It Tendonitis?
Unlike Plantar Fasciitis, the pain from tendonitis can be focused in several areas of the foot, depending on the type of tendonitis (the front, side, top, or back of your foot)–but not the fascia. Achilles Tendonitis, one of the most common types of tendonitis, can either come on suddenly due to an injury or develop more chronically, from improper footwear or overuse.
Causes of Tendonitis
Tendonitis can have similar causes to Plantar Fasciitis. Running without supportive footwear on hard surfaces is often a primary culprit, but tendonitis can also be brought on suddenly by an injury.
Symptoms and Characteristics of Tendonitis
If you have tendonitis, you’ll likely find that foot pain is worst at the beginning of the day, and that it ramps up in response to increasing physical activity. Also look for these symptoms:
- Pain gets worsens with increasing activity level
- Redness and swelling
- A soft, painful lump may develop at the tendon, over time
- Stiffness in foot and ankle
Diagnosis
Your doctor will do a physical exam of your foot, and may also do an MRI to determine whether any tearing or other damage has taken place to the tendons in your foot.
Treatment
Treatment for tendonitis, like Plantar Fasciitis, should focus on dealing with symptoms and addressing the cause that brought about the condition in the first place. Strengthening the muscles in the calf and foot to support the tendons, icing and rest to reduce inflammation, and anti-inflammatory pain relievers are likely to be recommended. Orthotics and supportive footwear will also improve the healing process and prevent a return of symptoms.
Whether It’s tendonitis or Plantar Fasciitis, seeking and following through with treatment as soon as possible will make all the difference in getting relief and preventing further damage. Left untreated, both conditions can have a significant impact on your quality of life.
At Heel That Pain, we’re here to help you find answers to the questions you have and get you back on your feet–without pain. If you’re currently experiencing heel or arch pain, you may find the following resources helpful as well:
Free exercises to try before you buy any treatment for foot pain
Helpful videos and home remedies for Plantar Fasciitis and tendonitis
I have had tendinitis for about eight months I did physical therapy three times a week for nine weeks I’ve been for treatments of acupuncture it is still very painful mostly when I get up in the morning when I get out of riding in the car or sitting down for a very long hurts really bad for about 10 to 15 feet of walking then the pain doesn’t get so bad after walking for a few minutes no MRI or x-rays have been taking my orthopedic doctor said it could be up to a year or two before it heals I did not do anything to it I just woke up one morning and the pain was there can you help me or give me any suggestions in anyway the doctor had me do two exercises but it put me in pain and tears I could not do them anymore
Hi Wanda
Sorry to hear you’ve been struggling with so much pain 🙁
Is it tendonitis of the foot/heel? Here are a couple of suggestions:
-seek a second opinion with a different doctor if you are unhappy with your current doctor
-ice for 15-20 minutes, at least 3 times a day
-try different stretches and see if any of them provide relief (and not pain!) You can see some of our favorite stretches here https://heelthatpain.com/home-remedies/
Hope this helps 🙂
I have all three. My feet heals and my calf’s are so painful all of the time. I’m not sleeping because of this. My calf’s are so tight I’m in agony. I have seen a specialist whom gave me orthotic insoles which I’ve had for four weeks now. I do all the exercises that is suggested It’s not getting better at all. Any idea please I’m desperate. HELP!!!!!
I have just read that certain antibiotices can cause tendinitis. Have you taken any antibiotics of the Fluoroquinolone “family”. They are often used to treat bacterial infections such as bronchitits, Pneumonia, UTI infections.
YES . . . I, too, am suffering from tendonitis in my R heel, brought on by being prescribed Ofloxin, which is an antibacterial Rx . . . side affects among older patients is potential for tendonitis in one’s heel. Extremely painful, and frankly, Phys Therapy was not at all helpful. Drs. need to be aware of this potential side effect amongst older patients.
I think I must have both..is that possible? I have all,of the symptoms for 14 months now after a severe fracture of my ankle, with the 2 ankle bones broken and dislocation. I am aged 69 and female type1diabetic.
