Foot Arch Pain: Plantar Fascia, Tendon or Something Else?

Written by Zita Sham, Principal Physiotherapist at Phoenix Rehab, AHPC A1302159H.Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H.Last reviewed 3 November 2026.

The injection into your heel helped for six weeks. Now the ache sits further forward, under the arch, and by the end of a shift you are pressing your thumb into it on the MRT home. Is this the same problem, or a new one?

Arch pain has several causes, and they call for different things. This page covers what each one feels like, what an injection or foot surgery changes, the signs that mean a doctor first, and what to do when insoles have not helped.

What causes pain in the arch of the foot?

Arch pain usually comes from the plantar fascia, the band under the foot, or the posterior tibial tendon, which helps hold the arch up. A jump in walking or running, long hours standing and a stiff calf can load both. Less often it is a stress fracture, a nerve or a torn fascia.

Key takeaways

  • Arch pain usually comes from the plantar fascia or the posterior tibial tendon.
  • A jump in walking or running, long hours standing and a stiff calf can load both.
  • A sudden pop in the arch with bruising under the foot needs a doctor the same day.
  • One arch getting flatter, with pain behind the inner ankle, points to the posterior tibial tendon.
  • A physiotherapist tests the fascia, the tendon, the calf and the single-leg heel raise to find which one is driving it.

First, the signs that mean a doctor, not this page

  • Go to the emergency department now if the foot turns cold, white or blue, or goes numb suddenly; if you cannot take weight after a fall or a twist; or if it is red, hot and spreading with a fever.
  • See a doctor the same day if you felt a pop in the arch, with bruising or swelling under the foot, especially after an injection; or if you have diabetes and the foot is red, warm or swollen, even without pain, or you have a new wound on it.1,2
  • See a doctor soon for one sore bony spot on the midfoot that builds over weeks of running or walking, an arch that is getting flatter on one side, a firm lump in the arch, numbness that is spreading, or pain at night with weight loss or a history of cancer.

None of these? Then the rest of this page is for you.

Had an injection for plantar fasciitis or heel pain?

A steroid injection into the heel is a procedure your doctor decides on. In one clinic series of 765 people with plantar fasciitis, 51 had a rupture of the plantar fascia, and 44 of those ruptures were associated with a steroid injection. Most came on suddenly. The heel pain usually eased, and the series reported arch strain and midfoot strain afterward in some people.1 Whether an injection suits your heel, and what to watch for afterward, are questions for your doctor.

An ache alone does not tell you whether the fascia has torn. A sudden pop, bruising under the foot or a new difficulty pushing off goes to your doctor first. If none of that happened, the arch may have started taking more load while the heel was quiet. That is the part a physiotherapist works on. More on physiotherapy after an injection.

Had surgery on the foot or ankle?

After a flatfoot reconstruction, a plantar fascia release, bunion surgery or an ankle fracture fixation, your surgeon’s protocol sets what the foot may do and when. Weeks in a boot leave the calf and the small muscles of the foot weaker, so the arch can ache when you first walk further on it. Anything hot, red, oozing or suddenly more swollen goes back to your surgeon first. See the Ankle Fracture Surgery Recovery Program and physiotherapy after surgery.

Which part of the arch, and what it usually points to

What you noticeWhat it usually points toWho checks it
Sharp under the inner heel and into the arch on the first steps, easing as you walkPlantar fasciitisA physiotherapist
Along the inner arch and behind the inner ankle bone, worse on stairs and tiptoe; the arch looks flatterPosterior tibial tendonA physiotherapist. A doctor soon if it is progressing
A sudden pop, then bruising under the footA torn plantar fasciaA doctor, the same day
One bony spot on the top or inner midfoot that builds with runningA stress fractureA doctor soon, who decides on a scan
Burning or tingling into the sole, worse after standing or at nightTarsal tunnel syndromeA physiotherapist or doctor
A firm lump you can feel in the archA plantar fibroma, or something elseA doctor soon
Both arches ache after a long day, with no single sore spotLoad: the hours on your feet, the shoes, and the strength of the foot and calfA physiotherapist, if it does not ease

Pain elsewhere on the foot is sorted in the foot pain chart.

Do flat feet or high arches cause arch pain?

Foot shape alone is not a diagnosis. Plenty of people with flat feet or high arches have no pain. Shape matters more when it changes: an adult arch getting flatter on one side, with pain behind the inner ankle, needs the posterior tibial tendon checked. Custom insoles covers who needs one and how they are made.

How do I relieve foot arch pain?

Cut back what jumped: the running, the steps, the hours standing. Wear supportive shoes or indoor footwear instead of going barefoot on tile, stretch the calf and the underside of the foot twice a day, and try a cold pack for 10 to 15 minutes after a long day. For plantar fasciitis, a clinical guideline supports fascia and calf stretching, and taping alongside other physical therapy. It advises against orthoses on their own for short-term pain relief, and says they may be used with other treatment.3 If nothing has changed after two weeks, get it looked at.

How long does arch pain take to go away?

Arch strain from a sudden increase in load often eases over weeks. Plantar fasciitis commonly takes months. In one trial on early posterior tibial tendon problems, the program ran for 12 weeks.4 Timing depends on which structure it is, so find that out first.

Why the insole helped for a week and then it was back

The thinking goes: the arch hurts, so support it.

Now you own three insoles. A tennis ball lives under your desk, and you roll your foot on it through meetings. Your Saturday run is down to the first two kilometers, then a walk back with the shoes in your hand. The doctor’s review is next month, and you would like to say more than “it comes and goes”.

