Pain guide · Foot pain

Arch pain: plantar fasciitis, the tibialis posterior tendon, flat feet, nerves, shoes and insoles

Pain in the arch of the foot is often plantar fasciitis, which the National Health Service (NHS) describes as pain around the heel and arch that is much worse when you first start walking after sleeping or resting. Pain along the inner arch and ankle, with the arch dropping on one side, is more often the tibialis posterior tendon, which is commonest in women over 40 and is often missed.

Flat feet are common and usually painless, and insoles help some people a little rather than being needed for life. This guide starts with the signs that need help today, from a 999 call or accident and emergency (A&E) to NHS 111 or a general practitioner (GP): bruising on the sole after an injury, a sudden pop in the arch, and a hot, swollen foot if you have diabetes. It then maps the causes by the exact spot, explains what shoes and insoles can and can't do, and gives a three-stage plan, with a lane for the heel and arch and a lane for the tendon, that ends with standing, walking, running and hiking.

3-stage exercise plan When to get help 45 sourcesUpdated 24 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: after an injury, you heard a crack, the foot or ankle has changed shape or points at an odd angle, a bone is sticking out, there is a bad cut over it, you're in severe pain, or the toes look blue or white, feel numb or are cold to touch. These can mean a broken bone. Don't drive yourself.
Call 999 or go to A&E: a foot or leg that is suddenly cold, pale, numb, weak or very painful without an injury. A sudden loss of blood supply is a vascular emergency.
Call 999 or go to A&E: you have diabetes and a foot ulcer with a fever or signs of sepsis, an ulcer with poor circulation, or gangrene. NICE asks for these to go straight to hospital.
Contact NHS 111: you have severe pain in the bottom of your foot, you're not able to walk, your foot has changed shape or is at an odd angle, you heard a snap, grinding or popping noise at the time of injury, or you feel faint, dizzy or sick from the pain. You could also go to an urgent treatment centre. If you think you may have broken your foot or any toes, do not try to treat it yourself.
Same day (urgent GP appointment or NHS 111): after an injury, you can't put weight on it or walk more than a few steps, the pain is very bad or getting worse, there is a lot of swelling or bruising or it is getting worse, or it feels very stiff. If you think it's broken, don't treat it yourself.
Same day: after a twist or a fall, if you can't walk four steps, if pressing on the bony bump on the inner side of the midfoot (the navicular) or the bump halfway along the outer edge of the foot (the base of the fifth metatarsal) hurts, if the foot looks out of shape, or if you're unsure, get it checked. Clinicians use these points, the Ottawa rules, to decide who needs an X-ray.
Same day (A&E, an urgent treatment centre or NHS 111): after a twist, fall or stamp, pain in the middle of the foot that stops you standing even after painkillers, bruising on the sole, or being unable to push off or stand on tiptoe. Ask to be checked for a Lisfranc injury, even if a foot X-ray was normal.
Same day: a sudden pop or tearing pain in the arch, with swelling, bruising or difficulty putting weight on the foot, especially if you've had a steroid injection for heel pain. The band under the arch can tear (our suggestion).
Same day: a sudden pop on the inside of the ankle followed by a change in the shape of the foot. The tendon may have torn (our suggestion).
Same day: a sudden, very painful, hot, swollen, red joint, often the big toe but sometimes the middle of the foot (the midfoot) or the ankle, especially with a high temperature, feeling shivery or being unable to eat. It may be gout, but it could be a joint infection (septic arthritis), which is urgent.
Same day: skin on the foot that is painful, hot and swollen. It could be a skin infection (cellulitis).
Same day: you have diabetes and a new foot problem, such as an ulcer or wound, signs of infection, or a hot, swollen foot with a change in colour, even if it doesn't hurt. Contact your diabetes foot team or GP: NICE asks for these to reach a specialist foot service within 1 working day, and a suspected Charcot foot is kept off weight until it has been checked.
If you have diabetes, see your local foot team urgently, within 24 hours, for a change in the colour or shape of your foot (especially a red, hot, swollen toe, ankle or foot), part of your foot feeling much colder or hotter than usual, new blisters, cuts or wounds (especially ones you can see but don't feel), a cut or wound that smells bad or is leaking fluid or pus, or new or unexplained pain in your foot. Meanwhile sit or lie down, take the weight off it and raise it.
Same day: burning foot pain that carries on at rest, toes that go pale, then numb, then red or black, or foot wounds that won't heal. The blood supply to the foot may be failing, which needs prompt checks.

