Best Shoes for Heel Pain 2025: A Sports Medicine Podiatrist's Complete Clinical Guide to Running Shoes for Foot Pain

If you’re experiencing heel pain while running, the problem isn’t always your shoes—but wearing inappropriate shoes can definitely make plantar fasciitis worse. As a board-certified sports medicine podiatrist who has treated thousands of runners with heel pain and foot discomfort, I’ve learned that most running shoe advice misses the point entirely.

Instead of chasing trends or copying what works for elite athletes, you need the best shoes for heel pain 2025 that match your specific foot function and address any underlying pathology. The right shoes can alleviate pain. The best shoe for heel pain provides optimal support, cushioning, and alignment tailored to your specific foot condition, such as plantar fasciitis or heel spurs. The wrong footwear can turn minor foot pain into chronic plantar fasciitis or other debilitating conditions.

This comprehensive guide will teach you how to choose running shoes based on clinical assessment rather than marketing hype. You’ll learn when supportive shoes can help versus when you need professional intervention from a foot doctor. Most importantly, you’ll discover how to prevent the most common running injuries through proper footwear selection, strength training, and maintaining overall foot health.

Finding the best shoes for your specific foot condition, such as plantar fasciitis or heel pain, requires understanding the relationship between foot anatomy, biomechanics, and shoe features. This isn’t just about comfort—it’s about preventing long-term damage to your heel bone, plantar fascia, and surrounding structures that support your body weight during every step.

About Dr. James Repko, DPM

Dr. James Repko is a board-certified podiatrist with 10 years of clinical experience specializing in sports medicine and running injuries. He is the owner of Bayshore Podiatry Center in Tampa, Florida, where he has successfully treated thousands of runners dealing with heel pain, plantar fasciitis, and complex foot and ankle conditions.

Dr. Repko earned his Doctor of Podiatric Medicine degree from Kent State College of Podiatric Medicine in 2014. He completed his surgical residency at Mercy Regional Medical Center in Lorain, Ohio in 2017, with advanced training affiliations through the Cleveland Clinic Foundation. He maintains active membership in the American Podiatric Medical Association (APMA).

His clinical practice emphasizes biomechanical assessment and functional movement patterns to identify the root causes of heel pain and running injuries. As an endurance athlete himself, Dr. Repko combines evidence-based medicine with practical understanding of training demands to help runners achieve their goals pain-free.

Dr. Repko's approach to treating plantar fasciitis and heel pain focuses on addressing the underlying biomechanical dysfunction rather than just symptom management. His patients consistently report superior pain relief compared to traditional treatment approaches that rely solely on rest and anti-inflammatory medications.

Understanding Heel Pain: The Foundation of Proper Shoe Selection

Heel pain affects millions of people worldwide, with plantar fasciitis being the most common cause of stabbing pain in the heel area. The plantar fascia is a thick band of tissue that connects your heel bone to your toes, acting like a rubber band to support the arch of your foot.

When this tissue becomes inflamed or irritated, it creates the characteristic sharp, stabbing pain that many people experience with their first steps in the morning. This pain occurs because the plantar fascia tightens overnight, and sudden stretching upon standing creates micro-tears in the tissue.

Wearing inappropriate shoes is one of the leading causes of plantar fasciitis and related heel pain conditions. Shoes with insufficient cushioning, poor arch support, or a narrow toe box can create excessive stress on the plantar fascia, leading to inflammation and chronic pain.

The heel bone, or calcaneus, bears tremendous forces during walking and running—up to three times your body weight with each step. Without proper shock absorption and heel support from your footwear, these forces can create painful conditions like heel spurs, which are bone growths that develop as the body tries to protect itself from repeated stress. A bone spur is a bony projection that forms in response to ongoing stress and inflammation in the heel area; it can contribute to heel pain by irritating surrounding soft tissues and is commonly seen in conditions like plantar fasciitis and heel spurs.

Understanding the anatomy of heel pain helps explain why the best shoes for heel pain 2025 must address multiple factors simultaneously: arch support, heel cushion, proper foot alignment, and adequate stability features.

Why Most Running Shoe Advice Fails People with Heel Pain

The biggest mistake I see runners make is choosing shoes based on trends, online reviews, or what makes them “feel faster” rather than what provides adequate arch support and heel support for their individual biomechanics. Instead, it's crucial to select good shoes that offer proper support and cushioning, as these can help prevent heel spurs and alleviate pain. This approach often leads to selecting inappropriate shoes that can make plantar fasciitis worse over time.

