What are the Best Ways for a Runner to Prevent and Improve Plantar Fasciitis?

If only we could walk on our hands.

The problem with heel pain or arch pain is that there is no way of avoiding it in daily life. If your foot hurts, every step hurts, and that does not even include how much it hurts to run. Even if you can keep running through plantar fasciitis, is it going to make it worse?

If you have experienced this, you know you will do anything for plantar fasciitis pain relief.

An irritation to the tough, fibrous tissue at the base of the heel, is one of the most bothersome running injuries due to its infamous stubborn nature.

Runners with plantar fasciitis can sometimes have heel pain for months or even years before the fascia finally heals. It can be especially difficult to find shoes for plantar fasciitis that make it feel better, rather than worse.

Because of this, it is very important to catch and treat plantar fasciitis quickly.

Fortunately, if you take care of it, most cases do calm down in a matter of weeks and you will be able to keep running through plantar fasciitis.

Today we are going to help you figure out whether you can run through it or if you should stop running, what causes plantar fasciitis and what you can do to prevent it in future. Most importantly, we are going to give you the best exercises for plantar fasciitis and an effective plan of treatment for plantar fasciitis.

If you struggle with Plantar Fasciitis or think you may be starting to feel it, get it taken care of now. Here is the ultimate guide for runners of how to improve it once you have it, and prevent it in the future. This guide has the symptoms to look for, the treatment for plantar fasciitis, and how to get back to running.

Plantar Fasciitis Symptoms

The plantar fascia is a thick band of fibers that runs from the base of the heel to the metatarsal heads.

It has several branches, any of which may become injured, but by far the most common area of the plantar fascia that’s hurt is the very base of the innermost bundle of fibers, right at the base of the heel.

What does plantar fasciitis feel like?

Plantar fasciitis will hurt the worst at the beginning of a run, but will gradually go away once you get warmed up.

It may return again at the end of the run, and will be more severe in less-supportive shoes or when barefoot.

Your arch or heel may also hurt after a long day on your feet, especially in hard or uncomfortable shoes.

Here’s the way you know you have plantar fasciitis:

The telltale sign involves your “first step pain”.

Do you have a sharp, stabbing pain at the base of the heel immediately after you get out of bed in the morning?

If the answer is yes, unfortunately, you have probably diagnosed your problem.

How common is plantar fasciitis?

Plantar fasciitis accounts for around eight percent of all running injuries,1 and is common among runners of all ability levels, and is even a problem for sedentary people, where obesity and working long hours while standing are probably the driving causes.

Runners, of course, face additional issues due to the forces associated with running, but you shouldn’t overlook your footwear or habits in the rest of your life if you come down with a case of plantar fasciitis.

Women’s footwear is especially bad with respect to strain on the arch, but unsupportive hard-soled men’s shoes are problematic too.

Kristin Marvin talked about what the best shoes for plantar fasciitis are and believe it or not, it is possible to even find dress shoes for plantar fasciitis for both men and women.

What Causes Plantar Fasciitis and What Makes it Worse?

Unfortunately, the root causes of plantar fasciitis are still not fully understood.

There are, however, some clues:

Some studies have found a connection between poor ankle range of motion, especially in dorsiflexion,2, 3 which implies that calf tightness plays a role in the development of plantar fasciitis. Indeed, the plantar fascia itself is in many ways simply a continuation of the Achilles tendon, which anchors the calf muscles to the heel bone.

Think of it this way:

Like a cable that angles around a corner, tight calves could put excessive tension on the plantar fascia, increasing the risk of injury.

As mentioned earlier, obesity and time spent on your feet are risk factors as well,2 though these are not as often a problem for runners.

However, they do indicate that putting high strains on the foot is problematic, and new research out of the University of Delaware has connected high impact loading rates with plantar fasciitis.4

The plantar fascia is also forced to absorb significantly more strain when you wear hard, flat shoes or walk around barefoot.

While the dynamics of “arch support” are not fully understood from a biomechanical perspective, it’s fairly obvious to most sufferers of arch pain that a cushioned, supportive surface feels better on the foot than a hard, flat one.

What is the Best Treatment for Plantar Fasciitis?

The first goal of treatment should be to protect the plantar fascia from additional strain while it is injured.

While the “-itis” suffix implies that inflammation is the cause of plantar heel pain, new evidence indicates that the real problem is damage and degeneration of the fascial fibers5—icing is always a good idea, but it’s not an excuse to continue to strain the plantar fascia with long runs, hard workouts, or unsupportive shoes.

Here’s the deal:

Aggressive rehabilitation, combined with avoiding activities that hurt, are your best chance for a speedy recovery.

Several conservative treatment methods are supported by scientific research.

These treatments are all designed either to protect the arch or stretch the plantar fascia/calf muscle complex.

Arch taping to limit stress

Several studies support arch taping, called “low-Dye taping” in medical circles after Ralph W. Dye, the inventor.6 While there are several ways to do a low-Dye taping, even its most basic form is effective.