See a doctor or physiotherapist if

Heel pain that is no better after 2 weeks of looking after it yourself, or is severe or getting worse.
Pain that isn't better after 2 weeks of looking after it yourself, is getting worse, keeps coming back, or stops you doing normal things.
Flat feet that are painful, stiff, weak or numb, that you didn't have before, or that affect only one foot.
You can't do a single-leg heel raise on the painful side, or the foot is visibly flattening.
In a teenager or young adult, a stiff, painful flat foot with repeated sprains: see a GP. It can be a tarsal coalition, where two foot bones are joined by a bar of bone or tissue.
A high arch that is new, getting higher or only in one foot, or high arches with weakness, tripping, numbness or ankles that keep giving way: see a GP. It can be the first sign of a nerve condition.
Tingling or loss of feeling in the foot, or a foot that feels weak.
Burning, tingling or numbness in both feet that starts in the toes and creeps upwards. This is more likely to be peripheral neuropathy (nerve damage), which needs its cause found.
See a GP about a new lump in the sole of your foot if it's still there after 2 weeks, or if a lump gets bigger, is painful, red or hot, is hard and does not move, or grows back after it's been removed. Most lumps are harmless, but a new one should be checked once.
One spot on a foot bone that hurts with every step and later at night: a possible stress fracture.
Pain in the middle of the foot that is hard to pinpoint, on the outer edge of the midfoot, or on the front of the shin bone in a running or jumping athlete. These sites heal less well and need prompt assessment, often with a scan.
Any foot pain if you have diabetes: foot problems can be more serious.
A child's heel or foot pain that isn't clearly linked to activity, or that comes with swelling, redness or a fever.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

Under the inner arch towards the heel, sharp on the first steps in the morning or after sitting, easing as you get going, then aching after long standing or walking

Plantar fasciitis (plantar heel pain).

Read: Plantar fasciitis (heel pain) →Along the inner arch and behind and below the inner ankle bone, sometimes swollen there, with the arch dropping on one side and rising onto tiptoe on that foot hard

The tibialis posterior tendon, which is often missed.

Read: Posterior tibial tendon dysfunction →Both feet flat, with an arch that comes back when you sit or rise onto tiptoe, and an ache after long days on your feet

Flexible flat feet, usually harmless.

Read: Flat feet →A teenager's stiff, painful flat foot whose arch doesn't come back on tiptoe, often with repeated ankle sprains

Possibly a tarsal coalition, where two foot bones are joined.

Read: Tarsal coalition →A high arch with pain under the heel or the ball of the foot, or an arch that is new, getting higher or only on one side

High arches; a new or one-sided one needs a GP.

Read: High arches →A firm, rubbery lump in the arch under the skin, sometimes sore in shoes

Possibly a plantar fibroma (Ledderhose disease), a harmless growth in the band under the arch.

Read: Plantar fibroma →Burning, tingling or numbness in the sole of one foot, worse after walking or standing

Possibly tarsal tunnel syndrome, a squeezed nerve behind the inner ankle.

Read: Tarsal tunnel syndrome →

Burning, tingling or numbness in both feet, starting in the toes

Nerve damage (peripheral neuropathy), most often from diabetes in the United Kingdom: see a GP.

A vague ache on top of the inner midfoot or at the top of the arch, hard to pin down, worse with sprints, push-off and jumps

A possible stress fracture of the navicular, a bone in the middle of the foot: get it checked. Where it's felt is our inference from the American Academy of Orthopaedic Surgeons' description of the bone and its pain.

Read: Stress fracture →A tender bony bump on the inner side of the midfoot that shoes rub

Possibly an accessory navicular.

Read: Accessory navicular →A young child (about 2 to 10) with a limp and pain on the inner midfoot

Possibly Köhler's disease. A limp needs a GP.

Read: Köhler's disease →Bruising on the sole after a twist, a fall or a stamp, with pain across the middle of the foot

A possible Lisfranc injury: get it checked the same day.

Read: Lisfranc injury →

A sudden pop or tearing pain in the arch, with swelling and difficulty putting weight on the foot

Rarely, a torn plantar fascia: get it checked the same day.

A sudden, painful tightening of the sole or arch, often at night, lasting seconds to minutes

A cramp, which our leg cramps guide covers.

Read: Leg cramps →

Diabetes, with a hot, swollen foot or a change in its shape, the arch collapsing

A possible Charcot foot: contact your diabetes foot team or GP the same day, and keep weight off the foot until it has been checked.

A stiff ache across the middle of the foot from mid-life, worse after standing

Possibly arthritis in the midfoot joints, which our pain on top of the foot guide covers.

Read: Pain on top of the foot →

In pregnancy, aching arches and feet getting longer

Arch height can fall in pregnancy and stay lower afterwards; supportive shoes and this plan are a sensible start (our suggestion).

