What is Plantar Fasciitis?

A runner tying a pair of Karhu running shoes

Plantar fasciitis is a pain.

The American Academy of Orthopaedic Surgeons says 2 million people are treated for the condition each year. But the ailment is prevalent in runners, too: One in 10 runners will suffer from plantar fasciitis at some point during their running life, and it might become long-lasting and chronic if it's not treated.

So, what is plantar fasciitis, why do some runners get it and how do we effectively treat it?

A runner kneeling in the grass to tie her shoes

What is Plantar Fasciitis?

Plantar fasciitis is a common running-related injury that affects the plantar fascia in your foot.

The plantar fascia is a band of connective tissue that connects to the back of your heel bone and runs along the bottom of your foot to your toes. Its job is to support your foot as you walk and run, acting like a shock absorber and preventing your arch from collapsing during the gait cycle.

People with plantar fasciitis might feel pain on the bottom of their foot near the heel when they first get out of bed in the morning or after not moving for long periods of time. The pain will subside throughout the day as you get moving.

Dave Strassburg, of the plantar fasciitis sock company Strassburg Medical, says the condition is a result of the plantar fascia (that tough band of tissue) moving away from the insertion point at the heel. Strassburg compared plantar fasciitis to a cut on your finger.

“Think about if you had a cut on your knuckle," Strassburg says. "While your finger is straight, the cut can close up and heal. But the moment you bend your finger, the cut bursts open again.”

This is similar to how plantar fasciitis works and why it tends to be most painful in the morning. While you’re asleep at night, the fascia starts to heal and reattach. Then, when you wake up and put weight on your foot, it pulls away again.

A man wearing warm running tights and clothes ties his shoes before a cold run

What Causes Plantar Fasciitis?

According to Wesley Miller, a physical therapist who works with runners in Asheville, North Carolina, plantar fasciitis ails two types of feet most often.

“There are two groups of people that are more likely than others to have plantar fascia issues," Miller says. "One (group) is those with high, stiff arches that don’t move sufficiently enough to allow for easy shock absorption and, two, are those with arches that fall from a medium to flatter position (navicular drop) during motion.”

Miller says the plantar fascia are passive shock absorbers, which means they absorb some load when your muscles get overwhelmed. In general, “the more mileage you do, the more susceptible you are to foot issues," Miller says.

How Do You Treat It?

There are many treatments for plantar fasciitis that you can do at home. Podiatric doctor Jason Havey recommends reducing the inflammation and pain with ice and anti-inflammatory medicines and using over-the-counter shoe inserts and orthotics made to ease plantar fasciitis, like Superfeet insoles.

Here are some other methods to treat the foot pain:

NOTE: While it's possible to treat the condition at home, you should always talk with a doctor about your medical history before beginning any treatment.

Six pairs of running shoes sitting on a shelf

1. Rotate Your Shoes

Running is a repetitive action, and wearing the same shoes every day adds additional repetitive stress to your feet whether you have high arches, rigid arches or flat feet. Rotating through a few pairs of shoes during the week will help keep your feet strong (and make your running shoes last longer). Consider using one pair for long run days, one pair for speed workouts, and another pair for easy days.

If you commit to buying more shoes, make sure you choose running shoes that fit and find a pair that matches your specific training. Additionally, wearing proper insoles can add additional comfort and support throughout the healing process.

A runner stretching her legs while sitting in the grass

2. Stretches for Plantar Fasciitis

While treatment options for plantar fasciitis are wide-ranging, a 2012 survey of foot and ankle specialists found that slightly over half of all surgeons preferred stretching and physical therapy as treatment over any other option. Statistically, stretching seems to yield the best results.

Here are three stretches to do first thing in the morning and before bed at night:

Calf and arch stretch. Pull back the foot with a towel to stretch the arch and the foot. Repeat three times for 30 seconds. At night, consider sleeping in the Strassburg Sock for an all-night passive stretch.
Roll the plantar fascia. Using something like a lacrosse ball or the Type J+ Junior Roller from Addaday, roll the plantar fascia while standing. Roll three times for one minute each, resting for 30 seconds between each roll.
Pull back the toes to stretch the fascia and massage with your opposite hand. Hold back your toes in a dorsiflex position with one hand while massaging the fascia with the other. Do this three times for one minute each with 30 seconds rest between.

A man running by himself on a road in the desert

3. Strength Exercises for Plantar Fasciitis

A study published in the Scandinavian Journal of Medicine and Science in Sports found that high-load strength training “may aid in a quicker reduction in pain and improvement in function” associated with plantar fasciitis. In fact, after just three months, patients who incorporated the prescribed strength training—unilateral calf raises with a towel under their toes—experienced greater improvement than people in the control group who only stretched.

To try it, use a stair step or a block. Roll a towel and place it under your toes (the thickness of the roll will vary based on your foot, but it should allow for maximum dorsiflex at the top of the heel rise).

Starting from the bottom, rise slowly for three seconds. Pause at the top for two seconds before slowly lowering back down. Perform three sets of 12 with a minute rest between each.

While participants in the study wore a weighted backpack, consider using your body weight until you feel strong enough to add weight.