The magnitude of the effect, however, is small, so arch taping is only one part of a rehabilitation plan.

low dye taping plantar fascia

Instructions for a low-Dye taping. The lateral straps (lower left, lower right) should be pulled reasonably firmly and should always come FROM the outside of the foot TO the inside.

Orthotic inserts for plantar fasciitis

Supporting the arch with a custom or over-the-counter orthotic is another strategy that can protect the arch while it heals.

It’s unclear whether there is a significant difference between custom orthotics or a rigid over-the-counter orthotic like SuperFeet Green or Powerstep insoles when it comes to treating plantar fasciitis.7

While they may not be tailored for your foot, over-the-counter insoles are not nearly as expensive and are available immediately—you’ll have to wait at least a few weeks for a pair of custom orthotics.

Now:

Avoid soft gel arch supports, as they’ll likely do nothing to help your injury.

Be careful with your casual and dress shoes with plantar fasciitis

In a similar vein, many runners find that wearing casual shoes with more arch support (including Birkenstocks and other brands of cork-soled shoes/sandals) relieves their symptoms.

Calf stretching, foot stretching, and using a night splint for plantar fasciitis have also been researched.

All three treatments are designed to stretch out the calf/Achilles/plantar fascia complex, reducing tension and strain on the arch.

Stretch for plantar fasciitis pain

For lack of any superior exercise, regular calf stretching is the mainstay of most plantar fasciitis treatment programs.

Calf stretching should be done several times a day, including right away in the morning. A typical protocol would be three sets of 30 seconds, three times per day, stretching with the knee straight and bent each session.

Calf stretches, with both a straight knee (top) and a bent knee (bottom)

calf stretches

One study compared a calf stretching protocol to a plantar fascia-specific foot stretch, held for 10×10 seconds, three times per day, and pictured below.8

Plantar fascia-specific stretch. Note that all the toes are stretched, not just the big toe.

This study found better results from the plantar fascia specific stretch; the authors hypothesized that the advantage of the foot stretch is that it recreates the Windlass mechanism, the pulley-like connection between the plantar fascia, heel, Achilles tendon, and calf.

Plantar fasciitis night splint

Night splinting is another treatment which aims to stretch out the plantar fascia.

As its name suggests, a night splint is a device you wear while you sleep which keeps your ankle dorsiflexed.

The theory is that the “first-step pain” that is the hallmark of plantar fasciitis is caused by the arch healing at night without any tension on it.

In the morning, the healing is disrupted by the tension put on the arch when you get out of bed.

Solid, cast-like night splints are available online and at a few specialty stores, but the Strassburg Sock is the best plantar fasciitis night splint we have found as it is an easier and more practical solution.9.

“The Sock” is a regular knee-high sock with a strap that runs from the toes to the kneecap. When this strap is (gently) tightened, the ankle is dorsiflexed like in a regular night splint, but so are the toes.

A Strassburg sock can be ordered online or often picked up at your local running store. Be careful not to put excessive tension on the strap.

Additional Forms of Treatment for Plantar Fasciitis

If you have tried and tested all the above treatments for your arch or heel pain, is there anything else that can be done if you are fed up of dealing with this.

Maybe give these a try:

Massage for plantar fasciitis

Manipulating the tissue of the plantar fascia is an approach that’s become more popular among runners recently.

Using a golf ball or other hard, round object, you can “roll out” your arch much like you’d roll out your quads or calves with a foam roller.

More aggressive soft-tissue manipulations like Active Release Technique (A.R.T.) or Graston Technique are also popular.

All of these are unproven in the scientific literature, however, so while many runners do find them very helpful, there’s no evidence they’ll work for you.

If you do decide to roll out your arch or get some soft tissue work done, icing your foot afterwards is not a bad idea.

Steroid injections in the foot to ease heel pain

Injections of corticosteroids are a common second-line treatment among podiatrists.

While some research has showed that they may help,7 other scientists have urged caution, since their success rate is fairly low and there is a risk of complete rupture of the plantar fascia.10, 5

Ouch.

Application of a corticosteroid like dexamethasone through the skin via iontophoresis, an electric charge-driven process, may be more helpful and have a lower risk of complications than a direct injection.11

This is an issue you should talk with your orthopedist or podiatrist about.

New, alternative treatment for plantar fasciitis

Chronic, long-standing cases of plantar fasciitis can be particularly tricky to deal with.

Two new treatments, extracorporeal shockwave therapy (ESWT)12, 13, 14and platelet-rich plasma therapy (PRP),15 show good promise in treating recalcitrant cases, especially in runners.

Because of their relatively recent development, they may be difficult to get access to, however, and their efficacy is not yet solidly vetted.

What are the best shoes for plantar fasciitis?

Many proponents of minimalist and barefoot running have cured plantar fascia problems by transitioning to a more flexible training shoe that allows the arch to stretch out and strengthen itself.