Pain mostly when you walk

Our foot pain when walking guide.

Read: Foot pain when walking →Pain mostly when you run

Our foot pain when running guide.

Read: Foot pain when running →Numb or aching feet on the bike

Our numb feet when cycling guide.

Read: Numb feet when cycling →

Understand it

Under the arch towards the heel: plantar fasciitisStrong evidence

The NHS describes plantar fasciitis as pain on the bottom of the foot, around the heel and arch. It's more likely if the pain is much worse when you first start walking after sleeping or resting, gets better as you move around but worse if you stand, walk or run for a long time, and hurts when you stretch the sole, for example raising your toes off the floor or walking upstairs. The NHS page on pain in the bottom of the foot calls it sharp pain between the arch and the heel.

It's more likely if you're 40 to 60, have recently started exercising on hard surfaces, exercise with a tight calf or heel, do a lot of standing, walking or running (or a lot more than usual), wear shoes with poor cushioning or support, or are overweight, the NHS says.

Sources 1, 2

Along the inner arch and ankle: the tibialis posterior tendonStrong evidence

The tibialis posterior tendon runs behind the inner ankle bone to the underside of the arch and helps hold it up. A clinical review calls its failure the commonest cause of a flat foot that develops in adulthood in otherwise healthy people, with women over 40 most at risk. It is usually diagnosed from the story and an examination, but most people are first told they have a sprain or arthritis. From behind, more toes show on the outside of the affected foot, and while someone with a normal foot can do 8 to 10 single heel raises, with this problem it's hard or impossible.

In a survey of women over 40 at one English general practice, followed by examinations, 3.3% of those who replied had early-stage disease, all undiagnosed despite long-standing symptoms. The American Academy of Orthopaedic Surgeons (AAOS) lists pain in the arch or along the inside of the foot and ankle, swelling and pain just behind and below the inner ankle bone, and difficulty rising onto tiptoe on one leg, and says it is more common in women, over 40, and with obesity, diabetes and high blood pressure.

Sources 3, 4, 5

Flat feet: usually not the problemEmerging evidence

The NHS says flat feet usually cause no problems, shouldn't stop you doing any activities, including sport, and are rarely a sign of anything serious; children usually develop arches between 3 and 10. A flexible flat foot's arch comes back when you sit or rise onto tiptoe, and it is usually painless, the AAOS says.

In 3,378 adults in the Framingham foot study, a flat foot went with arch pain in men (odds ratio 1.38) but not in women. Across 21 cohort studies of 6,228 people, a flat (rolled-in) foot was a small risk factor for shin splints and, on very limited evidence, kneecap pain, but not for foot and ankle injuries or bone stress injuries; in 927 novice runners in neutral shoes, rolled-in feet weren't at higher risk of injury. The NHS says see a GP if flat feet are painful, stiff, weak or numb, new, or only on one side.

Sources 6, 7, 8, 9, 10

A stiff flat foot in a teenagerEmerging evidence

A tarsal coalition is a bridge of bone, cartilage or fibrous tissue joining two foot bones. The AAOS estimates it affects about 1 in 100 people, both feet in about half; it usually hardens between 8 and 16, and can cause stiff, painful feet, a rigid flat foot, repeated ankle sprains, and more pain or a limp with more activity. Many coalitions show on X-rays, and a computed tomography (CT) scan shows them best.

Source 11

Nerves, lumps, bones and crampEmerging evidence

Tarsal tunnel syndrome is a squeezed nerve behind the inner ankle. A clinical review says its symptoms in the sole tend to worsen with walking and can look like diabetic nerve damage or a back problem, and that a magnetic resonance imaging (MRI) scan can show things that aren't the cause. A plantar fibroma is a harmless growth in the band under the arch, mostly in middle age, that can form painful lumps but usually doesn't cause the tightening (contracture) the hand form does; treatment ranges from watching it to surgery.

A navicular stress fracture causes pain that is hard to pinpoint, worse when you put weight on the foot and with sprinting or jumping; the AAOS describes the navicular as a bone on the top of the midfoot, so where it's felt in the arch is our inference. Pooled case series favour a cast with no weight on the foot. A sudden pop in the arch is rarely a torn plantar fascia: a case report lists sudden increases in activity, a direct injury, steroid injections and long-standing plantar fasciitis as things that make it more likely. Cramps can affect the feet and last from a few seconds to 10 minutes, the NHS says.

Sources 12, 13, 14, 15, 16, 17

Pregnancy and the archEmerging evidence

In 49 women measured early in pregnancy and again 19 weeks after giving birth, arch height and stiffness had fallen and feet had got longer, and the first pregnancy accounted for the loss of stiffness and the lengthening. The researchers think the loss of arch height is permanent, though they followed women only to 19 weeks, and they call for research into exercises to prevent it.