The "Trendy Shoe" Problem and Its Impact on Heel Pain

Whether it's minimalist running shoes, zero-drop footwear, or the latest carbon-plate "super shoe," trending athletic shoes may be excellent for some runners but completely inappropriate for others dealing with heel pain or plantar fasciitis. A shoe's popularity doesn't make it right for your foot function or provide the proper arch support you may desperately need.

Many trendy running shoes prioritize performance over foot health, often featuring minimal heel cushion or inadequate stability features. These design choices can be catastrophic for runners with existing heel pain or those prone to developing plantar fasciitis.

The influence of social media and marketing has created a culture where runners choose shoes based on appearance or brand loyalty rather than biomechanical needs. This leads to selecting shoes that may actually contribute to foot pain rather than provide pain relief.

The "YouTube Reviewer" Trap and Heel Pain Considerations

Many running shoe reviewers focus on feel, aesthetics, and performance metrics without any understanding of biomechanics, heel pain prevention, or long-term foot health considerations. They’re not assessing whether a shoe will cause you stabbing pain after 200 miles or provide adequate heel cushion for runners with sensitive heel bones.

These reviewers rarely discuss the relationship between shoe features and common foot conditions like plantar fasciitis. They also fail to explain what makes shoes for plantar fasciitis effective, such as proper arch support, cushioning, and stability features that help alleviate heel and arch pain. They don’t explain how a narrow toe box can lead to hammer toes, or how insufficient arch support contributes to chronic heel pain.

Most importantly, these reviews don’t address the critical question: will this shoe help treat plantar fasciitis or make existing foot pain worse? This omission leaves consumers making decisions based on incomplete information.

The "One Size Fits All" Myth in Heel Pain Management

Most shoe guides recommend specific brands or models without considering your foot type, gait patterns, injury history, or existing foot conditions. This approach ignores the fundamental principle that supportive shoes should match function, not fashion, and provide appropriate arch support for your specific foot structure.

Runners with flat feet need different supportive footwear than those with high arches. People experiencing heel pain require specific shoe features that may be completely unnecessary for those with healthy feet. Various shoe styles are designed to address different foot conditions, offering features like cushioning, support, and stability to improve comfort and reduce strain on the plantar fascia. The best shoes for one person may be inappropriate shoes for another.

This one-size-fits-all mentality has led to countless runners developing chronic plantar fasciitis because they followed generic advice rather than selecting shoes based on their individual biomechanical needs and foot health requirements.

Our Different Approach to Treating Heel Pain Through Footwear

At Bayshore Podiatry Center, we start with a comprehensive biomechanical assessment to identify any pathology or dysfunction, then match shoe recommendations to your specific clinical findings. Sometimes the best advice is "shoes won't fix this—you need professional treatment from a foot doctor."

Our approach recognizes that experiencing heel pain is often a symptom of underlying biomechanical problems that require more than just better shoes. We evaluate how your current footwear may be contributing to your foot pain and identify the specific shoe features needed to alleviate pain effectively.

We also understand that the best shoes for heel pain 2025 must work in conjunction with other treatments like physical therapy, custom orthotics, and targeted exercise routines to achieve lasting pain relief and improved foot health.

Our Clinical Assessment Methodology for Runners with Foot Pain

Before recommending any footwear for heel pain or foot health optimization, we perform a systematic evaluation to understand your foot function and identify potential issues that may be contributing to your discomfort.

Comprehensive Biomechanical Assessment for Heel Pain

Our assessment begins with understanding your specific symptoms and their relationship to your current footwear. We examine how your everyday shoe choices may be contributing to heel pain and identify patterns that suggest plantar fasciitis or other foot conditions.

Knee-to-Wall Test: This functional assessment measures ankle dorsiflexion and is crucial for understanding heel pain patterns. Less than 10 cm between the toe and wall suggests limited range of motion and increased risk of developing plantar fasciitis or Achilles tendon problems.

Limited ankle mobility forces the plantar fascia to work harder during the push-off phase of running, creating the repetitive stress that leads to inflammation and heel pain. This test helps us determine if ankle mobility restrictions are contributing to your foot pain.