Unfortunately, there haven’t been any scientific studies that have monitored the effectiveness of barefoot running as a possible treatment for plantar fasciitis.

Therefore, we list it under “other possible treatment options”. If you want to learn more, we recommend listening to our in-depth interview with minimalist running expert Dr. mark Cucuzzella.

Outline of Treatment for Plantar Fasciitis

Because of plantar fasciitis’ reputation for hanging around for months at a time if not properly addressed, even a mild case of arch pain should be attacked aggressively with several treatments.

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It’s a PDF with an outline of the conservative and aggressive treatment options to help you get through your plantar fasciitis.

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Protection, ice, and stretching should be the mainstays of your early treatment.

While you don’t have to completely stop running, you should avoid anything that makes your arch worse, and protect it while you run and while you go about your daily life.

Conservative treatments

These are methods that are fairly simple, inexpensive, and can be done on your own at home.

  • Wear comfortable shoes with some cushioning and arch support, and avoid hard shoes or anything barefoot.
  • Ice your foot several times a day, either with ice cups or a round, frozen object like a plastic water bottle. If you run, ice immediately afterwards.
  •  Stretch your calves at least three times per day. Each session should consist of 3×30 second holds, first with your knee straight, then with it bent.
  •  Stretch your plantar fascia three times per day. Each session should consist of 10×10 second holds. Make sure you stretch right after getting up in the morning.
  • Use a low-Dye taping to protect your arch when you walk around or exercise.
  • Consider using an over-the-counter orthotic like SuperFeet Green or Powerstep in your everyday shoes and running shoes.
  •  Roll out your plantar fascia with a golf ball, taking care not to press too hard on the injured area.

Aggressive treatments

These are treatments with more cost and less certainty about outcomes, but may prove useful in recalcitrant cases.

  • Consider seeing a podiatrist and getting custom orthotics made. They have a large up-front cost and may take a few weeks to arrive, but many runners credit their recovery to orthotics.
  • Talk with your doctor or podiatrist about the risks and benefits of a corticosteroid injection or, preferably (to reduce the risk of plantar fascia rupture), iontophoresis.

Cross Training While Injured and During Recovery

Cross training is recommended while you're injured and as you slowly return to running.

The best form of cross training for this injury is Aqua Jogging. Studies have shown that aqua jogging can enable a well-trained runner to maintain running fitness for up to 4-6 weeks.

Aqua jogging is a form of deep water running that closely mimics the actual running movement.  Your feet don’t actually touch the bottom of the pool, so it is zero impact and safe for almost any type of injury. In my experience, the only time to avoid aqua jogging is when you have a hip flexor injury, which can be aggravated by the increased resistance of the water as you bring your leg up. Because aqua jogging closely mimics natural running form, it provides a neuromuscular workout that, in addition to aerobic benefits, helps keep the running specific muscles active. The same can’t be said for biking and swimming. The only downside to aqua jogging is that you need a pool that is deep enough to run in without touching the bottom. If you’re lucky enough to have access to a pool of this size, aqua jogging should be your first cross training choice.

In one study, a group of ten runners trained exclusively with deep water running for four weeks and compared 5km race times pre deep water running and post deep water running.

The researchers found no statistical difference in 5k time or other markers for performance, such as submaximal oxygen consumption or lactate threshold.

In a second study, researchers measured the effects of aqua jogging over a six week period.

This time, 16 runners were separated into two groups – one who did aqua jogging workouts and the other who did over land running.

Using the same training intensities and durations, the researchers found no difference between the groups in maximal blood glucose, blood lactate, and body composition.

It get’s better:

Research has also demonstrated that aqua jogging can be used as a recovery tool to facilitate the repair of damaged muscles after hard workouts.

These findings make aqua jogging an important recovery tool in addition to being the best cross training method for injuries.

Need one more reason?

The calories burned aqua jogging are even higher than running on land, so if you want to avoid weight gain while you take time off from running, this is definitely the exercise for you!

Aqua Jogging Workouts For Runners

If you're interested in aqua jogging to rehab your injury, then the absolute best way is to use one of my favorite programs, Fluid Running.

First, it comes with an aqua jogging belt and waterpoof bluetooth headphones so you have everything you need to aqua jog effectively.

Second, they have an app that pairs with the headphones so you can get workouts, guided instructions on how to aqua jog properly, and motivation while you're actually pool running.

This has been an absolute game changer for me when I am injured.

I used to dread aqua jogging workouts because they were so boring and it took all my mental energy to stay consistent.

But, with workouts directly in my ear, it's changed the whole experience and I actually look forward to the workouts. So much so that I now use aqua jogging as a cross training activity in the summer, even when I am not injured.

Fluid running is an awesome deal when you consider it comes with the belt (highly recommended for better form), the waterproof headphones (game changer for making pool workouts fun), a tether (to add variety to the workouts you can do) and the guided workout app (to make your cross training structure and a whole lot more interesting).

