How to Run with Plantar Fasciitis

Plantar Fasciitis is inflammation of the band of tissue (ligament) which stretches underneath the sole of the foot, and is one of the most common causes of heel pain. This ligament supports the arch of the foot and connects the base of the toes to the heel, whilst a pad of fat cushions the heel and Plantar Fascia from impact when we run or walk.

How will I know if I have plantar fasciitis?

Your heels or the soles of your feet will feel tender either first thing in the morning when you first put your feet on the floor, or after standing on your feet for a while. You may experience sharp pain under the heel or a dull ache underneath the foot. If you sprain your plantar fascia, the bottom of your foot or your heel will be tender whenever you stand or walk.

What causes it?

Plantar fasciitis can be caused by anything that places a strain on the arch of the foot. Common causes are:

• High arches of the foot
• Flat feet
• Over-pronation (your foot rolls inwards too much)
• Standing, walking or running on hard surfaces
• Excessive body weight
• Tight Achilles tendon or tight calf muscles
• Poor-fitting footwear
• Frequent, high intensity exercise such as running.

This ligament often becomes inflamed when heel spurs occur and may be called plantar heel spurs. It is important to try and discover the cause of the fasciitis to prevent it happening again – in particular check the following:

• Check you have ample flexibility in your calf muscles and Achilles tendon – you should be able to take a reasonably large stride backwards to stretch these muscles and not feel tightness when you stretch.
• Check your footprint for over-pronation, flat feet or high arches or check out your running gait (footfall) in a specialist running shop or with a podiatrist. Buy supportive running shoes, and consider orthotics if necessary for your every day shoes to prevent inward rolling and provide extra support.
• Lose weight if you are overweight.
• Avoid standing or running on hard surfaces.

Can I continue to run?

No – the inflammation and injury will just become worse. How can I treat it?

Follow these guidelines initially, and if the pain continues see a physiotherapist or sports therapist for advice and a definite diagnosis.

• Stop running!
• Rest your feet as much as you can – avoid walking or standing for long periods of time.
• Keep off hard surfaces such as concrete pavements.
• Ice your heel or the bottom of your foot to reduce inflammation.
• Wear shoes with good arch support and cushioning.
• Avoid walking around bare foot.
• Consider inserting orthotics in your shoes to provide extra cushioning, support the arch of your foot and remove tension from the Achilles tendon.
• Gently massage the sole of the foot several times daily to release tension in the ligament and increase circulation.
• Perform gentle calf stretches several times a day. You can also stretch the calves by standing on a step, placing the toes of one foot on the edge of the step, and allowing the heel to drop downwards.

To adequately stretch the calf muscles and the Achilles tendon bear these guidelines in mind:

• You should not feel any pain when you stretch
• Ease into each position slowly and stop when you feel a stretch in the muscle or tendon
• Relax into this stretch and hold for 30 seconds
• Now see if you can stretch a little further and hold again.

Exercises for the plantar fascia

Try these exercises to ease plantar fasciitis, particularly first thing in the morning or after being on your feet for a long time. Doing these every day will also help to prevent this condition recurring as they strengthen the foot muscles which support the arch of the foot and increase the flexibility of the plantar fascia.

• Before you get out of bed, flex your foot up and down ten times slowly. Each time you bring the toes up towards you, you will feel a stretch underneath your foot – hold this position for ten seconds.
• Place a rolled towel beneath your foot holding the ends and keeping your leg straight. Pull both ends of the towel towards you, stretching the bottom of the foot and calf muscles. Hold this for 20-30 seconds.
• Whilst seated, roll a tennis ball underneath the arch of your foot. Progress to doing this whilst standing when you can.
• Try picking things up with your toes! This provides a workout for the foot muscles that they don’t often get.

How long will it take to mend?

As with all injuries, this will depend upon the severity of the fasciitis, how long you have had it, and how much remedial exercise you can do to enhance recovery. Plantar fasciitis normally develops over a long period of time, so it usually takes a few weeks or even months to fully heal.

Prevention is better than cure

• Do the exercises above to strengthen and stretch the foot muscles and ligaments.
• Wear shoes with good arch support and cushioning.
• Avoid running or walking long distances on very hard surfaces – run on dirt tracks or tarmac rather than concrete pavements, or at least vary your running terrain.