Plantar Fasciitis can be a stubborn injury that causes intense heel pain for runners. It can lead to extended time off running and even disrupt normal life activities.
As a runner, you’re at a greater risk of suffering from plantar fasciitis than the average person. And so, I highly recommend all my runners learn more about this injury even if they’re not currently suffering from it.
There are things you can do to prevent it, and in case you’re currently suffering from it, I have Jessica Nicolosi Slaven, Master of Physical Therapy, here today help share more about stages of recovery and what are the best treatment options out there for Plantar Fasciitis.
In this article, you’ll also learn exactly what Plantar Fasciitis is, and what are its symptoms and causes.
What is Plantar Fasciitis?
Plantar Fasciitis is essentially an inflammation of the plantar fascia, which is a fibrous band of tissue along the sole of the foot that connects the heel bone to the toes.
It can cause intense heel pain and is one of the most common causes of it as well. Plantar fasciitis can manifest as stabbing pain that can usually be felt with your first steps in the morning.
The pain normally subsides after getting up and moving, but it may return after long periods of standing or standing up after sitting for a while.
It’s a problem many runners face, in fact you’re more likely to suffer from plantar fasciitis if you’re a long-distance runner.
To try and understand this injury a bit more, let’s take a look at its symptoms.
Symptoms of Plantar Fasciitis
Not sure if your pain is Plantar Fasciitis? Here are some common signs and symptoms:
- Sharp stabbing or aching pain in the heel
- Sharp stabbing or aching pain in the arch (location depends on cause)
- Trouble walking after getting out of bed in the morning
- Same issue after sitting for long periods, but pain dissipates with movement
Can you run with plantar fasciitis?
As with any injury this is going to be a bit of trial and error. If you can run without pain then enjoy the miles, but as soon as it starts to act up stop. KEEP going with all of the physical therapy exercises whether there is pain or not to keep it at bay.
Some people find that with a solid warm up and taping, they can continue to run.
Others find that they immediately have heel pain when running and that’s a sign to stop and get some lasting treatment.
Causes of Plantar Fasciitis
The plantar fascia supports the arch of the foot and absorbs shock when we walk. Repetitive strain and tension on it can cause micro-tears to develop. This repeated tearing and/or stretching of the fascia can lead to irritation and inflammation.
When the fascia is irritated and inflamed in this way, it can lead to intense heel pain and manifests as plantar fasciitis.
Previously, doctors thought that bony growths in the feet called heel spurs were the cause of pain. Now it’s widely believed that heel spurs occur as a result of plantar fasciitis and are not the cause of it.
Causes of Plantar Fasciitis in Runners
Plantar fasciitis in runners is usually caused by:
Risk Factors for Plantar Fasciitis
You are at a greater risk of developer plantar fasciitis if:
- You’re a long-distance runner
- You’re overweight, which puts increased pressure on your plantar fascia ligaments. This is especially true if you have experienced sudden weight gain
- Your work involves being on your feet for most of the day, nurses, servers, cooks
- You have structural foot issues, such as low arches or flat feet (pes planus) or high arches (pes cavus)
- You often wear shoes that have soft soles and provide poor arch support
- You have tight Achilles tendons or ‘heel cord’
- You often wear high-heel shoes
- You have tight calf muscles, which makes it difficult to flex your foot and bring your shoes towards your shins
How to Get Diagnosed
If you suspect you have plantar fasciitis, I recommend heading to your doctor. You need to know what this is to start appropriately treating it right away.
Physical therapists are trained to tease out injuries of the plantar fascia itself from those mimicking it such as flexor hallucis tendinitis, interdigital neuroma and injuries to the joints of foot. So expect them to put you through a few movements to land on the correct diagnosis.
You may be asked to flex your foot while they push on the plantar fascia to check if the pain gets worse as your flex and better as you point your toes.
Imaging tests, such as an X-ray or MRI, may also be used to correctly diagnose plantar fasciitis. Although you can really get a good look at soft tissues with an X-ray, it can be helpful when trying to rule out other possible causes of heel pain such as bone fractures and heel spurs.
Why Do We Get Heel Pain from Running?
Heel pain from running is a common complaint in a Physical Therapist’s office. It’s often blamed on heel striking, but for all the reasons note above we can easily develop heel pain.
Go through the checklist to see if your symptoms match those of PF. If they do then use this guide to start getting some relief, but if not then it’s important to keep digging to find out why.
Make sure you don’t have a running stress fracture or a bone bruise.
Stages of Recovery for Plantar Fasciitis
Before you read on, it’s good to know that recovering from an injury moves in stages: acute, rehab and then prevention.
And, it’s also good to know these stages don’t always move in a forward direction. Expect a circuitous course with ANY injury. Our bodies are not easily “fixed”.
So how long does plantar fasciitis take to go away…it can take a very long time.
But don’t get frustrated, just keep following these tips!
{Amanda’s note: boy do I feel this!! Recovery from knee surgery was slow, then speedy, then a little setback, then on the road again. Do your best to take it one day at a time and know that it CAN and WILL get better if you persist with finding the right info for your body.}
So, which stage are you in?