Hi Cherie
Unfortunately it is possible to have both tendonitis and plantar fasciitis 🙁 Plantar fasciitis affects the plantar fascia ligament on the bottom of the foot, where tendonitis affects one or more of the tendons in the foot – most commonly the achilles tendon. Resting, icing, stretching, and slip-in orthotics are our top recommendations for home treatments, but if these don’t work it may be time to visit your doctor again. Hope this helps!
I have both Achilles tendonapothy and plantar fasciitis. I have had a AT since sept 2016. All conventional treatments have failed and I have now been referred for surgery. I have it in both the right and left and just want to be active again!
Good luck to anyone trying the physio, acupuncture and shock wave therapy, it didn’t work for me but maybe it will for you!
I started feelingthis pain jan 15 2018 I haven’t seen a doctr for it till june 2018 its now right on sept I feel the bone spur and when I spend more than a hours on my feet my tendons in calves kill both feet and legs will this ever go away since I let it go so long?
Can walking incorrectly from plantar fasciitis cause peroneal tendinitis?
Wanda, I think I have to disagree with you. Plantar fasciitis is often diagnosed and has become a catch all term for heel pain, kind of like shin splints of the lower leg. Often plantar heel pain is caused by the tendons of either the abductor hallicus, flexor digitorum brevis or abductor digiti minimi (less common) and not the plantar fascia. All of these muscles attach to the calcaneal tuberosities. Usually plantar fasciitis (osis) is felt in the medial band of plantar fascia more toward the longitudinal arch.
If this is the case, would strength training reduce the pain and inflammation?
Hi Danielle! Strength training is usually just one piece of a complex treatment regimen. It’s usually a good idea to start out with resting and ice, and once the initial inflammation is reduced strength training can further help. If your pain is persistent or severe, it may be best to seek the advice of your doctor 🙂
I power walk four times a week and have been getting a pain on mainly the back of my heel and right side of ankle. There is swelling and it aches although sometimes the pain is sharp. I’m not sure if it’s my Achilles tendon or something else?
Hi Theresa,
It sounds like it could be your Achilles tendon, but only your doctor or podiatrist will be able to give you a diagnosis. We would recommend starting by icing and resting your feet, and visiting a doctor if it gets worse or persists more than a few days. Hope this helps 🙂
I have dis plantar fascitis almost 2 yrs but this past 3 mos Im experienced severe heel pain at my left foot. I have a polio and a teacher. I have my 5 theraphy session but then the pain is still der what will I do. IT already affect my daily activities
I have ordered the complete set of heal seats and they make my feet hurt worse, I may have tendinitis not planter fasciitis heal pain is not real bad, my left food rolls and my ankle swell’s during the day it hurts bad and seems like I tend to lean on the left side of my foot, the only feet is the left one. Do you have any advise for me?
Sorry to hear you’re struggling, Liz 🙁
We usually recommend breaking in the Heel Seats slowly at first – start by wearing them for only an hour at a time, and slowly build up to the full day over the course of a week. If you are experience swelling or suspect it might be Achilles tendonitis you may want to visit your doctor to make sure your diagnosis is correct and that you’re on the right treatment path. Hope this helps 🙂
I’m not sure which one that I have because my pain is below the Achilles on top off my heel. I limp all day, but worse in the morning and late at night. Don’t want to take an anti-immflammatory pill, so I was wondering would a orthopboot help with the pressure off my heel?
Dear Cherie,
My doctor says I have tendonitis and some achilles which is causing bottom and side of my heels to be inflamed when I walk up to a 1/2 mile. I numbness and tingling sensations in my heel and toes when I walk or when they come in contact with anything. If I have my feet on the mattress, my heels will get numb and inflamed. It is driving me crazy because I have to sleep with my feet hanging off the mattress (I use a pillow under my calves. I cannot use any Posey boots because they would cause my heels and toes to tingle.
I had this for 6 weeks now. Can you suggest anything that I can use to use to relieve me from hanging my feet off the mattress so I can stop using sleeping pills? Thanks.