Source 18

When a scan or test helpsStrong evidence

A tibialis posterior tendon problem is usually diagnosed from the story and an examination, with the single-leg heel raise as the key test. X-rays taken standing show the shape of a collapsing flat foot and any arthritis, and an MRI scan can show inflammation or a tear when the diagnosis is in doubt, the AAOS says. A teenager's stiff flat foot needs X-rays, and a CT scan shows a coalition best; a suspected navicular stress fracture may need a CT or MRI scan.

Burning or numbness that persists needs a GP; in tarsal tunnel syndrome, an MRI can show a squeezed nerve but can also mislead. With diabetes, a suspected Charcot foot gets an X-ray taken standing, and an MRI if the X-ray is normal but the doubt remains, the National Institute for Health and Care Excellence (NICE) says.

Sources 3, 5, 11, 14, 12, 19

How it usually goesEmerging evidence

The AAOS says more than 90% of people with plantar fasciitis improve within 10 months of starting simple treatment, and the NHS says see a GP if it hasn't improved after 2 weeks of looking after it yourself. For a tibialis posterior tendon problem, the AAOS says most people's symptoms are relieved without surgery, though the pain may last longer than 3 months even with early treatment; left alone, the problem can slowly flatten the foot. Flat feet that don't hurt need no treatment. No one can promise you a date.

Sources 20, 1, 5, 3, 6

What helps, and how strong the evidence is

The heel and arch lane: stretch the sole, then heavy heel raisesEmerging evidence

In 101 people with heel pain for 10 months or more, a stretch aimed at the sole did better than a standard Achilles tendon stretch at 8 weeks (82 were followed up). In 48 people with plantar fasciitis confirmed on ultrasound, heavy single-leg heel raises with a towel under the toes, every second day, gave better foot function at 3 months than stretching the sole, both with insoles; there was no difference at 1, 6 and 12 months.

A best practice guide built on 51 trials (4,351 people), expert interviews and a patient survey found taping and stretching the sole eased first-step pain in the short term, and put taping, stretching, education and shoe advice at the core, with shockwave therapy and then custom insoles for people who don't improve enough.

Sources 21, 22, 23

The tendon lane: resisted exercise with a slow lowering phaseEmerging evidence

In 36 adults with early tibialis posterior tendon problems, insoles and stretching helped, adding resisted exercise helped more, and the group with a slow, lowering phase improved most. In 39 adults, a moderate home programme of strengthening added little to an insole and stretching, and strength didn't change. A review of 3 trials (93 people) found moderate effects for slow, lowering strengthening with stretching and insoles, but called the research thin and the doses poorly reported.

A review of 4 small trials (186 people, 75% at high risk of bias) found insoles reduced pain in early tendon problems, more so with exercise, and arch-supporting insoles did better than flat ones.

Sources 24, 25, 26, 27

Insoles: some help for some people, not needed for lifeMixed evidence

For heel pain, a meta-analysis of 19 trials (1,660 people) found insoles eased pain a little more than sham insoles at 7 to 12 weeks (moderate-quality evidence), but not in the short or the longer term; another of 20 studies found them no better than sham insoles or other treatments. In both, custom-made insoles did no better than ready-made ones.

The NHS says insoles won't change the shape of flat feet, though they can help with pain or stiffness. So try ready-made ones first; if your feet are comfortable without them later, you can stop wearing them (our suggestion).

Sources 28, 29, 6

Shoes: comfort and support, not foot-type prescriptionsStrong evidence

Across 12 trials of 11,240 people, no type of running shoe clearly reduced injuries, and choosing shoes by foot posture probably made little or no difference (moderate-certainty evidence, from military recruits). The NHS advises shoes with cushioned heels and good arch support for plantar fasciitis, and no flip-flops, backless slippers or walking barefoot on hard surfaces. The Royal College of Podiatry says the midsole under the arch shouldn't be too flexible, and that a shoe should support the heel and arch or have room for insoles.

Sources 30, 1, 31

Injections and surgeryMixed evidence

If plantar fasciitis doesn't get better, the NHS lists steroid injections and shockwave therapy, and less commonly surgery; the best practice guide places shockwave after the core care. A steroid injection is one of the things linked with a torn plantar fascia, and a steroid injection near the tibialis posterior tendon is a risk factor for that tendon failing.

Most people in the early stages of a tendon problem are treated without surgery, using insoles and braces, the AAOS says. Treatment for tarsal tunnel syndrome gave good or excellent results in 75.3% across 32 studies, all of low quality. A plantar fibroma is often just watched. Surgery is rarely needed for flat feet, the NHS says.