That's why we've partnered with them to give you 2 additional running-specific workouts you can load into the app when you use the code RTTT .

Check out the product here and then on the checkout page, add the code RTTT in the coupon field and the workouts will be added to your order for free.

If you'd rather do the aqua jogging workouts on your own, here are some great ideas to get you started!

Medium Effort Workouts

The Pyramid

10 minutes easy warm up - 1:00 hard, 30 seconds easy - 1:30 hard, 30 seconds easy - 2:00 hard, 30 seconds easy - 2:30 hard, 30 seconds easy, go to 5:00 in 30 second intervals and then come back down the pyramid (4:30 hard, 30 easy, 4:00 hard, 30 easy etc). Finish with 10 minutes easy cool down.

Wave your hands in the air like you just don’t care

10 minutes easy warm up, 1 minute medium (87-92% of maximum heart rate or what feels like tempo effort), 1 minute sprint (95-100% of maximum heart rate or all out sprint), 30 seconds hands in air (keep moving your legs in the running motion, but put your hand above your head), 1 minute rest, Repeat 10-15 times. 10 minutes easy cool down.

Hard Workouts

One of the difficulties of cross training is replicating those truly lung-busting, difficult workouts.

So, if you’re going to be pool running quite a bit due to injury or limited training volume, invest in a bungee cord designed for sprinters.

Tie one end of the resistance band to a sturdy object (pole, lifeguard stand, pool ladder) and bring the other into the water with you.

Put the strap around your waist and begin aqua jog away from your starting point.

You’ll begin to notice the bungee tighten and resist against you (depending on the length of your pool, you may need to wrap the bungee around the supporting object or tie it in knots to make it shorter to feel resistance).

Spend a few moments testing yourself to see how far you can pull the bungee.

This is a great challenge and a fun way to compete with yourself during an otherwise boring cross training activity.

Now for the hard part:

Pick a point on the pool wall or side of the pool that you feel stretches the bungee to a very hard sprint that you could maintain for 60-90 seconds.

This will be your “sprint” marker that you’ll use on sprint intervals (95-100% of maximum heart rate or all out sprint).

Now:

Find a point that feels like the end of a hard tempo run.

Mark this spot as your “medium” interval distance.

When you complete the hard workouts, you can use these reference points to ensure that you maintain a very hard effort.

The springboard

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minute medium, 1 minute sprint, 1 min rest (let the bungee pull you back – this is kind of fun). Repeat 10 times. 10 minutes easy cool down.

The race simulation

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 5 minutes medium (focus and concentrate, just like during the hard part of a race), 30 seconds sprint, 2 minutes rest. Repeat 4 times. 10 minutes easy col down

The lactic acid

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minutes sprint, 90 seconds rest. Repeat 12 times, 10 minutes easy cool down.

I guarantee that with the bungee, you’ll get your heart rate through the roof.

You can challenge yourself and make aqua jogging more fun by seeing how long you can stay at your maximum stretched distance or seeing how far you can push it.

Likewise, if you have a friend who is injured (or someone willing to be a good sport) you can try pulling each other across the pool for some competitive fun.

Cross training can be tough, especially when you’re injured or want to be increasing your volume faster.

However, I hope that providing a variety of workouts, either through the Fluid Running app (which also makes it easier to keep track of the workout while in the water) or on your own can add a fun challenge in the pool and you can emerge from your injury with minimal fitness loss.

How Can I Get Back to Running if Plantar Fasciitis Makes Me Stop Running

How quickly you can return to running will depend on the severity of your injury and how fast you heal.

Some runners find that they can work their way back into running even while some residual arch stiffness persists, but if running is making your arch pain worse, you need more time off and more time for your rehab program to do its job.

Don’t panic though, we do not lose fitness as fast as most people think!

As you return to running, consider increasing your stride frequency by 10% or so to reduce your impact loading rate,16 a factor connected with the development of plantar fasciitis in runners.

Keep stretching your calves even after you’ve recovered to stave off any future bouts with plantar fasciitis.