Hi Judith! Your doctor should be able to provide some specific treatment recommendations for you. You may have luck with a different type of night splint, or using orthotic inserts during the day 🙂
I’m sorry but I mistakenly thought your name was Cherie.
can you please respond to my question that I just posted.
Thanks.
Trying to figure out whether I’m dealing with plantar fasciitis or an Achilles tendon issue. I’ve thought for years it was plantar fasciitis, but the more I read about the pain location, the more I begin to doubt that. Everything about pf seems to indicate that the pain should be at the heel … the bottom of my foot. I’m not going to say that I have NO pain there, but the overwhelming majority of my heel pain is in the back side of my heel – not the bottom. If I flex my foot, as the tendon down the back side of my heel stretches, it feel as though someone is stabbing me with 1000 knives. Walking barefoot is excruciating (but that is common with pf issues as well). Morning walking is horrible (again … sounds like pf). Rolling a tennis ball under my foot and stretching the pf hurts, but it’s a “good hurt” if that makes sense …. and it only “hurts” initially. I suppose as it stretches the pf, the pain eases. I am desperately trying to lose weight (and I definitely need to do so). As I’m walking, the pain is there, but it’s not unbearable. However, later in the day, the pain can become horrible. I know I sound like I’m rambling. Is there a way to differentiate between pf pain and possible AT pain? And if it’s AT pain, what if anything can be done? NOT walking/exercising isn’t going to be an option if I’m going to lose this weight. Please help.
Hi Donalyn! You might find this article helpful: https://heelthatpain.com/plantar-fasciitis-vs-tendonitis/
Only your doctor will be able to give you a specific diagnosis, so if your pain persists you might want to get it checked out 🙂
Donalyn,
You aren’t rambling, I am at my wit’s end with the exact same issues you are having. Going on 3 years and no relief yet. Been thru medications, a walking boot, rapid pulse treatments and stretching exercises. All with a podiatrist. Next step is an orthopedic doctor. Like yourself, I too am trying to loose weight and it seems everything I do exasperates the pain. Hoping you find relief soon.
I firstly developed achilles tendonitis which then led on to plantar fasciitis. My tendonitis improved with specific exercises from my physio but my plantar fasciitis did not. I discovered a night splint following a conversation with another sufferer. I am now almost symptom free having worn it nightly for two months.
Adrienne,
Would you please share the name of the splint and where to get it?
Thank you
I’ve had both. Planter fasciitis was brutal but solid shoes with good orthotics fixed it. Tendonitis may be from an old injury but they do come back to haunt you when you age. Also precipitated by a quick, 5lb weight gain. I’ve been using a tens unit & am about to try icing it. I wish someone was here to get it for me. 4 story house.
Hello.
I’ve had tendonitis in my right achilles for over a year. Been to physio on 2 occasions and just getting ready for a 3rd go. No stretching exercise has done any good. Radiotherapy treatment and heat treatment help for a bit. But nothing easiest. I’m in constant pain.
What would be the next step
Hi John, thanks for writing. Sorry to hear you haven’t had luck with treatments. It may be time to try a different type of doctor for a second opinion. For example, if you have previously gone to a general practitioner, you may try seeking the help of a podiatrist, orthopedic specialist, or chiropractor. Hope you find something that works for you 🙂
Hello,
My GP thinks I have a Achilles tendinitis bug needs to be confirmed with x-Rays and ultrasound. My issue is with the tightness of my other muscles, the backs of my knees, hamstrings and hips lower back- I’m not sure if I’m overcompensating with my movements but it feels my legs are tight and ceasing up. Is stretching my calves, quads & hamstrings going to cause any detriment to my Achilles?
I’m dealing with this too. I’ve seen a few diff podiatrists who’ve explained aspects differently… you need to do the calc stretches etc bc it’s connected to the tightening of the Achilles which is tied into plantars fasc and tendonitis. Go to a podiatrist and they’ll give you this boot for stretching. Also when they give you the calf stretches don’t be dumb like me and not do all your stretches or it will not stop. The injection only temporarily masks the pain but if you don’t keep up with your stretches you’ll be screwing yourself over like I did and might need surgery bc I can’t get more injections. Good luck!