Sources 1, 23, 16, 3, 5, 32, 13, 6

How much pain is OK while you exercise?

Up to about 5 out of 10, settled within an hour, and tomorrow's first steps are the checkEmerging evidence

This guide uses the foot hub's rule. Some discomfort during exercise is fine. Aim for pain you would call mild to moderate, no more than about 5 out of 10, that settles within an hour, with no more swelling or stiffness the next morning. If it's worse the next day, do a little less (a smaller range, fewer reps, a lighter band), not nothing. NHS inform's foot exercises use the same limit: 0 to 3 is minimal, 4 to 5 acceptable and 6 or more too much, and your pain should be no worse the morning after.

For heel and arch pain, our plantar fasciitis guide treats the band under the arch like a tendon: discomfort up to about 5 out of 10 during loading is acceptable if it has settled by the next morning, and your first-step pain in the morning should trend down week to week. The 5 out of 10 figure borrows the pain-monitoring rule from an Achilles trial, where carrying on with activity under the rule did no harm; it hasn't been tested for heel pain. Expect some soreness in the first heavy heel raise sessions; if the heel is clearly worse the next morning, lighten the load.

For the tibialis posterior tendon, the same limit applies, and our tibialis posterior guide adds a booklet's rule: stop a heel raise or a squat if you feel you're losing your foot position, then reset. In trials of long-lasting muscle and joint pain, exercise that allowed some pain did no worse than pain-free exercise.

The exceptions: pain in one spot on a bone should be pain-free, because it could be a stress fracture; burning, tingling or numbness means stop that movement; and if your feet are numb, pain won't warn you, so check your skin after exercise. A sudden pop, bruising on the sole and a hot, swollen foot with diabetes aren't pain-rule questions: see the warning signs.

Sources 33, 34, 22, 35

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Settle: ease the arch, and start loading the sole and the tendon

About the first 2 weeks: supportive, cushioned shoes or insoles, less standing and barefoot walking, and swimming in place of impact, as the NHS advises; the sole stretch before your first steps for heel and arch pain, and light band work for pain along the inner arch and ankle. One spot on a bone, bruising on the sole, a sudden pop or a hot, swollen foot with diabetes gets checked first; with plantar fasciitis or a tibialis posterior tendon problem, that guide's plan can replace this one.

Plantar fascia stretch (seated) demonstrated on the 3D figure

3D demoPlantar fascia stretch (seated)Beginner · A bench or box

3 to 5 holds of 10 to 30 s, 2 to 3 times a day, before your first steps in the morning · The move page's dose, with the hold length the page reports from trials; a stretch aimed at the sole beat an Achilles stretch in a trial

Harder: Toes-tucked kneeling (toe squat)

Wall calf stretch (gastrocnemius) demonstrated on the 3D figure

3D demoWall calf stretch (gastrocnemius)Beginner · A wall

Hold 20 to 30 s, 2 to 3 sets, 2 to 3 times a day; gentle and never forced with inner ankle pain · NHS inform's calf stretch and stretching dose; our tibialis posterior guide keeps calf stretches gentle and optional

Easier: Seated calf stretch with a towel · Harder: Heel-on-step calf and hamstring stretch

Band ankle inversion demonstrated on the 3D figure

3D demoBand ankle inversionBeginner · A band + A bench or box

3 sets of 15, twice a day, with a lighter band to start · For pain along the inner arch and ankle: the move page's dose, which the page takes from the Kulig trial (the abstract gives no dose); a lighter band first is the page's editorial step

Harder: Single-leg calf raise from a step

Seated bent-knee calf raise (soleus raise) demonstrated on the 3D figure

3D demoSeated bent-knee calf raise (soleus raise)Beginner · A bench or box

2 to 3 at a time, building to sets of 8, 2 to 3 times a day, up to 2 sets of 15 · NHS inform's seated heel raise, with its pacing

Harder: Slow calf raise

Towel toe curl demonstrated on the 3D figure

3D demoTowel toe curlBeginner · Other / check instructions + A bench or box

2 to 3 at a time, building to sets of 8, up to 2 sets of 15 · NHS inform's toe curl, with its pacing

Easier: Big toe press (seated toe-flexor hold) · Harder: Short foot + toe splay

Foot roll (ball or roller) demonstrated on the 3D figure

3D demoFoot roll (ball or roller)Beginner · A massage ball

1 to 2 min per foot, gently, if it feels good · The move page's dose, an editorial starting point; for comfort only, and gentle with numb feet or diabetes, as the move page says

Harder: Calf foam rolling

Move on when: First-step pain is easing (our plantar fasciitis guide's check), or 3 sets of 15 with a light band stay within the tendon rule and have settled by the next morning (our tibialis posterior guide's check).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Build: heavy, slow loading

About weeks 2 to 6: the heel raise from the plantar fasciitis trial, every second day, and heavier, slower band work for the tendon, with the arch held up as you rise.

