Running Tips: Plantar Fasciitis

what is plantar fasciitisHave heel Pain when you wake up? Here’s a 3 step approach to treating Plantar Fasciitis!

Do you have heel pain when you first wake up in the morning? Is that first step just a killer? Plantar Fasciitis is a common running injury and is also common among people who spend a lot of time on their feet in shoes. Where it isn’t common is among habitual barefoot populations. In fact, it doesn’t exist among people that don’t wear shoes.

What is Plantar Fasciitis?

The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the toes. It has been reported that plantar fasciitis occurs in two-million Americans a year and in 10% of the U.S. population over a lifetime. It is commonly associated with long periods of weight bearing. Among non-athletic populations, it is associated with a high body mass index. The pain is usually felt on the underside of the heel and is often most intense with the first steps of the day. Another symptom is when the sufferer has difficulty bending the foot so that the toes are brought toward the shin (decreased dorsiflexion of the ankle). Knee pains, especially among runners, is a  symptom commonly recognized among sufferers of plantar fasciitis. (Wikipedia)

In 18 years of working with people with plantar fasciitis, I’ve seen a good deal of what works and what doesn’t. There doesn’t seem to be any magic bullet. Sure, getting arch supports or wearing a night splint may provide some immediate relief, but they often don’t end up being a long-term solution. Despite what many believe, it CAN be cured long-term with a bit of commitment…

Plantar Fasciitis Treatment

  • Step 1) Reduce Inflammation
    • Apply ice to affected area (Rolling a frozen Dixie cup works well)
    • Apply topical anti-inflammatory cream, preferably Myomed
    • Use soft arch supports shoe inserts (When not strengthening) such as Profoot Triad, etc.
  • Step 2) Break Up Scar Tissue/Stretch
    • Give yourself a DEEP tissue massage for the entire foot and lower leg every third day
    • Roll a Foot Rubz ball (preferable) or Golf/Tennis Ball regularly to the bottom of your foot
    • Stretch your calves & feet (Lots of stretches on the internet)
  • Step 3) Strengthen (Most Important Part)
    • Start with 30-seconds of barefoot running/walking on soft/natural surfaces and add 30 seconds every few days (Probably the single most effective way to eradicate PF; subtract this time from your regular workout, i.e. 30 Minute Regular Workout = 29 minutes in shoes, 1 minute barefoot)
    • Pull in a towel w/toes and repeat
    • Stand on one foot (affected foot)
      • 1) Waiting in line, standing at work, whenever, wherever
      • 2) As an exercise: barefoot eyes closed on carpet
    • Pick up marbles w/toes and spell alphabet (advanced exercise!)
  • More exercise tips

Notes:

The goal is to inversely fade out the need for support while slowly implementing foot strengthening. This makes the foot strong and independent.
Stay away from being barefoot on hard and flat surfaces until the feet are strong enough to handle it. In most cases, feet have been weakened by years of shoes and arch support. It will take some time to get them strong enough to reverse those effects.

In many people, devices like the Strassburg Sock drastically reduce the “first step in the morning” pain.
Continue strengthening/barefoot running once or twice a week

In my experience, the closest thing to a magic bullet for curing plantar fasciitis is strengthening your feet. In conjunction with reducing the inflammation and reducing built-up scar tissue, making the feet strong seems to be the long term solution to curing plantar fasciitis. It stands to reason that if habitually barefoot people don’t experience plantar fasciitis and people with shoes and arch supports do, there must be a reason behind that. That reason is likely that their feet are strong while ours are weak.

In theory, wearing corrective or “supportive” shoes and arch supports do for our feet what our feet should be doing for themselves. This ultimately ends up weakening our feet. As our feet become weaker, we need more and more support, and become dependent on it. This is why people may feel some relief when getting arch supports or orthotics, but a few months to a few years later, the pain comes back worse than ever. I rarely meet runners who love their orthotics, and even most that say they like them admit that they are dependent on them and wish they didn’t “have to” wear them. In essence, they don’t. Even dependence on arch support can be reduced by returning the feet to their natural state by building up strength.

To say that the average person “needs” support is to argue that we weren’t created right or that evolution didn’t work.
Returning our feet to a more natural state by reducing the inflammation that has built up, breaking up the scar tissue, and strengthening the feet will have very positive effects on arch, heel and body pain.

ALTRA footwear can help with plantar fasciitis because their innovative Zero Drop platform and foot-shaped design place the foot in a “barefoot” position. This helps elongate and stretch the entire plantar fascia-calf region while relaxing the foot and arch muscles.

  1. One Dog August 9, 2012

    I suffered from PF for years. I know it sounds too good to be true, but within a week of beginning forefoot striking when running, it was gone. That’s a year and a half ago, and it’s never come back.

