Do you get that stubborn pain in the bottom of your foot especially when you take that first step out of bed in the morning? Are you wondering, why do my feet hurt when I run? Like so many of you, I have suffered from plantar fasciitis with running and thought to myself…can I run with heel pain?
Foot and ankle injuries can perhaps be some of the most debilitating injuries. Not only do they shut you down from running, they also can shut you down from being able to function in your regular daily activities. They can also take a long time to get over, as you have likely experienced…
But, here’s the great news…They don’t have to!!!
Many runners use “band-aids” as their fix for foot and ankle injuries – change shoes, purchase orthotics, ice, stretching, and all sorts of other fads out there.
And if they have done some strengthening, it often hasn’t worked either…because they are likely strengthening the wrong areas.
Does this sound familiar to your story?
Click the audio file above to listen to our conversation in which we got down to the root cause of plantar fascia injuries, how to stretch and strengthen your feet, prevention advice, as well as dispel some common myths about rehabbing plantar fasciitis.
Click the video below to watch the LIVE training I did on this topic within the Healthy Runner Facebook Group
I have helped several runners overcome this stubborn common running injury and wanted to share the best tips and plantar fasciitis exercises that I have learned over my 17 year career as a physical therapist and running coach. Everyone responds slightly differently but the strategies I will outline in this article will set you up for success in utilizing the most evidence informed treatment we have on this painful foot condition.. If you are a frustrated runner who has already been to physical therapy that included no running, heat, ice, massage and stretching and you are considering a cortisone injection, please keep reading, listening, and watching the tons of valuable content in this resource. As you will soon find out, the best way to get you back to running and get rid of this foot pain takes persistence and consistency in the strategies I will outline. There are no band-aides and quick fixes for this condition!
In episode 41 of the Healthy Runner Podcast and in this article, SPARK Physical Therapy wanted to help you as a runner become stronger with specific tips on how to deal with plantar heel pain. In this article, we will take a deep dive and discuss what plantar fasciitis (heel pain) is in runners. We will share treatment as well as the best exercises for your foot to help your body become more resilient with your running and to prevent any future foot injuries!
In this article, we are going to be covering:
-What is Plantar Fasciitis
-How do I know if I have plantar fasciitis (what are the symptoms)
-What causes Plantar Fasciitis
-How do I get rid of it (treatment)
-What is the best exercise for plantar fasciitis?
-How do we prevent it from starting or coming back?
I will share with you the SPARK Method which is 5 actionable tips to get rid of plantar fasciitis and keep it from coming back!
You can also listen to the audio version of this in depth training on the Healthy Runner Podcast…available on your favorite podcast app and perfect for a long run!
You can listen to this week’s episode here!
Hopefully it is okay that I share this story with you.
This runner is 39 years old (middle age) and they started feeling some soreness in the bottom of their heel when they took their first step out of bed in the morning one day. However, after a couple of steps it would loosen up and the pain would go away.. As each day passed they noticed that it took longer to loosen up.
This runner consistently gets after it 4-5x/week and would feel some discomfort and pain the first ½ mile of their run and then the pain would go away. They noticed that it felt tight when they tried to stretch the foot and started feeling pain when they would be on their feet all day standing (because they have a standing desk as a result of low back pain with sitting too long). Pain would also worsen when they would go for a walk with their spouse or take the dog for a walk. They also noticed the foot started to be painful after they would sit for an hour watching Netflix and then go to get up and walk to the other room. Running now has become more frustrating as it would take a mile to finally feel loose and their long runs were starting to be shortened because pain and stiffness would return when they got to 7 or 8 miles. Additionally, they were having more pain after each of their runs that would last hours now.
Has this happened to you? Does this story resonate with you?
Do you know who that runner was? Well, it was me and I share this with you because I not only help runners stay healthy but I am a runner too and I have felt many of the aches and pains you are feeling. This foot pain can be extremely frustrating and that is why I wanted to put together this ultimate guide to treating plantar fasciitis in runners so you can get back on the pavement doing what you love sooner than later!
Plantar fasciitis is one of the most common causes of heel pain and is one of the most common running related injuries. The plantar fascia is a thick piece of connective tissue (like a web) that essentially connects the back of your foot (heel area) to the front of your foot. This web of ligaments acts as a shock absorber and supports the arch of your foot, helping you run.