Passive Range of Motion Testing:

• Joint mobility evaluation throughout the foot and ankle to identify restrictions

• Assessment of how limited mobility affects running mechanics and contributes to heel pain

• Evaluation of compensatory movement patterns that may be causing foot discomfort

Alignment Evaluation for Foot Health:

• Resting position analysis reveals how your feet naturally align when non-weight bearing

• Standing alignment assessment shows changes that occur with weight bearing

• Forefoot positioning evaluation includes hallux valgus assessment and its impact on overall foot health

Critical Functional Tests for Heel Pain Diagnosis

1st Metatarsophalangeal Joint (Big Toe) Assessment: The big toe joint plays a crucial role in normal walking and running mechanics. Restrictions in this joint can lead to compensatory patterns that increase stress on the plantar fascia and contribute to heel pain.

• Loaded and unloaded range of motion testing reveals essential information about push-off mechanics

• Functional hallux limitus assessment identifies restricted motion during weight bearing that affects the entire gait cycle

• Big toe joint dysfunction often correlates with increased heel pain and plantar fasciitis symptoms

Ankle Mobility Testing for Plantar Fasciitis Prevention:

• Knee-to-wall test results directly correlate with plantar fasciitis risk

• Dorsiflexion limitation assessment reveals how ankle restrictions impact Achilles tendon and plantar fascia stress

• Mobility restrictions often require specific interventions beyond just selecting better supportive shoes

Why We Use the Knee-to-Wall Test at Bayshore Podiatry Center: This test helps identify limited ankle dorsiflexion, which is a common contributor to plantar fasciitis, Achilles tendon pain, and altered running mechanics. It's quick, functional, and far more meaningful than standard measurements for predicting heel pain risk and determining appropriate footwear recommendations.

Stability and Strength Evaluation:

• Single limb stability test assesses proprioception and balance control

• Single leg squat test reveals hip, knee, and ankle control deficits that may contribute to heel pain

• Instability patterns show direct correlation with injury risk and chronic foot pain development

Pathology Identification and Its Impact on Shoe Selection

Forefoot Pain Causes and Shoe Implications:

• Intrinsic foot muscle weakness leads to overload of metatarsal heads and requires shoes with superior cushioning

• Functional hallux limitus causes compensatory stress patterns that increase heel pain

• Hallux valgus creates 2nd metatarsal overload and requires shoes with a wide toe box to prevent hammer toes

Midfoot Assessment for Arch Support Needs:

• Tarsometatarsal joint stability testing reveals midfoot instability patterns

• Arch collapse patterns affect load distribution during running and indicate need for extra arch support

• Midfoot dysfunction often requires custom orthotics beyond what even the most supportive shoes can provide

Posterior Tibial Tendon Evaluation:

• Flat feet association requires specific strengthening and arch support interventions

• Medial ankle pain often indicates posterior tibial tendon dysfunction

• This condition typically requires stability features and proper arch support that a neutral shoe lacks, as a neutral shoe does not provide the necessary stability for this foot condition

Heel Pain Specific Assessments:

• Plantar fascia palpation reveals inflammation patterns and tender areas

• Heel spur assessment through imaging when indicated

• Morning pain patterns that help differentiate plantar fasciitis from other heel pain causes

When You Have No Pathology: Fit and Comfort Guidelines for Healthy Feet

If our assessment reveals no significant dysfunction, shoe selection focuses on fit, comfort, foot health optimization, and personal preference. However, even healthy feet benefit from proper footwear choices that prevent future problems. Ensuring there is enough room in the shoe's toe box is essential for comfort and helps prevent foot problems.

Problem-Solving Approach for Shoe Selection

First, identify your current concerns and preferences:

• What problems are you having with current shoes?

• Where do you experience any discomfort during or after activity?

• What specific features are most important for your activities?

• Do you have any family history of foot problems that might influence your choices?

Understanding your individual needs helps guide shoe selection even when no current pathology exists. Prevention is always easier than treatment when it comes to foot health.

Brand-Specific Fit Characteristics for Optimal Foot Health

Nike Running Shoes: Nike offers some excellent highly cushioned options with higher heel-to-toe drops that provide good heel support. However, Nike shoes tend to run narrow in the forefoot, which may not provide an adequate wide toe box for all foot types.

