You have Plantar Fasciitis... Now what?

Running with Plantar Fasciitis

Are you experiencing a nagging pain in the heel or sole of your foot? Running with plantar fasciitis at its peak can be very painful, but the initial stages are sometimes missed. Ignore the warning signs at your peril.

Thankfully, plantar fasciitis (which can be really painful) only accounts for 10% of all running injuries. But when you do find yourself with this injury, it can be really frustrating.

Plantar fasciitis has a tendency to become quite stubborn and persistent if not cared for properly. Proper rest, recovery and tissue management are all key components to resolving this foot injury, but many runners hope to continue training through the recovery process.

Here’s what you need to know about recovering from plantar fasciitis and returning to running...

What causes plantar fasciitis?

Knowing how to treat an injury all begins with understanding how it developed in the first place. Going back to the cause can give you a roadmap to reversing the injury and running pain free.

Plantar fasciitis tends to strike those who overdo it - which is a relative concept of course, depending on where you are in your running journey! This could be overtraining in general (too much volume / too many miles per week) or it could be more specific than that (too much speed work or hill training).

It could even be an appropriately aggressive amount of training but a lack of essential recovery work.

This frustrating injury develops as a response to training stress. When collagenous tissues such as tendons, ligaments and fascia incur repetitive stress, they will thicken to better handle the stress in the future.

This is a normal response to training. If changes in training occur too rapidly, or if you do not manage the tissue well during aggressive blocks of training, the stage is set for the tissue to adapt poorly and lead to PF pain.

How to Treat Plantar Fasciitis Yourself

Here are the primary solutions to consider if you find yourself battling plantar fasciitis:

• Reduce your mileage
  If you're suffering from plantar fasciitis, you don't always have to stop running completely (although sometimes it's important to do so), but definitely consider taking 1-2 weeks of lower volume to see how your body responds to running with plantar fasciitis. Try not to increase your total weekly mileage by more than 10% a week once you start training again.
• De-load the injured tissue
  Along the same lines, make sure that you are taking time every 2-3 weeks to reduce mileage and de-load. This allows your body to recover and strengthen for the next block of training.
• Mind your intensity
  Take account of how much speed work and hill training you are doing. Both of these are great in the right doses, but they do place much higher stresses on the Achilles tendon and plantar fascia. Consider removing a session or two a week if you think you may be overdoing it. You may also simply need more recovery time after these intense sessions (48 hours or more).
• Check your shoes
  Do you have any idea how many miles you have on your shoes? Around the 300-mile mark, you need to pay attention to your body and how you are responding to workouts. Pain and discomfort could be indicators of needing new shoes. As a general guideline, try not to go any longer than six months on the same pair of shoes.
• Rotate Shoes
  Consider having several options of shoes to rotate through each week. This can give your feet a different stimuli each run which helps develop strength in the little muscles of your feet and keeps your shoes in better working order overall.
• Tissue Management
  This one has many names: massage, self-myofascial release, foam rolling, etc. They all have the same end in mind: managing the tissue so that it moves as it should. Repetitive motion inevitably causes some level of dysfunction in your tissue after awhile. It may start small, but when ignored can cause poor biomechanics and bigger problems. Take the time to roll out your plantar fascia. Common tools for this include an icy water bottle, golf balls and lacrosse balls. Pay particular attention to your calves, as tension in these muscles can place additional load on the Achilles tendon and cause problems further down the chain... namely the plantar fascia. The same tools work here, too, plus the addition of foam rolling or using a rolling pin (or the stick). Being consistent in this area can go a long way in recovering quickly and maintaining your health after the injury.
• Equally important is spending some time after each run to stretch the tissue out
  For plantar fasciitis, stretch the gastrocnemius, soleus and plantar fascia after each run. Combine this with soft tissue work and your lower legs should be able to move as intended.

Good luck in managing your plantar fasciitis. Running with this type of heel pain is sometimes manageable, but know that a coherent rehab plan is the key to you overcoming the problem once and for all.