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References

1. Taunton, J.; Ryan, M.; Clement, D.; McKenzie, D.; Lloyd-Smith, D.; Zumbo, B., A retrospective case-control analysis of 2002 running injuries. British Journal of Sports Medicine 2002, 36, 95-101.
2. Riddle, D. L.; Pulisic, M.; Pidcoe, P.; Johnson, R. E., Risk factors for plantar fasciits: a matched case-control study. Journal of bone and Joint Surgery 2003, 85 (5), 872-877.
3. Kibler, B. W.; Goldberg, C.; Chandler, T. J., Functional biomechanical deficits in running athletes with plantar fasciitis. American Journal of Sports Medicine 1991, 19 (1), 66-71.
4. Davis, I. S.; Pohl, M. B.; Hamill, J., Biomechanical and Anatomic Factors Associated with a History of Plantar Fasciitis in Female Runners. Clinical Journal of Sports Medicine 2009, (19), 372-376.
5. Lemont, H.; Ammirati, K.; Usen, N., Plantar fasciitis: a degenerative process (fasciosis) without inflammation. Journal of the American Podiatric Medical Association 2003, 93 (3), 234-7.
6. Dye, R. W., A Strapping. 1939. Journal of the American Podiatric Medical Association 2007, 97 (4), 282-284.
7. Cole, C.; Seto, C.; Gazewood, J., Plantar Fasciitis: Evidence-Based Review of Diagnosis and Therapy. American Family Physician 2005, 72 (11), 2237-2242.
8. DiGiovanni, B. F.; Nawoczenski, D. A.; Malay, D. P.; Graci, P. A.; Williams, T. T.; Wilding, G. E.; Baumhauer, J. F., Tissue-Specific Plantar Fascia-Stretching Exercise Enhances Outcomes in Patients with Chronic Heel Pain - A Prospective, Randomized Study. Journal of Bone and Joint Surgery 2006, 88-A (8), 1775-1781.
9. Barry, L. D.; Barry, A. N.; Chen, Y., A Retrospective Study of Standing Gastrocnemius-Soleus Stretching versus Night Splinting in the Treatment of Plantar Fasciitis. The Journal of Foot and Ankle Surgery 2002, 41 (4), 221-227.
10. Ziya Tatli, Y.; Kapasi, S., The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies. Current Reviews in Musculoskeletal Medicine 2009, 2 (1), 3-9.
11. Gudeman, S. D.; Eisele, S. A.; Heidt, R. S. J.; Colosimo, A. J.; Stroupe, A. L., Treatment of Plantar Fasciitis by iontophoresis of 0.4 percent dexamethasone-a randomized double blind placebo-controlled study. American Journal of Sports Medicine 1997, 25 (3), 312-317.
12. Rompe, J. D.; Decking, J.; Schoellner, C.; Nafe, B., Shock Wave Application for Chronic Plantar Fasciitis in Running Athletes: A prospective, randomized, placebo-controlled trial. American Journal of Sports Medicine 2003, 31 (2), 268-275.
13. Ogden, J. A.; Alvarez, R.; Levitt, R.; Cross, G. L.; Marlow, M., Shock wave therapy for chronic proximal plantar fasciitis. Clinical Orthopaedics and Related Research 2001, (387), 47-59.
14. Moen, M. H.; Rayer, S.; Schipper, M.; Schmikli, S.; Weir, A.; Tol, J. L.; Backx, F. J. G., Shockwave treatment for medial tibial stress syndrome in athletes; a prospective controlled study. British Journal of Sports Medicine 2011, 46 (4), 253-257.
15. Barrett, S. L.; Erredge, S. E., Growth Factors for Chronic Plantar Fasciitis? Podiatry Today 2004, 17 (11), 36-42.
16. Hamill, J.; Derrick, T. R.; Holt, K. G., Shock attenuation and stride frequency during running. Human Movement Science 1995, 14 (1), 45-60.

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39 Responses

  1. In my personal experience, plantar pain is always connected with tightness and knots higher up in the calf, either the gastrox/soleus or the peroneals (which run down the outer part of the calf). Trigger point massage on those muscles, often coupled with use of the foam roller or massage stick and a day or two off, can usually eliminate plantar pain quickly if I catch it right away.

    1. Agreed, Adam. I think the keyword sentence there is “if you catch it right away”. PF problems are pretty easy if treated immediately, but once it gets bad – ouch.

      1. My wife has the worst case scenario – back in college in the late 80s, she started having foot pain, and over the next 25 years she went through nearly every imaginable treatment for PF. Everything seemed to help a little at first, but was ultimately unsuccessful. In the last year or so, she has managed to beat it largely by focusing on better running mechanics and getting into more minimal shoes, and she’s run her first races since college this fall (which makes going to cross-country meets even more fun!). I suspect that a number of the treatments actually did help, but because her form was bad and she was wearing problematic (in retrospect) shoes, it just came back quickly each time.

    2. I find with plantar fasciitis there is a specific intensely painful point about 6 inches above the lateral ankle between the tibia and the fibula with a coresponding point behind that point toward the back of the calf. (It is not a trigger point.) Releasing it only requires firm (but not hard contact). Over a period of time, it releases and the pain reduces. I find the peroneals are actually more important than the gastroc and soleus for relieving PF pain.