Hi. I was just diagnosed with Levaquin-induced tendonitis. It is in both feet and is excruciating. It hurts worse if I walk or stand, both at the time and afterwards. I tried Meloxicam for about 3 weeks, with some icing of the feet, but both feet are continuing to get worse. Any suggestions?
Jonia I would love to know how they diagnosed you. I fear I may have the same thing. I was prescribed levaquin a year ago.
Hello, 10 days ago I was diagnosed with Plantar Fasciitis, but after looking at all the symptoms for this on the internet I wasn’t convinced it was Plantar Fasciitis, so went back for a second opinion, the nurse at the drop in centre confirmed it was actually Achilles Tendonitis, which matched my symptoms more, although the pain I have is higher on the Achilles’ tendon than my heel area, my heel does hurt but I get really sudden, sharp stabbing pains about an inch higher than my heel, I also find these pains worse when I’ve been on my feet for too long or sometimes they can come suddenly in the night why I am resting, is this normal for Achilles Tendonitis? I only taking paracetamol and ibuprofen for it at the moment, to be honest it doesn’t seem to do a great deal.
I recently broke my 3rd and 4th metatarsals. I have been in a hard boot for the last 3 weeks, and now my heel is in pain and killing me. The ortho doc just said it was tendonitis and would go away when I stop wearing the boot in 3 more weeks, but I am a nurse on my feet 12 plus hours a day – I need better advice or ideas to treat than that. The pain is directly over my calcaneus, and is worst at the end of the day.
Hi my Achilles’ tendon is sore to touch for the past 6/7 weeks and it’s not getting better and now the underside of my heel is starting to hurt too,the pain is not that sore but I need to get back running I’m just afraid I could rupture the Achilles’ tendon if I do, is their a chance of this happening if I go back running?Cant afford to be off work for 9 months if that happens.
I have worked as a Security Guard for 7 years; wearing safety shoes and standing long hours on my feet; my socks rubbed against my feet causing sores and my feet swet alot; I am on Disability now because of other health issues (congested heart failure;severe sleep apnea) but the pain in my feet are so bad I have a hard time walking also my toenails may have fungis,they get thick very painful to clip even when they soak.
On my left foot, I have sharp and dull pain on the inside of my ankle between the bone and the achilles tendon in the back. It feels like a tendon or ligament and throbs a little even when it is resting. I also have intense, sharp pain when I’m walking and setting my heel down so that I can only walk on the ball of my foot, and still uncomfortably. I’ve found that I can’t bend my outer toes in as well as I can on my right foot; it’s like something is preventing those muscles from working. My toes and heel feel warm/a little tingly when resting as well. What on earth is happening? Is it ligaments or tendons or something to do with plantar fasciitis or a combination?
Hello, I have achilles tendonitis and have had a achilles rupture a year ago. I find compression socks helpful but I have been looking for a shorter pair or a very comfortable pair of sports socks (rather than the typical knee high compression type). Does anyone have any recommendations? Thank you.
Hi Sharlene
Have you seen our low cut compression socks? You can purchase them from the same page as our high cut: https://heelthatpain.com/treatments/health-socks/
The last photo on this page will show you how far up they go – just above your ankle rather than knee high.
Like all of our products, they are 100% guaranteed so there is no risk to try them!
Hi guys! Hope you can maybe give me an answer. The back heel aches really bad when it gets stiff. I get a limp as well. Its fine once strecthed out until ive been on it to long then it starts to hurt again. So usually in the morning or after ive sat for to long is when it really hurts. Usually hurts really bad when i get home from work after the car ride. Im wondering whether this sounds like planter faciatis or Achilles Tendonitis!
I fell up a hill and since that time I have had intense heel pain that rounds up from the bottom of my foot about 3/4 of an inch. Sometimes walking on it will cause it to hurt….intermittently just starts to throb. I have the heel seats from Heel that pain and have also used the compression mini sleeve. It’s been a little over a month. Tried ice and heat, tylenol doesn’t help, don’t take ibuprofen.