Heel raise with a towel under the toes demonstrated on the 3D figure

3D demoHeel raise with a towel under the toesIntermediate · A step + Other / check instructions

Every second day: both feet then one, at a load you can lift about 12 times, for 3 sets · The move page's dose, from the Rathleff trial

Easier: Slow calf raise · Harder: Standing dumbbell calf raise

Slow calf raise demonstrated on the 3D figure

3D demoSlow calf raiseBeginner · A wall

Heel and arch lane: 3 sets of 12 to 15. Tendon lane: build from 2 sets of 10 to 3 sets of 30, twice a day, the arch held up · As in our plantar fasciitis guide; the tendon lane is our tibialis posterior guide's dose, which it takes from the Houck trial (the abstract gives no dose). Stop a rep if the arch collapses

Easier: Seated bent-knee calf raise (soleus raise) · Harder: Standing dumbbell calf raise

3D demoBand ankle inversionBeginner · A band + A bench or box

3 sets of 15 with a band you can only just manage, twice a day, taking 2 to 3 s to let the foot back · The move page's dose, which the page takes from the Kulig trial (the abstract confirms only that the slow, lowering group improved most); 2 to 3 s for the return is our tibialis posterior guide's

Harder: Single-leg calf raise from a step

Single-leg stand demonstrated on the 3D figure

3D demoSingle-leg standBeginner · A wall

3 holds of 30 s each leg, near a support · As in our flat feet and tibialis posterior guides

Easier: Tandem stance and heel-to-toe walk · Harder: Single-leg reach matrix

Tibialis raise demonstrated on the 3D figure

3D demoTibialis raiseBeginner · No equipment

2 to 3 sets of 10 · As in our foot pain when walking guide

Harder: Single-leg tibialis raise

Move on when: 3 sets of 12 single-leg heel raises with a towel under the toes stay within the pain rule (our plantar fasciitis guide's check), or 20 or more two-leg raises are comfortable with the arch held (our tibialis posterior guide's check).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Strengthen, then standing, walking, running and hiking come back

From about week 6, and ongoing: heavier and single-leg strength, balance and more time on your feet, with insoles if they help, while everyday activities come back by the written steps below.

3D demoHeel raise with a towel under the toesIntermediate · A step + Other / check instructions

Every second day: from about 12 reps towards heavier sets of about 8, adding a backpack or dumbbell · The move page's dose, as in the trial's pre-set heavy-slow programme

Easier: Slow calf raise · Harder: Standing dumbbell calf raise

Single-leg calf raise from a step demonstrated on the 3D figure

3D demoSingle-leg calf raise from a stepIntermediate · A step + A wall

2 to 3 sets of 10, building · As in our tibialis posterior guide; on flat ground first, the heel turning in and the arch lifting as you rise. On a step, face it and keep a hand on a rail, as the move page says

Easier: Slow calf raise · Harder: Single-leg pogo hops

Single-leg reach matrix demonstrated on the 3D figure

3D demoSingle-leg reach matrixIntermediate · No equipment

3 rounds of 5 reaches in each direction, each leg · The move page's dose, an editorial starting point

Easier: Standing crossed-leg side reach · Harder: Single-leg Romanian deadlift

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

Build your standing and walking time gradually · As in our plantar fasciitis guide; walking outdoors counts the same

Harder: Treadmill jogging

Treadmill jogging demonstrated on the 3D figure

3D demoTreadmill joggingIntermediate · Cardio machine

Every other day for 30 min: jog 1 and walk 1 minute in week 1, 2 and 1 in week 2, 4 and 1 in week 3, 9 and 1 in week 4, 15 and 1 in week 5, then 30 minutes' jogging in week 6 · The NHS sports medicine service's programme, once 30 minutes of fast walking is pain-free: up a level after a week without pain, down a level with pain

Easier: Treadmill walking · Harder: Sprint intervals

Move on when: Our suggestion: a full day on your feet, your usual walks and, if you run or hike, your usual distances stay within the pain rule, with first steps no worse the next morning. Keep two strength days a week; if a busy week flares it, drop back a stage for a few days rather than stopping.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

What to change for now (written steps)

Our 3D figure can't show these changes. They come from the NHS, the Royal College of Podiatry, the insole reviews and Diabetes UK; where a step is our suggestion, it says so.

