Injury Interrupted

How To Prevent And Manage Plantar Fasciitis

Don’t give up on running just yet.

by Aaron Stern
Originally Published: 
A man bends down in pain.

There are few things as sneakily debilitating as a foot injury. While common, with some one in ten people experiencing it in their lifetime, plantar fasciitis is also one of the most painful running injuries. The good news is it is preventable, treatable, and not something you have to live with forever. By following some basic injury prevention guidelines, including getting good shoes and following smart exercises, you can keep plantar fasciitis from keeping you down.

What Causes Plantar Fasciitis

Plantar fasciitis is inflammation of the plantar fascia, which is the name for a group of bands of tissue that runs from your heel to your toes.

Plantar fasciitis has several causes.

  • Tight Calf Muscles are a common anatomic cause of plantar fasciitis, says Dr. Mariam Zakhary, a sports medicine physician at Mount Sinai Hospital in New York. The calf muscles attach via the Achilles tendon to the heel at the same place as the plantar fascia. “So, if you imagine, if you have a tight calf, its going to tug at your Achilles, which then tugs at your plantar fascia and puts a lot of pressure there, causing inflammation, Zakhary says.
  • Poor Foot Structure, particularly flat-footedness, is another common anatomical cause of plantar fasciitis. Flat-footedness puts more stress on your fascia and makes it operate in a way it’s not designed to, Zakhary says.
  • Inappropriate Footwear, particularly flat-soled shoes, can cause or exacerbate plantar fasciitis by encouraging poor foot structure, poor walking or running surfaces, and prolonged standing with any of those conditions.

What To Do If You Get Plantar Fasciitis

Plantar fasciitis is often worse when you first wake up in the morning, because when we sleep our bodies relax and our ankles drop, tightening the calf muscles and stressing the plantar fascia, as described above. “Everyone will say that first step in the morning is the absolute worst,” Zakhary says. Zakhary recommends having supportive slippers by their bedside and sliding right into them, instead of walking with bare feet on the flat floor.

Once you’ve begun your day on the right foot (dad joke intended), you should consider the variety of stretches, exercises and other tips below to manage your plantar fasciitis.

There are a variety of things you can do both to help prevent plantar fasciitis, many of which also apply if you already have it. Zakhary recommends that if you’re diagnosed with plantar fasciitis that you work with a physical therapist to create a personalized set of exercises targeted at strengthening and lengthening your lower leg muscles. “Literally anything to stretch that posterior chain in your lower leg,” Zakhary says. Those stretches and exercises can include:

  • Runner Stretches: Put your foot on the wall with your heel on the floor, and lean toward the wall. Hold that for several seconds. Alternatively, you can do towel stretches, where you sit on the floor with your feet out in front of you, put a towel around your toes, and pull the towel to stretch your lower leg. These and other stretches for your lower leg are good both for prevention and treatment.
  • Eccentric Step-downs: Also called ‘negative’ exercises or reps, an eccentric exercise is one that puts the muscle under stress while it is lengthening — as opposed to the usual muscle-building technique of putting muscles under stress while they are contracting. In an eccentric step down, you will stand on a box or platform and then take a slow, controlled step down. This is just about the only way you can strengthen the Achilles tendon, Zakhary says.
  • Roll a Ball Under Your Foot: This is a good treatment technique because it breaks up scar tissue that builds up from the inflammation. “It’s quite painful, and that’s okay — we actually say you should be doing it where it hurts,” Zakhary says. A lacrosse ball is good for this, and Zakhary also recommends using a frozen water bottle because it’s hard enough to break up the scar tissue but its coolness is soothing.
  • Picking Up Marbles with Your Toes: This is as straightforward — and potentially as difficult — as it sounds, and is a great way to increase overall foot strength, and is especially good for increasing arch integrity, Zakhary says.
  • Wear Supportive Shoes: Again, the goal here is to wear shoes with good overall structure and especially have good arch support. For women who wear flats at work Zakhary urges them to at least wear supportive sneakers on their commute to and from the office.
  • Consider Orthotics: If a well-structured shoe isn’t doing it, Zakhary recommends orthotics, including heel cups if you have Achilles tendinitis, or arch supports — but make sure they aren’t too hard or too high. And these days, you don’t necessarily need to get prescription-caliber orthotics from a podiatrist — Zakhary says you can get high-quality orthotics at the drug store.

Zakhary stresses that plantar fasciitis is not something that has to stop you from a healthy lifestyle. Any other workout that you enjoy doing should be on the table for you, as long as it isn’t causing you pain. And if you’re managing and doing what you can to prevent it, hopefully you’ll be back on your workout grind before long.

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