I have been diagnosed with plantar fasciitis as well as Achilles tendonitis bad thing is I work on my feet standing and climbing stairs for 12 hours a day thinking I might have to give it up and find different work. Do you think being on my feet for 12 hours will do any more damage?
My doctor told me I had tendonitis and didn’t mention Plantar Fasciitis at all. The pain is on the bottom of my foot and when it gets stretched it hurts. It used to hurt when I walked but now that I ice it, it just feels like its moving/tight when I walk. Do you think she misdiagnosed? The article says you can’t have tendonitis where she told me I had it, and she insisted on not doing an x-ray, she barely checked my foot at all.
I am a 70 year male in reasonable good health. About a week ago the top of my left heel to the outside left of my Achilles tendon became so sore to the touch it prevents me from wearing nearly every pair of my shoes, except one pair of old tennis shoes, or slip ons like flip flops that have no backs touching my heel.
There is little to no pain if I just wear socks or have no shoes on.
There is also pain at night waking up me from a good sleep.
Should I be seeing a doctor? Is there anything I can do to make this pain subside?
no help here from me, Dennis, other than to say that sounds *exactly* like what I’m dealing with. Does yours hurt more in the morning? Mine does, which seems to lend itself to PF, but the description of *where* the pain is for PF seems off for our symptoms.
Also, mine came on very quickly. It started hurting one afternoon, and the next morning I couldn’t put the foot on the floor. How about you?
I had pain through harsh overuse of “tippy toe” movement and applying pressure when I go on my “tippy toes” it’s been bothering me for a month and my Achilles is very tender I just what to know a method to stop pain and rehab my achilles to go resume physical activity.
I am reading much about the effects of certain antibiotics on the tendons. Many of the fluoroquinolone Antibiotics can cause tendon damage. These antibiotics are used often to treat bacterial infections such as bronchitis, pneumonia, or UTI infections. I too am having pain in my heel area and am concerned since I have taken Cipro for a UTI.
I have something at the inside of my right side of my heel that is pushing out. It feels like a round 1/8-1/4″ something and it hurts. I’ve been told that I would need to get an MRI done to fully identify it and then a surgery to shave it down.
I am very concerned about it and I am wondering how well the surgery will leave me if I end up doing it or if there is anything else I can do.
I am a long distance runner. I have the sharp pain in the bottom of my heel. It is NOT in my arch. It is not worse in the morning. Does this still sound like PF?
I have flat arches and so much pain in the sole of my foot directly under them. I don’t have any heel pain however, and it is localised to the underside of my arch.
Could this still be plantar fascitis?
I has planters fasiitis over an over, now my heel are not so bad , but the top of both Feet hurt so bad sometimes I can’t walk on them, the left one is the worst, now they are bad all the time. My foot doc gives me injections I the top of both Feet , most the time it don’t help. Been going on for aprox 2 yrs , what to do. Or ask my foot doc to do..looking for answers an help.
My heel is very tender in the morning when waking up and flares up after rest. I can use supportive shoes to get by but once they are off the pain is there. I don’t always wear them, barefoot most of the day at home, and I wear sketchers foam for ease and convenience to run errands which I believe caused this problem. I’m now getting tenderness behind my right ankle and occasionally the latter side of my lower leg. Would this all be tendonitis instead of PF and is the hip involved and weak abs? I feel I need to start a the top for stretching and work down but not sure what muscles to work?
I have plantar fasciitis and heel spurs on both of my feet. Every where I read it says the pain is the worse in the morning but I honestly don’t believe so. It’s worse after a 8 hour shift. I have been dealing with this for over two years now been told to stretch take meds blah blah blah… Nothing works! I was recommended to use night splints… within an hour of wearing them both my feet and legs are numb… I have extreme calf pain in both legs… the feeling is worse than the plantar fasciitis… is this common for this foot condition? What should I do? I can feel exactly where the knots are on my calf. My heel spurs are engraved to all my shoes and insoles. Compression sock or emerging my lower body into a cold bath usual do a little bit of the trick. What else should I do. I am a server two days out the week in one restaurant and a manager at another restaurant on the weekends… I’m about ready to cut these legs off myself