    3. Completely agree, with my history of plantar fasciitis including my SO’s recent battle with it, tightness of the calves is definitely a huge factor. I find that proper stretching of the legs/calves including using a foam roller would help immensely with prevention- good shoes and a proper running form will also help you make great strides. Issue is people assume one they get plantar fasciitis that stretching it or wearing orthotics will help- big nono. Firstly, the plantar is a thin tissue comprising of 3 bands (tough fibrous tissue) which like any other of your muscles, will further tighten and get agitated when stressed. Would you jab at an open wound? Stretching and using hard orthotic inserts will essentially be the same thing. My secret just literally consists of icing, rest, massaging, Dr. Scholl’s athletic gel soles/inserts (super soft supports that wont cause further harm) and BFST Plantar Wrap (stimulates blood flow in my plantar using EMR to bring nutrients and oxygen back into my feet to promote healing). http://www.kingbrand.com/Plantar_Fasciitis_Treatment.php?REF=33PV1

  2. Excellent article. All of the stretches and strengthening exercises demonstrated can prove incredibly useful, however, the overwhelming stress of a person’s bodyweight upon an arch in a gravity environment cannot be overcome without a helping hand. Let’s not forget the average person takes over 10,000 steps per day. This is largely exaggerated by running.

    So, the true question is…”How does this inflammatory process begin?” Common contributors to this condition include: progressive flattening of the arches over time (primary reason); lack of flexibility in the calf muscles; changes in activity levels; overuse; and weight gain. When your arch drops, the plantar fascia begins to tear away from its insertion at the heel. When this happens over a long period of time, it can overcome the body’s ability to repair itself.

    So, a potential solution is a custom foot orthotic created from an accurate 3D impression of a clients corrected foot posture and calibrated to their weight, foot flexibility and activity level. Unfortunately, most “custom” foot orthotics fail to support the clients arch in a full contact position which clearly fails to meet the definition of custom. Therefore, a truly custom foot orthotic created from an accurate 3-D impression of their feet, calibrated to match their weight, foot flexibility, and activity level could provide the relief and solution you need! Additionally, an orthotic made completely from scratch, with no generic starter plates, add-on pads or arch filler could make a huge difference of force passage through your foot.

  3. I like to call Plantar fasciitis the “nuisance injury” because it’s pretty hard to fully rest your feet…ever! Tight calves, lack of arch or foot support, or a tight Achilles are often causes of PF. Stretching the interconnective chain of the lower leg (Calves, Achilles, and bottom of foot) is key to getting rid of PF for good. THe ProStretch is a great tool that stretches all three areas at the same time. Check it out: http://www.medi-dyne.com. Medi-Dyne offers a discount to Facebook fans http://www.facebook.com/medidyne if they order online.

  4. Very well researched, but also balancing out the peroneals and the tibialis anterior strength in relation to the calf will really help with the relief of plantar fascitis

  5. A very informative article. I don’t do all of the stretching/preventive techniques discussed, but I definitely do some of them and I notice a difference (usually cramping) if I don’t do those. I think it is important to take this kind of preventive action even if PF is not a problem for future prevention.

  6. Fantastic advice, for which many thanks. Can anyone give me any idea about the recovery takes place? Will it suddenly feel better? Is the improvement gradual? Are there improvement/deterioration plateaux? I have now had this injury for 9 months – is there any likelihood that it will recover in the next few months? I have done no running or other impact sports in this time. Should I keep off them, or is it a good idea to re-introduce activity before complete recovery?

  7. my only good lasting results for dealing with plantar fasciitis and achilles tendonitis, have been with the ancient practice of castor oil hot packs daily for several days. i use a clean thick white cotton sock, and soak only the heel area with castor oil, heat it a bit in micro when i take it out of freezer storage, put it on, and wrap in 2 plastic bags, another larger sock. Then wrap and secure a heat pad around the heel. low heat for 45 minutes or more. i dont wash any oil off but rather, rub it in. use castor oil hot pack for 3 days or more, then only as needed. it’s been a life-changing tool for me. many videos on YT about castor oil packs, but i’ve never seen one for tendonitis, fasciitis pain.

  8. I have had cronic plantar fascitis for over 2 years. I’ve done physical therapy, injections, surgery, more PT, more injections all with no positive results. I’ve worn several types of boots during the day and at night. I’ve used various orthopedic inserts in my sneakers. I’ve been to 2 orthopedic surgeons, and 6 podiatrists. I don’t know what to do next. Is there any research going on that I could participate in? Do you have any other suggestions?

  9. A very good article Jeff, well researched. I’d like to pass along our Technical Paper on exercises & stretching for Plantar Fasciitis and get your comments as we are in the process of setting-up a clinic trial. In addition to some of the exercises and stretches you’ve outlined, we’ve had success with incorporating eccentric loading in to the strengthening program after about 4 weeks, essentially treating the plantar fascia as a thick tendon:
    http://www.afx-online.com/news_research/afx-technical-paper-plantar-fasciitis/
    Full Disclosure: I’m one of the people who invented the product that is seen in the exercises and the Paper is on our Company website, but it is *not* a marketing piece. I just want to reach out to people who have done solid research on PF and see if they have anything to add. You can send your comments to me directly at matt progressivehealth.ca. Thanks!