Nike's construction typically favors speed and performance over maximum comfort, making them excellent choices for healthy feet but potentially problematic for those with existing foot conditions requiring extra support.

New Balance: New Balance excels at width accommodation, offering multiple width options that provide true wide toe box support rather than just stretching the upper material. Their wide shoe platform design provides authentic width support that benefits overall foot health.

New Balance maintains consistent sizing across models, making it easier to find proper fit. Their shoes often feature good arch support and heel cushion, making them excellent choices for both healthy feet and those requiring additional support.

Hoka: Hoka combines superior cushioning with responsiveness, providing excellent shock absorption without sacrificing energy return. Their designs typically offer moderate stability and good heel support.

Most Hoka models feature a wide toe box and substantial heel cushion, making them comfortable for extended periods of activity. The Meta-Rocker technology in many models promotes natural foot mechanics.

Topo: Topo Athletic specializes in wide toe box designs that allow natural toe splay while maintaining a secure midfoot and heel. Most models feature a standard 5mm heel-to-toe drop that works well for most runners.

Their focus on natural foot shape makes Topo shoes excellent choices for people prioritizing long-term foot health and natural movement patterns.

Altra: Altra features excellent forefoot width and wide toe box space in all models, promoting natural toe positioning. However, their standard 0mm heel-to-toe drop across most models makes them inappropriate for many people with heel pain or plantar fasciitis.

Altra shoes work well for runners with strong posterior chain strength and good ankle mobility, but require careful consideration for people with any history of heel pain.

Common Fit Issues Affecting Long-term Foot Health

Lacing Pattern Problems: Proper lacing is often overlooked but critical for optimal fit and foot health. Incorrect lacing can create pressure points, allow heel slippage, or fail to provide adequate midfoot security.

Different lacing techniques can resolve specific fit issues:

• Skip-lacing for high insteps

• Heel lock lacing for heel slippage

• Wide-foot lacing for pressure relief

Width Accommodation Failures: Many shoes marketed as "wide" only stretch the upper material without widening the actual platform. True supportive shoes need wider midsoles and outsoles to provide genuine width accommodation.

Platform width affects stability and pressure distribution throughout the foot. Shoes that are truly wide provide better weight distribution and reduce the risk of developing pressure-related foot problems.

Size Variations Between Brands: Shoe sizing is not standardized across brands, and many people wear incorrect sizes without realizing it. Professional fitting can reveal size discrepancies that affect comfort and foot health.

Feet change size throughout the day and over time. Regular size checks ensure that your shoes continue to provide proper fit and support as your feet change.

Strength & Stability: The Foundation of Injury Prevention

The biggest mistake runners make isn't shoe choice—it's running too fast too often without developing the strength and stability needed for injury-free running. Proper footwear with adequate heel support and arch support supports good mechanics, but it can't create the strength and stability needed for optimal foot health.

The Relationship Between Foot Strength and Heel Pain

Weak intrinsic foot muscles contribute significantly to heel pain development by failing to provide adequate support for the foot's arch structure. When these small muscles cannot maintain proper foot mechanics, larger structures like the plantar fascia must compensate, leading to overuse and inflammation.

Building foot strength is essential for long-term heel pain prevention and overall foot health. Even the best shoes for heel pain 2025 cannot replace the stability and support that comes from strong, well-coordinated foot muscles.

Essential Exercises for Runners to Prevent Heel Pain

Lower Extremity Strength for Heel Pain Prevention:

• Single leg calf raises - 

  • Builds posterior chain strength and Achilles tendon health while reducing heel pain risk

  • Single leg Romanian deadlifts (RDL) - Develops posterior chain integration and balance critical for proper foot mechanics

  • Single leg squats - Functional strength assessment and development for overall lower extremity control

  • Glute bridges - Hip stability and gluteal activation that supports proper foot alignment

  Strong glutes and hamstrings help maintain proper alignment throughout the kinetic chain, reducing compensatory stress patterns that can contribute to heel pain and plantar fasciitis development.