    • Jeremy Howlett August 11, 2012

      That is excellent! As we run more as our body is intended our feet get stronger and we are able to overcome so many of these nagging injuries.

    • Stacy J August 24, 2012

      Me too. Had PF foot pains bad, I was limping. Started forefoot strike and immediately gone haven’t had pain since.

  2. danielleecarter August 20, 2012

    When would you recommend to start transitioning to the Altra if recovering from plantar fasciitis? I transitioned too quickly and now I’m back in some more supportive shoes (Mountain Masochists) so that I can still run some. I think the PF is improving but the pain has moved from the arch and heel to just the heel. I look forward to getting back in the Altras and agree that they will be a long term solution

    • Golden Harper August 20, 2012

      Danielle, you can likely start back in now. Let me explain:

      If you are used to running in shoes like Mountain Masochists and many other Montrail shoes, you are used to wearing shoes that have a TON of arch support. As we now know, tons of arch support is ok until they weaken your feet enough that they give out and manifest with something like Plantar Fasciits. Weaning off of the support too quickly can also accelerate a negative manifestation as well. The best solution for now would probably be to buy a pair of 3/4 length arch supports (around $9-10) and put them under the footbeds in your Altra’s. This way you can keep the benefits of our shoes while still getting more arch support like you’re used to having in your old shoes. We really like the Profoot Triad and Smart Arch—both are around $10 and available and running stores, Rite Aid, and Walgreens.

      The idea will be to wear the arch supports full time at first and then slowly wean off of them by taking them out for shorter and easier runs at first and then progressing from there. Shouldn’t take too long. Good luck!

  3. Altra Zero Drop Shoes – Helping you Learn To Run Better | Running Tips: Plantar Fasciitis | Running News | Scoop.it August 26, 2012

    [...]   [...]

  4. Plantrees September 27, 2012

    I changed my shoes and rested for a month.

  5. William January 12, 2013

    Good info on PF from a physician led nutrition, fitness, lifestyle site.

    http://www.nrgtribe.com/arghhh-my-feet-are-killing-me-what-to-do-about-plantar-fasciitis/

  6. William Prowse February 7, 2013

    I love your step #2. I think the step #3 would be horrible for someone with severe Plantar fasciitis though. I think it is great to build up to that, but if you have dysfunctional tissue and tight fascia with associated trigger points and adhesions in the muscles, you will cause much more damage. I also like to see the blood supply of the quadratus plantae and notice how much blood the plantar fascia gets from that muscles supply alone. I find that moving the toes and ankle pump lots of nutrients in the area and can speed things up, but if you force a muscle to be strengthened with resistance, such as standing on one foot, while the person has dysfunctional tissue, wouldn’t that cause more damage?

    Also, do you believe that anti inflammatory creams can penetrate that deep? Considering the adipose tissue and bursaes around the Plantar Aponeurosis, I find that even with such modulaties as iontophoresis, it still has no effect on the inflammation.

    What do you think?

  7. catania July 19, 2013

    I suffered from PF for years. I was stretching, building up the muscles, but I hadn’t been able to effectively break up scar tissue. My chiropractor performed Graston Technique. The treatments were incredibly painful, but they worked. After about 12 sessions, I had no more PF- for the first time in over 10 years.

    Now, I’m thinking of going to minimalist shoes because i DON’T want pf again!!!

  8. Candy sturtz January 6, 2014

    I was wondering what advice you have for this condition for those that stand all day in in one place. I’m a hairdresser and stand 8-12 hours a days 5 days a week in place doing hair. I’m not sure what shoes will work best now since I’ve read this blog. Until now I thought more support and inserts. I’ve eliminated jogging for the most part since I’ve had this issue for 6 months. It’s not improving. Can you offer suggestions?

    • Golden Harper January 8, 2014

      Candy,
      I’ve had many experiences (working at a running store for over a decade) dealing with people in your exact situation.
      One of the first things I would do is to change up the shoes and insoles you are wearing throughout the day. This will change the muscles in your feet that are being used, helping to give them a break while balancing the musculature. I recommend bringing a second pair of shoes to work and also a pair of insoles to switch in and out of the shoes. This gives you the opportunity to have 4 different set ups for your feet throughout the day.
      I would also never wear any shoes that have any type of drop (heel lift) or tight toe boxes—the more your feet can be in their natural position (feet flat with the toes relaxed and spread), the faster healing can occur.
      You should start by wearing more support at first but slowly phase the supports and supportive shoes out (as your feet get stronger) until you don’t need them anymore. Good luck!

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Running Tips: Plantar Fasciitis
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