The plantar fascia ligaments experience a lot of wear and tear in your daily life. Too much pressure on your feet can damage or even tear these ligaments. With overuse (or ramping up your mileage too quick) the plantar fascia can become inflamed, and the inflammation causes heel pain and stiffness.
The cause of plantar fasciitis heel pain and stiffness is still unclear. However, research suggests this condition may involve degeneration as opposed to inflammation of the plantar fascia. Because fasciitis means “inflammation of a fascia,” a better name for this condition may be plantar fasciosis. Also, some may get an appearance of a bone spur on x-ray, however, the bone spur does not cause your foot pain when you get up in the morning. It is the irritation of the plantar fascia that is causing your pain. We know this because there are many people who get x-rays of their feet and we see bone spurs but they do not have pain. If you have been told you have a bone spur before, that doesn’t mean you can’t run. You will be able to run if you keep reading and learning about the strategies outlined in the SPARK method!
The symptoms associated with plantar fasciitis are localized pain under the heel and arch that worsens with your first step in the morning, walking following sitting for a long time, standing for extended periods or after a long run.
There are some characteristics that would make you more prone to developing plantar fasciitis such as:
Treatment for a plantar fascia injury is going to depend on the severity of the injury and how long you have had this pain.
Most of the runners I see with this condition have already tried changing their running shoes, purchasing orthotics, icing, stretching and it doesn’t help them be able to run again.
These runners are not getting down to the root cause of the problem and it takes a good detailed evaluation by a running physical therapist to determine if there is a mobility issue in the foot and ankle or if your problem is due to muscle flexibility or strength that is not allowing the plantar fascia to withstand the load and demands of running.
Below, I will outline the general treatment plan that has helped hundreds of runners get back running doing what they love without that stubborn heel pain. Keep in mind this is a generalized plan that will help 75% of you reading this if you do in fact have plantar fasciitis. However, there is no substitute for a personalized evaluation to get properly diagnosed and working 1-on-1 with a medical professional who has a ton of experience treating runners with this condition to help guide you on timing and specific prescription of when to implement these treatments. Overall, if I had to share 1 golden nugget tip that will give you the most bang for your buck in overcoming this condition it is to start loading the fascia with weight bearing stretching and strengthening to make sure your body is strong! This will be pivotal in preventing plantar fasciitis and helping you get back to running as healthy as you can!
Treatment can be broken down into the SPARK METHOD that has 5 actionable tips to get rid of plantar fasciitis and keep it from coming back for good!
If there was 1 stretch that you can start doing today to help with your pain especially when you take that first step out of bed it is to stretch the plantar fascia. This focuses on stretching that windlass mechanism of the fascia and its connection to the first toe.
Click THIS LINK to see exactly how to stretch your plantar fascia in the morning before you get out of bed.
The calf muscles run down the back of your lower leg and tightness in theses muscles can limit the flexibility in your ankle and can be a contributing factor to plantar fasciitis. Therefore, I recommend foam rolling these muscles as well as stretching them!
Click the YouTube video below to learn how to foam roll your calf muscle properly by isolating either the outside muscle or the 2 inside muscles. This video actually shows my top 5 foam roller exercises for runners but the first exercise in this video is amazing for the calf muscle! This is important to do to help loosen up tissue and increase mobility in the muscle.
Wondering how to stretch your calf muscles? Click the video below to learn how to stretch these muscles AFTER your run or workout!
At SPARK Physical Therapy, I like to compliment self foam rolling techniques with instrument assisted soft tissue massage (IASTM). You may be a runner who can benefit from seeing a massage therapist who can “work out” that calf muscle. To learn more about IASTM, click this video on my YouTube channel.
The other soft tissue treatment option that can be beneficial for treating plantar fasciitis pain in runners is trigger point dry needling. Dry needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments. To learn if dry needling is the same as accupuncture click the video below to find out. If you are wondering what dry needling looks like and how it is performed for the calf muscle especially if you have tight calves or chronic achilles pain, plantar fasciitis, and shin splints.
Unfortunately, there is no quick fix…no gimmicks, no single thing, tool, tape, brace, orthotic that is going to cure plantar fasciitis. The normal recovery process can take 6-18 months but with treatment and staying consistent with the strategies outlined in this resource you should be able to get rid of it in 6 months and stay running all along the way!