  10. I’ve had Plantar Fasciitis in both feet and I couldn’t seem to find any relief from the pain. I took 5 shockwave therapies till now and have been stretching exercising and putting night split, ice rolling, shoes. And I couldn’t even walk without pain. I’ve been using MEDICOVI Twin-heels orthopedic insoles. There’s extensive information for patients on their page – http://www.medicovi.com . It’s a new type of orthopedic from Scandinavia, Denmark. I’ve been using theese for months now and I’ve just bought my second pair. I’ve always suffered from pain in my feet, especially around the heels. Since owning these my life has literally changed. I can now run with a smile on face. Can’t recommend them highly enough.

    1. Thanks Michael. I have suffered from Plantar Fasciitis for about 3 years. Advil and icing were no longer giving any relief. I was desperate as the PF was getting debilitating. These MEDICOVI inserts gave me great relief from day 1. Highly recommend.

  11. Plantar fasciitis is one of the most common explanations of heel pain. It is caused by inflammation to the thick band that connects the toes to the heel bone, called the plantar fascia, which runs across the bottom of your foot. The condition is most commonly seen in runners, pregnant women, overweight people, and individuals who wear inadequately supporting shoes. Plantar fasciitis typically affects people between the ages of 40 and 70.

    Symptoms
    Plantar fasciitis commonly causes a stabbing pain in the heel of the foot, which is worse during the first few steps of the day after awakening. As you continue to walk on the affected foot, the pain gradually lessens. Usually, only one foot is affected, but it can occur in both feet simultaneously.

    Diagnosis
    To diagnose plantar fasciitis, your doctor will physically examine your foot by testing your reflexes, balance, coordination, muscle strength, and muscle tone. Your doctor may also advise a magnetic resonance imaging (MRI) or X-ray to rule out other others sources of your pain, such as a pinched nerve, stress fracture, or bone spur.

    Treatment
    Treatment for plantar fasciitis includes medication, physical therapy, shock wave therapy, or surgery.

    Medications
    Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are used to treat the inflammation and pain of plantar fasciitis, but they won’t cure the condition. Corticosteroids can also be used to ease pain and reduce inflammation. Corticosteroids are applied either as a topical solution in conjunction with a non-painful electric current or through injections to the affected area.

    Physical Therapy
    Stretching exercises for the Achilles tendon and plantar fascia are recommend to relieve pain and aid in the healing process. Sometimes application of athletic tape is recommended. In moderate or severe cases of plantar fasciitis, your doctor may recommend you wearing a night splint, which will stretch the arch of your foot and calf while you sleep. This helps to lengthen the Achilles tendon and plantar fascia for symptom relief. Depending on the severity of your plantar fasciitis, your physician may prescribe a store-bought orthotic (arch support) or custom-fitted orthotic to help distribute your foot pressure more evenly.

    Surgery and Other Procedures
    When more conservative methods have failed to reduce plantar fasciitis pain, your doctor may suggest extracorporeal shock wave therapy, which is used to treat chronic plantar fasciitis. Extracorporeal shock wave therapy uses sound waves to stimulate healing, but may cause bruises, numbness, tingling, swelling, and pain. When all else fails, surgery may be recommended to detach the plantar fascia from the heel bone. Few people need surgery to treat the condition.

    Home Remedies
    Stretching your plantar fasciitis is something you can do at home to relieve pain and speed healing. Ice massage performed three to four times per day in 15 to 20 minute intervals is also something you can do to reduce inflammation and pain. Placing arch supports in your shoes absorbs shock and takes pressure off the plantar fascia.

  12. Ive been training for a half marathon (which is Sunday) and I started feeling the arch pain two weeks ago. I’ve been able to do a few short runs since then without pain, maybe just some pulling. If I feel the pain during my race Sunday, will the pain subside at any point if I try to run through it to finish?

  13. I have also found a stretch that really really helps relieve my plantar fasciitis. Put your leg up at a 90 degree angle or as much as possible resting it on a chair, bed ect. Dorsiflex your foot and pull on it at the toes, or ball of your foot, while bending your back forward. I saw video on this once and it has helped give instant relief. They called it the fascia stretch and the theory behind it, is that it stretches your fascia from your back, all the way down to your foot. Which is supposedly all connected? Anyways it gives me instant relief.

    1. Thats great William, thanks for sharing your insight on what helps to relieve the stress. That is not surprising that it helps though, you are right that it is all connected. Hope your plantar fasciitis continues to improve!

  14. Stretches are by far the best treatments for PF, For the loads of pain that you have in the morning I suggest the splints be worn at night. Ice works when the pain gets worst through out the day, but in my opinon the wall stretch works the best. However the cure could be a challenge, I’ve spent quite a lot of time and money on my PF.

    1. Hi Montrell, thanks for sharing. Great thinking with the splint at night, it helps many runners out, and is great for easing the pain in the morning. Thanks for sharing your thoughts on the best stretch that worked for you!