1. Shoes: cushioned heels and good arch support, with insoles or heel pads (the NHS); a midsole that isn't too flexible under the arch, support for the heel and arch or room for insoles, and laces or a strap rather than slip-ons (the Royal College of Podiatry).
2. For now, avoid long spells standing or walking, high heels and tight, pointy shoes, flip-flops and backless slippers, and walking barefoot on hard surfaces (the NHS).
3. Swap impact for exercise that doesn't put pressure on your feet, such as swimming (the NHS).
4. Rest and raise the foot when you can, and use an ice pack wrapped in a towel for up to 20 minutes every 2 to 3 hours if it helps (the NHS).
5. Insoles: try ready-made ones first; custom ones were no better for heel pain. With a tibialis posterior tendon problem, wear what you've been given while you rebuild strength (our suggestion). Insoles won't change the shape of flat feet (the NHS).
6. Weight: the NHS suggests trying to lose weight if you're overweight.
7. Diabetes: see your local foot team urgently, within 24 hours, for new or unexplained foot pain or a change in the colour or shape of your foot (Diabetes UK).

Sources 1, 2, 31, 6, 28, 29, 36

Standing, walking, running and hiking come back (written steps)

No trial has tested how to bring these back after arch pain as such. These steps are our suggestion unless a source is named.

1. Standing at work: change position often, use a cushioned mat if you can, and build standing time as you would a walk.
2. Walking and hiking: add distance on the flat before hills, carrying weight or rough ground; tomorrow's first steps are the check (our plantar fasciitis guide's rule).
3. Running: start the walk-jog weeks once 30 minutes of fast walking is pain-free (the NHS sports medicine service's programme), and choose running shoes by comfort rather than by foot type (a Cochrane review).
4. Barefoot and minimalist shoes: if you want them, change slowly over months, as our foot pain guide says.
5. Insoles: if the pain has gone and your feet feel fine without them, you can stop wearing them gradually.
6. If it isn't improving after 2 weeks of looking after it yourself, see a GP (the NHS). In many areas you can get physiotherapy without seeing a GP first, and with flat feet you might be able to refer yourself to a podiatrist (the NHS).

Sources 1, 6, 37, 30

Positions to swap, and why

Habit or position	Why it matters	Instead
Flip-flops, backless slippers and walking barefoot on hard floors	They're on the NHS's list of things not to do with plantar fasciitis.	Shoes with cushioned heels and good arch support, or insoles.
Long spells standing or walking, or a sudden jump in them, in the first weeks	The NHS lists doing a lot more standing, walking or running than usual among the causes, and long spells on your feet among the things to avoid.	Shorter spells, then build up; swimming, or cycling if it's comfortable, instead of impact.Try: Stationary cycling
Hard stretches at the inner ankle with tendon pain	The move page says don't force this stretch with pain along the inner ankle; the trials strengthened the tendon rather than stretching it.	Gentle calf stretches.Try: Seated calf stretch with a towel
Heel raises done while the arch collapses	Our tibialis posterior guide's rule: stop if you lose your foot position, then reset.	Fewer reps with the arch held, or a hold at the top.Try: Isometric calf raise hold
Rolling the arch hard on a ball as your main treatment	Only two small trials have tested rolling for heel pain (our plantar fasciitis guide); the sole stretch and heavy heel raises have more trial support.	Rolling for comfort, then the sole stretch.Try: Plantar fascia stretch (seated)
Buying stability or motion-control shoes for flat feet	Choosing shoes by foot type didn't prevent injuries in large trials, and rolled-in feet weren't at higher injury risk in novice runners.	Shoes that feel comfortable.
Starting with expensive custom insoles	Custom insoles were no better than ready-made ones for heel pain in two reviews.	Ready-made arch supports first, and a podiatrist if they don't help.
Running or jumping through a vague ache on top of the inner midfoot	It can be a navicular stress fracture, which heals less well and did worse with treatment that allowed weight on the foot.	Get it checked; cycle if it's pain-free.Try: Stationary cycling
Repeated steroid injections for heel and arch pain	Steroid injections are among the things linked with a torn plantar fascia, and a steroid injection near the tibialis posterior tendon is a risk factor for that tendon failing.	Stretching, heavy heel raises and insoles first.Try: Heel raise with a towel under the toes

Routines to follow

Plantar fascia routine

Plantar fascia and calf stretches, a gentle foot roll and the towel heel raise: the exercises the 2023 heel pain guideline supports.

8 minBeginner7 movesA bench or box, A massage ball

Foot and ankle strengthening routine: toes, arches, calves and balance

A 15-minute barefoot routine for stronger toes, arches, calves and ankles, finishing with balance. You need only a towel, a wall and a resistance band.