Through a couple of different activities and exercises you can strengthen and activate those deep foot muscles. These are important to have stability throughout your feet and to make sure those muscles are working instead of putting so much strain on other aspects of the foot.
Check out the toe yoga and the foot doming exercise (short foot) by clicking the link below to work some of the deeper intrinsic muscles!
In episode 39 of the Healthy Runner Podcast, I discuss training barefoot and in lower stability shoes. This challenges the foot to use those intrinsic muscles instead of relying on the shoe! Click THIS LINK to catch the replay video of this episode!
You thought that “R” was going to be for rest, didn’t you?! We will talk about running in the next principle. Resistance training is key to loading the fascia to it can withstand the load during running.
Here are my 4 favorite weight bearing progression exercises to load the fascia so it can build that resiliency to tolerate the demands of running!
Also don’t forget strengthening the achilles, calf, hams, glutes for posterior chain/ sling strength and resiliency!
Here is one of my new favorites on strengthening both the deeper soleus muscle as well as the gastrocnemius muscle which both make up your calf muscle complex.
What is the best exercise for plantar fasciitis?
To summarize the exercises you should do…
Activity modification is key in treating Plantar Fasciitis…
Modify your exercises but don’t stop. I have had this now for 18 mo. To such a low level because I am doing the strategies I outlined above and I still was able to run my fastest half marathon in 4 years!
If you want to learn more about 3 reasons you should not stop running when you have an injury (Check out episode 36 of the healthy runner podcast on your next run or just click this link to watch the video and read the blog)
Quick summary is that you…
⁃ Lose your running fitness
⁃ You get weaker! Your muscles atrophy!
⁃ You get stiffer!
The rehab for this condition becomes the prehab! To learn more about prehabilitation and how to prevent running injuries, click THIS LINK.
Are you a runner that is trying to stay healthy but can’t train because heel pain is stopping you from meeting your goals?
Are you worried that your foot injury will limit you from doing what you love like working out and training?
Have you wondered what it will cost you in the long run if you continue to train through pain? Will you have to stop running totally and lose your mojo, confidence, and all the mental stress release that running provides?
Have you seen other medical providers in the past that just tell you to stop running?
I have a unique treatment approach that focuses on solving these problems with the runners I work with. At SPARK Physical Therapy whether it is in person or virtually through video sessions, we get down to the root cause of your problem and provide you with the structure of a guided supervised exercise program as well as return to run program to help you get stronger, pain-free and perform at your peak level to get you back on the road doing what you love. My goal is to help keep you active and on the road, while recovering from injury by guiding you in ways to modify your training, rather than eliminating running!
If this is you, let’s chat and jump on a call to see if you are a good fit for how I help runners. Just click THIS LINK and and I will give you a call.
Here is what one of our SPARK Winners had to say about their experience getting back to running after plantar fasciitis.
Want to know how I help runners at SPARK Physical Therapy? Click this video below to learn more
In this blog article we took a deep dive into plantar fasciitis pain and why so many runners get this condition. I shared with you the causes, symptoms, treatment, and prevention to help you get over heel pain and be able to run! Following this SPARK method of 5 actionable tips and exercises will allow you to have a body that is more resilient and allow you to do what you love…run!
Listen to the Podcast Episode during your next run!
Before your next run, training session or race implement the latest from SPARK… It’s our 5 minute Dynamic Warm-Up! Please take a moment to watch the video, drop a like and subscribe to our YouTube Channel so we can continue creating the best content for our healthy runner community!
Thank you (running friends) for taking the time to read and I hope you enjoy the podcast episode!
Duane Scotti, PT, DPT, PhD, OCS
Do you get stubborn pain on the outside of your knee with running especially going up hills? This could be sharp at times and may even cause you to walk during your run. Have you thought… will IT band syndrome ever go away? Have you tried rest, ice, and stopping running but every time you try and go back that pain just comes back and stops you in your tracks?
Click THIS LINK to to help you as a runner become stronger with specific strength training on how to fix iliotibial band syndrome (IT band syndrome). In this resource, I will share with you the causes, symptoms, treatment, and prevention to help with iliotibial band syndrome in runners. Following these running tips and exercises will help build up your body to be more resilient with your running and prevent future injuries.