Core and Rotational Stability:

• Planks - Static core endurance that supports proper posture and reduces lower extremity compensation

• Rotational chops - Dynamic stability and power transfer that improves overall movement efficiency

• Kettlebell swings - Posterior chain power and coordination development

• Single leg overhead press - Core engagement with upper extremity demands that challenges total body stability

Foot and Ankle Specific Strengthening:

• Anterior tibial raises - Anterior compartment strengthening that helps with shock absorption

• Daily barefoot walking - 10-15 minutes preferably with toe spacers to promote natural foot mechanics

• Intrinsic foot muscle strengthening - Foundation exercises for proper foot mechanics and arch support

• Towel scrunches - Simple exercises that can be done anywhere to build foot strength

Training Philosophy for Heel Pain Prevention

Mobility work combined with strength training at end range of motion is critical for preventing heel pain and maintaining foot health. Simply being flexible isn't enough—you need strength and control throughout your entire range of motion to handle the demands of running.

The most effective exercise routine for heel pain prevention addresses both mobility restrictions and strength deficits simultaneously. This comprehensive approach provides better results than focusing on either element alone.

Many runners with chronic plantar fasciitis have both ankle mobility restrictions and weakness in the intrinsic foot muscles. Addressing these issues through targeted exercise often provides better long-term results than relying solely on supportive shoes.

Specific Shoe Recommendations by Condition for Maximum Pain Relief

Stability Shoes for Flat Feet/Posterior Tibial Tendon Issues

Brooks Adrenaline GTS 24 GuideRails technology provides gentle guidance without overcorrection, making it one of the most supportive shoes for runners with flat feet. The proven track record for overpronation control, combined with reliable heel cushion and stability integration, makes this an excellent choice for heel pain relief.

The Adrenaline GTS features a firm heel counter and deep heel cup that work together to control excessive foot motion while providing the arch support necessary for flat feet. The balanced cushioning provides comfort without sacrificing the stability needed to treat plantar fasciitis.

Hoka Arahi 7 J-Frame technology offers lightweight stability without the bulk typically associated with motion control shoes. The maximum cushion design combined with effective motion control makes this excellent for runners wanting both comfort and heel support.

The Arahi provides superior cushioning for sensitive heels while maintaining the structural integrity needed to support flat feet. The wide toe box design prevents compression issues that can develop secondary to altered gait patterns.

ASICS Gel Kayano 31 The 4D Guidance System provides advanced stability through multiple components working together to control overpronation. Premium materials and construction make this ideal for serious runners needing maximum support for complex foot conditions.

This shoe features excellent shock absorption and a deep heel cup that provides stability for the heel bone during ground contact. The comprehensive arch support system helps maintain proper foot alignment throughout the gait cycle.

Maximum Cushion for Severe Heel Pain and Chronic Plantar Fasciitis

Hoka Clifton 10 Meta-Rocker technology reduces forefoot pressure while providing substantial heel cushion for pain relief. Despite maximum cushioning, the shoe remains lightweight, making it excellent for high-mileage training when dealing with heel pain.

The Clifton's design specifically addresses the heel strike phase of running, providing excellent shock absorption that reduces stress on inflamed plantar fascia tissue. The wide toe box prevents secondary forefoot issues.

Hoka Bondi 9 Offering ultimate forefoot cushioning combined with maximum heel cushion, the Bondi provides a wide platform for stability that's ideal for runners with severe heel pain or those recovering from chronic plantar fasciitis.

The substantial midsole cushioning absorbs impact forces that would otherwise stress the heel bone and plantar fascia. This makes it an excellent choice for runners who need maximum pain relief during the healing process.

Brooks Glycerin Max Superior cushioning throughout the entire midsole provides excellent shock absorption for sensitive heels while maintaining the structural support needed for proper foot alignment during running activities.

Neutral Cushioned Options for Healthy Feet

Asics NovaBlast 5 A versatile neutral platform that provides excellent daily training capabilities—this is a neutral shoe suitable for runners with a natural gait and no significant foot pathology. Dr. Repko has personally tested this shoe and found it provides good balance of cushioning and responsiveness for runners without significant foot pathology.

New Balance Fresh Foam X 1080 v14 Versatile neutral platform excellent for runners with mild overpronation or normal foot mechanics. The reliable daily trainer provides good cushioning while maintaining the responsiveness needed for varied training activities.

The 1080 offers adequate arch support for most foot types while providing sufficient heel cushion for comfortable daily training. The wide toe box accommodates natural toe splay without compromising midfoot security.

What to Avoid: Shoes That Cause Problems and Make Plantar Fasciitis Worse

Understanding which shoes to avoid is just as important as knowing which shoes to choose when dealing with heel pain or trying to maintain optimal foot health.