An insole takes load off the arch while it sits in the shoe. It does not make the tendon and the calf able to carry that load. In a 12-week trial of 36 adults with early posterior tibial tendon problems, orthoses and stretching helped, and adding resistance exercise reduced pain and improved reported function further.4 Has anyone counted your single-leg heel raises against the other side, measured how far your ankle bends, and watched what the arch does when you rise on your toes? If not, you are still guessing which part needs the work.

What a physiotherapist does with it

Finding the real problem is half the battle. Treating it is the other half.

At the Assessment & Treatment, a physiotherapist asks when it started and what changed, in your words, then tests the plantar fascia, the posterior tibial tendon, the nerve behind the inner ankle and the midfoot bones. We count single-leg heel raises on both sides, measure ankle and big toe movement, compare the arch sitting and standing, and watch you walk. If anything points to a torn fascia, a stress fracture or a tendon that needs a doctor, we tell you and write to your doctor. Scans and injections are theirs.

Most of the 45 minutes is treatment: hands-on work for stiff joints and the calf, taping where it helps, and a resistance program for the foot and calf that is measured up at each review. You leave knowing which stage you are in, what is limiting the arch, and a written plan. If an insole belongs in that plan, custom insoles are made at Serangoon.

Every appointment is one to one with your physiotherapist for the full 45 minutes, at five clinics: Orchard, Tampines, Serangoon, Tanjong Pagar and Jurong East. Bring any scan report, the date and type of any injection or operation, and the shoes you stand in most.

Questions about foot arch pain

What causes my arches to ache?

The usual causes are the plantar fascia and the posterior tibial tendon, often after a jump in walking, running or hours standing. A stiff calf can add to it. If both arches ache after a long day with no single sore spot, load and footwear are the likely reasons.

Why does the arch of my foot hurt all of a sudden?

Sudden arch pain can follow a jump in activity or new shoes. A pop with bruising under the foot can mean a torn plantar fascia and needs a doctor the same day. One sore bony spot that builds over weeks can be a stress fracture, which needs a doctor soon.

Why does the arch of my foot hurt when I walk?

Walking loads the plantar fascia and the posterior tibial tendon with each step. Sharp first steps that ease point to the fascia. Pain along the inner arch and behind the inner ankle that worsens with walking points to the tendon. A physical test tells them apart.

How do I relieve foot arch pain?

Cut back the activity that jumped, wear supportive footwear instead of going barefoot on tile, and stretch the calf and the underside of the foot twice a day. A cold pack can ease a sore spot. If nothing has changed after two weeks, get it assessed.

Do insoles help arch pain?

They can, as part of a plan. A clinical guideline on plantar fasciitis advises against orthoses on their own for short-term pain relief and says they may be used with other treatment. A small trial on the posterior tibial tendon found adding resistance exercise to orthoses and stretching reduced pain further.

Six weeks after the injection and the ache has moved into the arch? Get Assessed & Treated, and leave knowing whether it is the fascia or the tendon, which stage you are in, and what the next stage asks of it.

Sources: 1. Acevedo JI, Beskin JL. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int. 1998;19(2):91-97. 2. National Institute for Health and Care Excellence. Diabetic foot problems: prevention and management. NICE guideline NG19. 2015. 3. Koc TA Jr, Bise CG, Neville C, Martin RL, McDonough CM. Heel pain: plantar fasciitis, revision 2023. J Orthop Sports Phys Ther. 2023. 4. Kulig K, Reischl SF, Pomrantz AB, et al. Nonsurgical management of posterior tibial tendon dysfunction with orthoses and resistive exercise: a randomized controlled trial. Phys Ther. 2009;89(1):26-37.

Where are you with this right now?

1. It is settling on its own

Most injuries and most flare-ups settle over weeks with sensible load management and a return to normal movement. Improvement is judged over a month, not over a day, and good days and bad days inside that are usual. If you are doing more this month than last, and sleeping better, it is behaving the way it should. You do not need us for this, and we would rather say so.

2. It has stopped improving

You have adapted without noticing. The other foot takes the load, you plan your walking around the arch, and you have quietly dropped things you used to do.

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Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. That is the gap worth measuring, and it is not measured by how you feel on the day.

The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a joint does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds.

3. You have had surgery, or you have a date

Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. Bring your surgeon’s protocol and we work inside it. See the Ankle Fracture Surgery Recovery Program, physiotherapy after surgery, or all the recovery programs, hand and physiotherapy.

All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.

Next step

Find out which stage you are in

Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.

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Where we are

Clinics across Singapore

ORCHARD

400 Orchard Road #12-12

Orchard Towers, S238875

NS22 Orchard MRT

Physiotherapy and hand therapy in Orchard →

TAMPINES

9 Tampines Grande #01-20

Asia Green, S528735

EW2DT32 Tampines MRT

Physiotherapy and hand therapy in Tampines →

SERANGOON

265 Serangoon Central Drive #04-269

S550265 · Lift C only

NE12CC13 Serangoon MRT

Physiotherapy and hand therapy in Serangoon →

TANJONG PAGAR

10 Anson Road #02-77A

International Plaza, S079903

EW15 Tanjong Pagar MRT

Physiotherapy and hand therapy in Tanjong Pagar →

JURONG EAST

2 Venture Drive #02-02

Vision Exchange, S608526

NS1EW24 Jurong East MRT

Physiotherapy and hand therapy in Jurong East →