Do you get that stubborn pain at the top of your hamstring right where it connects to your “sit bone” and you are wondering if it is ok to run with hamstring pain? This could be a dull achy pain that gets worse after your runs or sitting for a long period of time during your work day. Do you dread long car rides? Like so many of you, I have suffered from proximal hamstring tendinopathy (PHT) when I started running and thought to myself…will it ever go away?
Click THIS LINK to to help you as a runner become stronger with specific strength training on how to fix PHT.
⚡️ SPARK Physical Therapy and the Healthy Runner Podcast Helping Active Adults Be Able To Run Without Aches and Pains So You Can Feel Good About Yourself Again…
[Even If You Don’t Think You Are A Runner]
If you are a runner and frustrated with your nagging aches and pains and have been told to stop running, we can help you.
Is running bad for your knees? Will I get arthritis from running? Are you new to running or considering starting to run and you have had knee pain in the past, are you wondering if you can safely run even if you are not a “runner”? Or have you been running for years now and… View ArticleRead More
Runners! Have you ever experienced foot pain? Are you frustrated that you are receiving poor advice about your foot pain and your foot pain is not going away? I know I’ve been there. I was ignored and wasn’t taken seriously. I was told I shouldn’t be a runner! Well, that resulted in a total of… View ArticleRead More
Are you a fair-weather runner? Are you wondering how to run in the winter? Is it bad for you to run in the cold? Are you wondering what to wear when running in the cold? In this episode, we learn about how to stay healthy and running through the winter and during COVID-19 with… View ArticleRead More
“I developed IT band syndrome during my first marathon training cycle last year and ended up in physical therapy for about 3 months. I was told not to run if I had any pain at all. I lost so much time “recovering” that I ended up deferring my registration to the next year. I spent the next summer training for the same marathon when about 6 weeks out, that familiar IT band pain returned. I could barely finish a mile. I didn’t want to go back to my physical therapist because I knew what he was going to tell me. Stop running. I was so frustrated and started to feel like marathons weren’t for me. I stumbled upon the healthy runner podcast and learned that I don’t have to stop running in order to recover from injury! I was skeptical about an online physical therapy session. But I reached out to Dr. Scotti and he was able to give me the tools to mitigate my pain within the first session! I was able to complete my training cycle and made it to the finish line of my first marathon with his help! I highly recommend!”
“I’d been dealing with Proximal Hamstring Tendinopathy (PHT) for about 4 years and had been doing PT, but still had lingering pains. I just figured I’d have to suck it up and deal with it because that was as good as I was going to get. But then, I came across a podcast of Duane being interviewed by Jason Fitzgerald on PHT and how he overcame the injury, and my curiosity was piqued. I met with him virtually and he has been a GODSEND! I’m able to sit as I type this! I can bend over and get in and out of cars without pain! And, I’m RUNNING again!!! It is amazing to be able to do things that I haven’t been able to do without pain since 2016!!! Thank you so much Duane for being an incredible PT!!”
“I suffered from IT band syndrome for four years before seeing Dr. Scotti in April 2020. Before then, I couldn’t run more than about 10 minutes without stabbing pain near my left knee. I’d seen various orthopedists, physical therapists, and chiropractors looking for some relief. My career needed me to run a mile and a half within a certain amount of time, and it was impossible to do so with the knee pain. I saw Dr. Scotti and he immediately got to work! That first visit, he helped me understand the anatomy and underlying cause of my knee pain (aka IT Band syndrome). Once I understood what was happening, the course of treatment made so much sense. Not only did he have online videos of all the recommended exercises to treat the problem, his “healthy runner” Facebook group, Podcast, and YouTube videos held a wealth of information and supplemented my plan. I soon understood that running wasn’t just a casual hobby – it’s a sport and one that deserves dedication and focus. Without his dedication to the sport and his community, I wouldn’t have realized this! Over the next few months, I had many ups and downs – victories and failures – and even some tears! Two steps forward and one step back. Dr. Scotti always checked in between appointments and tweaked my plan if needed. By August, I was regularly running 3-4 miles with barely any pain! If I did get pain, it was because my dedication and focus were lacking – and I quickly picked it back up and overcame. I’m so thankful I took another chance at having my knee looked at and trusted someone else. I run regularly now and am really enjoying it. I can’t thank Dr. Scotti enough and would highly recommend him to anyone having trouble.”