What Are the Best Ways For a Runner to Prevent and Improve Plantar Fasciitis Symptoms?

By Dr. Janet Pearl.

The plantar fascia is a ligament that lies beneath the skin on the bottom of the foot and connects the bottom of the heel bone to the toes. It offers structural support to the arch of the foot, it helps to support the load we place on our feet, and it absorbs the impact of our gait. It also assists in gait by acting like a spring in our foot when we walk or run.

Given these functions of the plantar fascia, it is not surprising that the stress to our feet is sometimes too much for the plantar fascia to handle. When the plantar fascia is overloaded, overtightened, or overstretched, small tears may develop, along with inflammation and pain. This inflammatory condition of the plantar fascia is called Plantar Fasciitis.

Plantar Fasciitis is the main cause of heel pain. Typically, Plantar Fasciitis pain is most severe with the first steps after a rest period, especially in the morning or after sitting for a long time, and it usually improves when you walk for a while. However, it can become worse if you stand or walk for a long time.

Running can also aggravate not only the pain, but also the injury itself. In fact, running can be the initial trigger for the development of Plantar Fasciitis. Estimates indicate that Plantar Fasciitis occurs in about 10% of the general population, particularly in active working adults aged 25 to 65 years. However, among runners, it is estimated that Plantar Fasciitis may have an occurrence as high as 22%.

But you don’t have to give up running to avoid (or manage) Plantar Fasciitis. There are a lot of precautions you can take to decrease the likelihood of injuring your plantar fascia. Keep in mind that anything that decreases the support or increases the impact on the plantar fascia increases the likelihood of injuries. Therefore, as a rule of thumb, the best prevention is to increase the support and strength of the plantar fascia and minimize the impact of running on your feet.

Let’s go over a few of the best ways for a runner to prevent Plantar Fasciitis or to minimize the impact of running on an existing injury.

Wear appropriate running shoes

Wearing adequate running equipment is a basic requirement to avoid Plantar Fasciitis. The amount of damage that bad running shoes can do to your feet is massive. The shoes you wear determine the impact of each stride and the placement of your feet while you run. Poorly supportive shoes can put an excessive strain on the plantar fascia. Therefore, inappropriate footwear can greatly magnify the impact that running will naturally have on your feet. Invest some time in finding the right shoes for your feet.

One of the main requirements for good running shoes is good cushioning, adequate arch, and heel support — it is one of the most effective things you can do to prevent Plantar Fasciitis. Find running shoes with an arch cushion that fits your foot. It is very important that your shoes can physically support the arch to absorb the shock when you land your foot. Without physical support, you’ll be placing extra pressure on the plantar fascia. If you can’t find shoes with a good arch fit, you may opt for shoes with removable insoles, as these will allow the replacement of the insole with over-the-counter arch supports that will best fit your foot.

Find comfortable and well-fitting shoes. Shoes that are too tight or too loose allow your feet to move around. You may not notice it, but this forces you to land your foot in awkward positions while you run. Your shoes must also be stable and have a thick sole that diminishes the shock of your stride on your feet.

Don’t wear old shoes with worn-out and uneven soles and that have lost cushioning and stability. These will add to the strain on the plantar fascia by making you land your foot at an awkward angle.

Enhance your running shoes

If your running shoes fail to adequately support your foot arch, you can upgrade them with orthotics. Orthotics are orthopedic devices you can insert in your shoes to add support to the foot arch and to the heel. You can either get generic over-the-counter inserts or acquire custom-made orthotics. The advantage of custom-made orthotics is that they are specifically designed for your foot and will, therefore, have a perfect fit and provide optimal support. However, they are more expensive than over-the-counter orthotics.

Custom-made orthotics will not only improve foot support but may also make up for any biomechanical problems your foot may have, such as flat feet (excessive rolling of the foot inward toward the arch) or a high arch, that predisposes you to develop or worsening Plantar Fasciitis. Custom-made orthotics can support the arch, elevate and cushion the heel, stabilize and correctly aligning your foot, reduce pronation, and thereby diminish pressure and overuse of specific ligaments, tendons, muscles or bones.

Warm up and stretch before running

Always warm up before exercising by starting with a walk or a light run. Cold muscles, tendons, and ligaments are more likely to be injured with an abrupt burst of activity. Gradually and slowly increasing the speed and intensity of your run will warm the plantar fascia, the Achilles tendon, and the calf muscles, preparing them to endure your main exercise.

Stretching is also essential for the prevention of use-related injuries. Tight ligaments, tendons, and muscles in the feet and legs, not only the plantar fascia but also the Achilles tendon and the calf muscles, are a major risk of injury because they help support and strengthen your foot. Stretching will increase the flexibility of these tissues. Taking a moment to stretch your feet and lower legs will help you warm up and prepare for the demand that will follow. There are various plantar fasciitis stretches available, which you can perform before running to reduce the risk of injury.

Adapt your running routine

Choose to run on a good track or on softer surfaces such as grass or trails; avoid hard surfaces such as asphalt and concrete as much as possible. Importantly, if you are running and feel pain in your feet, do not neglect it. It may be a sign that you are overdoing it and that you should avoid the activities that are causing it. 

Overall, work out sensibly

When you run, it is fundamental that you take appropriate protective measures to minimize the impact of your exercise on your feet. All the advices above are important and should be incorporated into your running routine:

1) Use supportive running shoes suited for your type of exercise

2) If necessary, add insoles or orthotics to increase protection to your feet

3) Warm up properly before starting the main exercise

4) Stretch to increase the flexibility of muscles, tendons, and ligaments and prevent use-related injuries.

Also, do not increase your exercise intensity abruptly. If you want to increase the intensity of your regular running routine, do it slowly and gradually, so that your feet can adapt, otherwise it is more likely that your plantar fascia will become overpowered.

About the Author:

Dr. Janet Pearl, Member of the American Pain Society, The Massachusetts Medical Society, the Massachusetts Society of Anesthesiologists, the Massachusetts Society of Interventional Pain Physicians and more. Received M.D. from the Columbia College of Physicians and Surgeons and received a M. Sc. in Health Planning and Financing at the London School of Hygiene and Tropical Medicine.
Medical Director at the Center for Morton’s Neuroma and Fasciitis.com

Follow Dr. Janet on LinkedIn

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