ACUTE – your injury is recent and it’s quite painful, it’s difficult to walk and/or run
REHAB – your pain is intermittent and moderate to mild, you’re feeling able to get back to exercise
PREVENTION – you’re running pain free and loving life. In this stage, you’ll do some routine maintenance to keep it that way.
Plantar fasciitis is one of those lingering nagging injuries that make runners insane. But you can treat and prevent it with these tips! #runchat Click To Tweet
Acute Stage: Begin Recovery Process
In the ACUTE STAGE, you’re going to be begging for exercises, but your injury needs active movement, compression, protection and ice before you can begin to rehab it.
Can I say that again for the folks in the back? Many ask for exercises and stretches at this stage, but ankle/foot stretches and strengthening exercises need to wait a bit.
Ice
Your number one goal when pain is high and you’re having trouble walking is to get that pain under control. Ice the bottom of your foot with a frozen water bottle or dunk it in ice water for up to 15 minutes then let it come back to a normal temperature. Repeat as needed.
This is also the time to start doing all those anti-inflammatory things Amanda preaches! 
Compression
Use a compression sock for comfort and to decrease excessive swelling. Compression socks are designed to reduce inflammation and these particular socks help to provide additional ankle and arch support.
Sensible Shoes
Wear what your Grandma would call “sensible shoes” – sneakers, hiking boots, cushioned slippers – something that allows you to walk pain free, even when just walking around your home.
At night, keep a pair of slippers or flip flops at your bedside for bathroom and snack trips. Most running stores carry “recovery flip flops” that can also be used around the house. In essence, you want SUPPORT.
Taping The Foot
Speaking of support, I just learned about a product, which is extremely useful no matter what type of shoe you’re wearing: QUICK TAPE® foot straps by Support the Foot. No figuring out how to tape your foot, this pre-cut strap wraps around your foot to provide correct alignment and arch support!
It’s designed to stay on while running (and showering), which means this is great from first noticing the issue to getting back to running pain free! 
It’s just a peel and stick which is nice and thin to be worn without any fit issues to your normal shoes.
“QUICK TAPE® support straps custom fit to the shape of either foot, supporting the arch while keeping the ball of the foot and the heel together during the actions of walking, running, and jumping. This is what supports the foot, easing tension off the fascia and arch, relieving pain instantly.”
Fight the Urge to Stretch!
Most stretch too aggressively and this can make the injury worse.
Initial plantar fasciitis recovery plan:
- Make slow circles or letters with your foot throughout the day.
- Move your toes up and down as far as you can.
- Use your fingers to stretch your toes apart or consider purchasing a toe spreader, carried at most pharmacies.
- Bridges and clam shells for strengthening are ok
Stay in the pain free zone with everything.
Find a type of cardio exercise that’s pain free – cycling or swimming are usually tolerated well – to maintain your fitness.
Rehab Stage: Evaluate
In the REHAB STAGE, slowly move into different shoes. Meaning you can start to leave behind the sensible…but really should consider upgrading or changing our your shoes to ensure they aren’t part of the issue.
Let’s go through some ideas for shoes and exercises that you can start to utilize immediately.
What are the Best Running Shoes for Plantar Fasciitis?
The most important quality for most people with PF is arch support.
As your arch falls down during your foot strike, the entire foot rolls inward which is what your body then tries to correct by tightening u pall those other foot and lower leg muscles. It’s also trying to protect you from knee pain.
A few of the shoes often recommended:
Plantar Fasciitis Exercises for Re-Hab
- Begin stretching toes against a wall
- Use a tennis ball or a can to massage the bottom of your foot
- Begin single leg balance (stand on single leg while holding the other at 90 degrees, advance to standing on a pillow)
- Use a Strassburg sock or boot for gentle Achilles stretching. Pro tip: these devices are better tolerated during the day while at work or while watching TV than when sleeping.
- Start towel curls and isolated movement of the toes
If you can’t move your big toe up and down independent of the little toes, keep trying!
It’s like figuring out how to ride a bike. One day your brain will “get it”, your muscles will learn to do these movements and become stronger, protecting your foot from re-injury.
Once your foot is pain free, ease back into walking for exercise and then running. Note this didn’t stay start running right away, it said fix the issue then walk…then run.
Taping for Plantar Fasciitis?
Amanda is a massive fan of RockTape as it made running with her knee injury possible, so we know it’s a great option.
But as will all things, careful not to overdo it just because it makes things seem like they’re better. 
There are a lot of techniques for taping to relieve foot pain, you’ll have to experiment to see which one works for you. Read more on the example above.
Prevention Stage: Keep it From Coming Back!
In the PREVENTION STAGE,we’re committing to ongoing treatment protocols to prevent that pain from reappearing.
- do the toe spreading and toe movements two or more times each week
- continue the glut exercises too, to strengthen hips and glutes
- Work toward being barefoot in the house and then in your yard to develop balance and strength of the smallest muscles of your foot
If anything flares up, head right back to the acute stage strategies until it’s under control. Heel pain when running is NOT normal, don’t convince yourself that it is.
Does your pain persist after trying all of this?
Book a PT consult.
We can assess your posture, movement patterns, test for muscle imbalances, protect the foot with taping and even use dry needling to bring things into balance.
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