A sudden heel pain? That might be the first sign of notorious Plantar Fasciitis, a common overuse injury that impacts a lot of runners.
Did you know that most runners who develop plantar fasciitis overlook the early signs of injury or fail to take the necessary steps that could prevent it from getting worse?
Plantar fasciitis, when addressed early is fairly easy to resolve. Ignoring the early signs, however, can lead to a chronic injury condition that can take months or years to get rid of.
Disclaimer: This article is written from the perspective of a running coach who has worked with numerous runners to address the issue before the medical intervention was needed. This information should not be interpreted as medical advice, but rather training advice. Please consult a physician or physical therapist if you are unsure what type of injury you may have or you are in severe pain. This article is intended for those who have not reached a point where they think medical assistance is needed.
Plantar fasciitis (PF) is inflammation of the plantar fascia tissue that connects your heel bone to your toes. One of the classic symptoms of plantar fasciitis is pain and tightness in the heel and arch.
Plantar Fasciitis can affect runners of any experience level for a number of reasons:
Plantar Fasciitis is a common running injury that can be very difficult to get rid of. Depending on the severity of symptoms, the recovery process may take a couple of weeks, around 6 months or even more than a year. That is why the earlier you take action against plantar fasciitis, the faster you’ll fight this health issue and get back to training.
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Plantar Fasciitis occurs when there are little micro-tears that have become inflamed and as a result painful. By taking a few days off as soon as you notice that initial heel or arch pain, you can help reduce that early-stage inflammation and jump-start the healing process.
During the first day or two of injury onset, using an NSAID (anti-inflammatory) is OK and can help reduce initial inflammation, but NSAIDs should not be used long term or to 'mask pain' while running with plantar fasciitis.
During the first few days of noticeable pain, ice your feet for 10-15 minutes a few times per day. You can use a frozen water bottle, ice packs or even frozen bags of peas to help apply ice to the area. Ice helps reduce the inflammation and can help reduce the pain.
Oofos are the best shoes for plantar fasciitis. Wearing Oofos feels amazing!
So much so, many runners often wear them after training runs or long runs to help with recovery even if they are not injured!
Seriously, get Oofos! You will thank me later, injured or not.
Along the lines of recovery shoes, what we wear at work can aggravate or even cause Plantar Fasciitis. If possible, see if you can get permission to wear shoes with more support or even your running shoes. Flat or high heeled shoes are not your friend when you have Plantar Fasciitis. Flat shoes do not support your arch, and high heels place tremendous stress on your arches. At the bare minimum consider adding in temporary plantar fasciitis running insoles to help provide additional cushioning.
(Read more about plantar fasciitis inserts for running below)
When a coaching client first presents with heel or arch pain, the first thing I do is temporarily cut volume by at least 50%. With most cases of plantar fasciitis (unless a tear is involved), you can continue to run unless pain is severe to the point where running is no longer fun or your form is negatively impacted.
Cutting running volume in half, allows the runner to continue training but allows the body to recover. By taking you back to pre-injury training loads (and then some for added measure), we can prevent the injury from getting worse, while allowing your body to still heal. If you can tolerate it, continuing to run will help you heal as long as the workload is significantly reduced.
In order to get rid of plantar fasciitis, proper stretching techniques are crucial. Once the pain starts to settle, we can start introducing specific exercises that help build strength and loosen up your lower legs.
Practice stretches for plantar fasciitis regularly for better flexibility and faster recovery!
Inside our PaceBuilders training program, there are several training plans and runner-specific strength and flexibility routines. Having a sound training plan with built-in strength and flexibility routines, many of which are geared towards injury prevention will get you back on track and ready for race day.
To help keep the fascia loose and to help with the healing process, applying a cross-fascia massage using your hands can help. To do this, instead of massaging along the length of your foot's arch, you massage or rub your feet perpendicular to the fascia, or from inside of your foot towards the outside. I recommend that you do this as often as you can.
In addition to massage, you can use a lacrosse ball or tennis ball to loosen the fascia. I found that a lacrosse ball worked best for me because a tennis ball was too forgiving. Other foot massagers like this one can also work. Again, massage your feet often as you can to help prevent plantar fasciitis as well as recover from it.
If you suffer from severe pain in the arch of foot, you may wonder whether plantar fasciitis inserts for running can make a difference or it's just an advertising myth.
Unless a runner has a very specific foot anatomy that requires significant correction or arch support, I am not a fan of 'shoe store' custom-molded shoe inserts. If a runner follows a sound training program with a conservative ramp up and resistance training, the vast majority of runners do not need them. I actually had a very well known sports medicine doctor actually remove and throw my shoe store inserts into a trash can. Plus, if you do not ease your way into a custom-molded insert (which uses hard plastic to hold the mold) you can actually increase your chance of injury.
However, when an injury occurs, a temporary cheap over the counter foot insert for PF like this one can work wonders. In fact, it has been one of my most successful tips for getting rid of plantar fasciitis in runners.
The value of the temporary plantar fasciitis running insoles is not in the support it creates, but rather the temporary change it has on the pressure and shock absorption of your foot when walking or running with plantar fasciitis. In other words, it temporarily takes the pressure off your PF and moves that shock absorption to a healthier part of your foot, giving your foot time to heal. It is NOT a long term solution but should be used in both work and running shoes.
Once your heel and arch pain resolves, you can slowly return to your pre-injury level of training. The best way to do this is to follow a return to running program and slowly increase your training load. As you do this, evaluate your pain levels along the way, especially the next morning as you get out of bed. If it does not get worse, you can handle that new level of training volume. If it gets worse, you are not ready and need to step back and continue your recovery.
Do not be surprised if you have some days that are better than others pain levels fluctuate but should be trending towards improvement as you go through this process.
There are so many remedies out there on how to get rid of plantar fasciitis. So much so it drives me crazy. To get rid of it, you need to be consistent, diligent and understand that it can take several weeks to get over it and you need to treat your recovery as if it was your main focus. Getting over PF is a process, and the sooner you start the process, the more likely you will achieve pain-free running.
I have helped dozens of runners and in almost every case, one specific product or tip did not work. It was a combination of several things and addressing the training deficiencies that fixed it. Recently, one of my PaceBuilder's clients came down with Plantar Fasciitis the day after she started working with me.
During our initial coaching call, I had identified that she was ramping up for her half marathon too fast. We took immediate steps (like those in this article) to deal with it. We modified her training and in her case, we were successful at resolving her Plantar Fasciitis in about two weeks but she went all-in with her recovery.
You can read more about it here, as we turned her coaching into a published case study.
If pain is severe enough that you can't function normally in your day to day activities, or you have gone through all the steps mentioned above, but the pain remains - don’t hesitate to consult a sports medicine doctor or physical therapist.
Sometimes the injury is much more complicated than expected and the accurate diagnosis may shed a light on the underlying cause of pain in the heel and arch.