For Runners with Achilles or Plantar Fascia Issues

Avoid these shoe categories that can make heel pain worse:

All Altra models - The zero drop design is inappropriate for heel pain conditions as it increases stress on both the Achilles tendon and plantar fascia

Merrell barefoot/minimalist shoes - These lack the necessary heel support and arch support needed for heel pain relief

Any shoe with less than 5mm heel-to-toe drop - Insufficient heel elevation fails to offload affected structures and can make plantar fasciitis worse

Worn-out athletic shoes - Once shoes lose their cushioning and support properties, they become inappropriate shoes that can contribute to heel pain development

The relationship between heel-to-toe drop and heel pain is well-established in clinical practice. Shoes with inadequate heel elevation force the plantar fascia to stretch more during the stance phase of running, increasing tension and inflammation in already sensitive tissues.

For Flat Feet/Overpronation

Avoid these shoe types that compromise foot health:

Pure neutral shoes without stability features - These allow excessive pronation that stresses the medial foot structures

Maximum cushion without stability (such as Gel Nimbus or More v5) - Soft cushioning without control features allows harmful foot motion

Minimalist or barefoot shoes - These worsen arch collapse and increase stress on structures already compromised by flat feet

High heels for daily wear - These alter foot mechanics and increase forefoot pressure while providing no arch support

Runners with flat feet require shoes that provide both cushioning for comfort and motion control to prevent the biomechanical patterns that lead to heel pain and other foot problems.

Universal Shoe Problems That Affect Foot Health

Flip flops and unsupportive sandals - Provide no arch support, heel support, or stability features necessary for proper foot mechanics

Shoes with narrow toe box designs - Create compression that can lead to hammer toes and altered gait patterns

Completely flat shoes - Lack the arch support necessary for maintaining healthy foot mechanics during daily activities

Shoes with insufficient cushioning - Fail to provide adequate shock absorption, increasing stress on the heel bone and plantar fascia

When Shoes Aren't Enough: Custom Orthotics and Professional Intervention

Important limitation: Some foot conditions cannot be adequately addressed with even the best shoes for heel pain 2025 alone. Understanding when to seek professional help is crucial for preventing chronic problems.

Conditions Requiring Orthotic Intervention

Functional Hallux Limitus: No shoe recommendation exists that can adequately address this condition. The big toe joint restriction requires custom orthotics with specific modifications to restore proper mechanics.

This condition cannot be treated through shoe gear alone, regardless of how much arch support or heel cushion the shoe provides. The mechanical dysfunction requires professional intervention to prevent compensatory heel pain.

Severe Biomechanical Dysfunction: Some patterns of overpronation are so severe that they exceed what even the most supportive shoes can control. These cases may need posting and arch support beyond shoe capabilities.

Leg length discrepancies require specific accommodations that cannot be achieved through standard footwear selections.

Complex forefoot deformities need individualized modifications that address multiple problems simultaneously.

Learn more about custom orthotics, their uses and indications here! 

Chronic Plantar Fasciitis and Persistent Heel Pain

When heel pain persists despite wearing appropriate supportive shoes with proper arch support and heel cushion, custom orthotics may be necessary to provide the specific biomechanical control needed for healing.

Custom orthotics can address the underlying mechanical causes of plantar fasciitis while working in conjunction with appropriate footwear to provide comprehensive treatment.

The combination of custom orthotics and the right shoes often provides superior pain relief compared to either intervention alone.

When to Seek Professional Help from a Foot Doctor

Immediate consultation indicators:

• Heel pain persisting despite appropriate shoe changes and conservative measures

• Recurring injuries in the same location that affect daily activities

• Inability to walk pain free regardless of footwear choices

• Morning stabbing pain that doesn't improve with activity

• Heel pain that worsens over time despite treatment efforts

• Your pain is greater than 5/10 on a pain scale 

Progressive symptoms requiring evaluation:

• Development of chronic plantar fasciitis despite wearing supportive shoes

• Heel pain that begins affecting sleep or daily activities

• Signs of compensation injuries in other areas of the foot or leg

• Inability to maintain an exercise routine due to persistent foot pain

A qualified foot doctor can perform comprehensive evaluation including imaging studies when necessary to rule out conditions like heel spurs, stress fractures, or other structural problems that require specific treatment approaches.