  15. I had my first bout with PF three years ago, in my left foot. I saw a sports chiropractor who treated me with Graston and ART. As it turned out, my left leg is shorter than my right and I had a ton of accumulated scar tissue under my heel and in my arch. Graston and ART helped to a certain point, and then my doctor started me on shockwave treatments which finally did the trick. It took about six months, and it probably would have been less if I didn’t try to run through it.

    Now I have PF in my right foot along with achilles tendonitis at the insertion and my doctor is treating me with Graston and ART again. I am sure that there is something wonky in my gait that is causing this (along with other minor injuries that my doc has treated since my first case of PF went away). Not only is it depressing to be in too much pain to run, but the constant pain when just trying to do everyday things like walk through the grocery store can bring a person down, too. However, since I had success with Graston, ART and shockwave before, and because I have caught this bout of PF early, I am confident that I’ll have it beaten quickly.

    PS — I also read your article about achilles tendonitis and have started doing the exercises for insertional tendonitis….and I swear, after only a couple of days, it is making a difference! I was feeling pain in my lateral heel, along with PF pain under my heel — miserable! The lateral heel pain is a good bit better already.

  16. It’s so incredibly rare for real clinical research to be a part of sports medicine media, I was immediately drawn by the title of your article. Can you cite the journal articles supporting your statements? It would really add value; otherwise it’s just another of the thousands of “trust me” articles (albeit better-written).

    Thank you!

  17. I have same problems for 6 months . When I spoke with my doctor he said most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. But your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time.
    I love running and walking so he reccommended running shoes to me. I bought running shoes on http://www.yourcomfyfeet.com/ and now I can run without pain.If you have foot pain at night , you can use night splint.It is a good solutioni

    1. ce Massage

      Although technically not an exercise, it is a muscle-manipulator in a manner of speaking. This is quite a straightforward ‘exercise’.
      Freeze a water bottle (filled with water, of course) and roll it under your feet for 10 minutes.
      Not only does this technique loosen your foot muscles it also controls any inflammation in that region. The cold can be a tad uncomfortable but then again the pain of plantar fasciitis can be far worse.

  18. it’s a real nightmare, pf…
    it happened to me a week ago, quite sudden, it feels like i will never run again. i’m on crutches most of the day, limping the rest. i try to do a lot of deep tissue massage myself, but would like a pro to do that. gonna get a night splint as well, i do lots of ball rubbing and stretching, icing, hot / cold footbath (feels really good) but very little improvement so far. question: can you do too much work on the foot, like would stretching 10 sessions be bad? or rolling the ball for half an hour?
    i wish everyone speedy recovery and pleasureable runs in the near future!!!

  19. Very well researched, but also balancing out the peroneals and the tibialis anterior strength in relation to the calf will really help with the relief of plantar fascitis

  20. In my article “Boots to work in” I primarily count on georgia giant workboots in my job as a truck driver. otherwise after straining the heel and being diagnosed with plantar fascitis in 08, it was a couple years before I found relief from the constant pain and discomfort. It was a sudden traumatic move on the baseball field that tore this part of the foot when I jumped long and landed hard! it is mostly ok now except I fully relate that sometimes I wake up and its obvious its not going to be a good day especially on my right foot with a deep radiating soreness. it passes eventually so I’m thankful for that. whether a “relapse” or caused by other, such as sciatic related, or simply sometimes from not remembering to remove my wallet from my pocket and sitting and driving, wheras the pain is related the next day, rather than at the time of offence. thanks for the article. take as little pain meds as possible, use the shoe that offers support and relief, as well as get off your feet as often as possible!.

  21. Stretching
    There is a particular way to do this, so do not rely on the first visualization that pops into your mind
    • Sit down on a chair and cross a foot at the ankle
    • Using your hands to pull your toes up until you feel that singular stretching sensation along the heel region, including the ball of your foot
    • Hold that position for 30 seconds
    This exercise alone can make a world of difference to your pain levels, providing instant relief in most cases.

  22. The shoes you choose matter a lot if you want to prevent or improve plantar fascistic symptoms.

    The plantar fascia is the flat band of ligament that connects your heel bone to your toes. It supports the arch of your foot. If you strain your plantar fascia, it gets weak, swollen, and irritated. Then your heel or the bottom of your foot hurts when you stand or walk.

    It is relatively more common problem for you if you are an athlete or a runner. This can make your feet sore and your walk painful. But it can be effectively dealt with if you do the best for your feet with the right and best running shoes for plantar fascistic. And if you are willing to say goodbye to the aching feet then start it with the new pair of shoes.

    1. I was having a lot of pain in my ankles so I had to stop running. Lucky for me, I got to test out a pair of Shoe Bubbles. They feel great, my ankles have healed up, I was told by some specialist that I was over-pronating, seems like these have fixed the issue and I’m back to running again!! It’s been about 10 months http://wealfeet.com/

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