15 minBeginner11 movesA wall, Other / check instructions

Balance exercises routine

Balance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.

10 minBeginner7 movesA wall, A bench or box

Run-walk intervals for beginners

A 30-minute beginner run-walk session: a brisk walk, then 1-minute jogs with 1-minute walks, building to 3-minute runs over your first three weeks.

30 minBeginner5 movesCardio machine, A wall

More moves for this area

Questions people ask

What causes pain in the arch of the foot?

Often it's plantar fasciitis, which the NHS describes as pain around the heel and arch, worst on the first steps after rest. Pain along the inner arch and ankle, with the arch dropping on one side, is more often the tibialis posterior tendon. Less often it's a stress fracture, a nerve, a lump in the band under the arch or cramp, and the map on this page shows the clues.

Why does my arch hurt in the morning?

Pain on the first steps after sleep or sitting that eases as you get going is typical of plantar fasciitis. A stretch for the sole before you get up, shoes with cushioned heels and good arch support, and heavy heel raises over a few weeks are the steps with trial or NHS support. Our plantar fasciitis guide has the full plan.

Why does my arch hurt when I walk, stand or run?

Long spells on your feet, or a sudden jump in walking, standing or running, can bring on plantar fasciitis, the NHS says. Shorter spells, supportive shoes or insoles, and a gradual build-up help. An ache that gets worse on long walks, with the arch flattening on one side, needs checking for the tibialis posterior tendon.

Do flat feet cause arch pain?

Not usually: the NHS says flat feet usually cause no problems and shouldn't stop you doing sport. In 3,378 adults, a flat foot went with arch pain only in men, and only slightly. A flat foot that is new, painful, stiff or only on one side needs a GP.

Do insoles or arch supports help arch pain?

They help some people a little: for heel pain, insoles beat sham insoles slightly at 7 to 12 weeks in one review and not at all in another, and custom insoles were no better than ready-made ones. For early tibialis posterior tendon pain, arch-supporting insoles reduced pain, especially with exercise. Try ready-made ones first; if your feet feel fine without them later, you don't have to wear them for life.

What shoes are best for arch pain?

Shoes with cushioned heels and good arch support, laces or a strap, and a sole that doesn't bend too easily under the arch. Avoid flip-flops, backless slippers and long spells barefoot on hard floors while it hurts. For running, choose by comfort: picking shoes by foot type didn't prevent injuries in large trials.

Why does the inside of my arch and ankle hurt?

Pain along the inner arch and behind the inner ankle bone, sometimes with swelling and the arch dropping, is typical of the tibialis posterior tendon, most often in women over 40. It's often missed: in one English practice, 3.3% of the women over 40 who replied to a survey had early signs, all undiagnosed. If you can't rise onto tiptoe on that foot, see a GP or physiotherapist.

What is the lump in my arch?

A firm, rubbery lump in the arch can be a plantar fibroma (Ledderhose disease), a harmless growth in the band under the arch that can be sore in shoes but usually doesn't cause the tightening that the hand form can. Treatment ranges from watching it to surgery. A new lump should be checked by a GP once, as our plantar fibroma guide explains.

Why does my arch burn or tingle?

Burning, tingling or numbness in the sole, often worse after walking, can be tarsal tunnel syndrome, a squeezed nerve behind the inner ankle. Numbness in both feet that starts in the toes needs a GP to find the cause. If you have diabetes, new or unexplained foot pain needs your foot team within 24 hours.

What exercises help arch pain?

For plantar fasciitis, a stretch aimed at the sole beat an Achilles stretch, and heavy heel raises with a towel under the toes every second day did better than stretching at 3 months. For the tibialis posterior tendon, resisted exercise with a slow lowering phase did best in a small trial. The plan on this page builds from stretches and light band work to heavy heel raises and balance.

Can pregnancy cause arch pain?

In 49 women measured early in pregnancy and 19 weeks after the birth, arch height had fallen and feet had got longer, with the first pregnancy accounting for much of the change. No exercise has yet been tested to prevent it, so supportive shoes and the foot and calf exercises here are a sensible start (our suggestion).

When should I worry about arch pain?

Contact NHS 111 for severe pain in the bottom of the foot, not being able to walk, a foot that has changed shape, a snap at the time of an injury, or feeling faint or sick from the pain. Get same-day help for bruising on the sole after a twist, fall or stamp, a sudden pop with swelling in the arch, or a hot, swollen foot if you have diabetes. See a GP if heel and arch pain hasn't improved after 2 weeks of looking after it yourself.

Related exercise guides

Ankle and foot guide

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.