Hacking Plantar Fasciitis: Curing the Vampire Bite of Running Injuries

by Jason Fitzgerald

I crested the top of the hill, the hot summer sun beating on my bare shoulders. I had just finished my eighth hill repetition on a narrow, winding trail near my home town of Lexington, MA.

It was August, 2004. I was running close to 80 miles a week and preparing for the fall cross country season of my Junior year at Connecticut College. My mileage had almost doubled since my spring training in outdoor track.

Running a hill workout before cross country season officially starts is aggressive. But I was seeking massive improvement.

Massive improvement = increased volume + increased intensity. Warning: all increases should be gradual.

Two days after my hill workout, my right foot developed a burning pain from the heel to my forefoot. After a visit to a specialist, and later a physical therapist, I was delivered the bad news.

I had plantar fasciitis. One of the worst injuries a runner can get. And my season started in less than a month. My hopes for making the varsity squad were threatened, along with my goal of breaking 27 minutes for 8k.

I did what I always did when I got an injury: I immediately took a week off from running. Fortunately, I was able to visit a physical therapist twice a week who massaged my plantar fascia and performed the standard treatment of heat, massage, ice. It didn’t work well as it took me weeks to get back into a regular running routine.

How to Cure Plantar Fasciitis

After my experience seven years ago, I’ve managed to run more, run faster, become more minimalist – all without a single complaint from either plantar fascia.

It’s not luck – it’s a systematic plan for prevention that includes general strength, specific exercises, and a training upgrade. And I’m predisposed to foot injuries because of my low arches and over-pronation. I’m not a model of biomechanical efficiency – but I do the best I can with what I have.

First, if you happen to have plantar fasciitis, all hope is not lost. Depending on the severity of the injury, you can usually treat it and be back running with 3-7 days. Within two weeks, you should be back to your normal training.

Follow these steps if you come down with a case of plantar fasciitis and you can cut your recovery time down substantially.

  1. Stop running during the acute phase of the injury. For most runners, this will be 3-7 days.
  2. Ice your affected foot for 20 minutes three times a day. If you can, cycle the icing as 20 minutes on, 20 minutes off. The best ways to ice your foot are dunking it in a bucket or cooler of ice water or using a frozen cup of water to give yourself an ice massage. Use the edges of the ice cup to dig into your plantar fascia!
  3. Just because you’re not running doesn’t mean you’re not working out. Stay current with your strength and core exercises as planned.
  4. Spend 5-10 minutes doing specific foot exercises to strengthen your feet.
  5. When you finish the foot exercises, use a golf ball or lacrosse ball to roll the underside of your foot. There is no “best way” to do this – just feel around your arch and plantar fascia and aggressively massage any area that’s sore or feels “crunchy” (this is scar tissue – break it up!). You should be aggressive but don’t roll so hard that you’re in pain. Find a balance.
  6. Use your foam roller to roll your soleus and calf muscles. Tightness here can aggravate plantar fasciitis.
  7. Ice your foot after every workout.
  8. While I don’t have experience with a night splint, many runners have found them helpful. Experiment with what works for you.
  9. Your body is healing itself, so help it out by eating a nutrient filled diet and getting a lot of sleep.

This routine is far more aggressive than what the majority of runners do for an injury. It also rivals the recovery protocols of most physical therapists. It’s also more effective at getting you back on the road and running sooner.

For an even more detailed, step-by-step rehab protocol, see the Injury Prevention for Runners program.

Once you start running again, take care to limit your faster workouts during the first week. Your plantar fascia will first be able to handle running slowly – then it’ll be ready for more intensity.

When you start running, you should continue to massage your foot with a golf or lacrosse ball and foam roll your soleus and calf to break up residual scar tissue and keep the area supple. Keep up with the foot exercises and remember to ice religiously.

Plantar Fasciitis Prevention Strategies

Plantar Fasciitis

If you don’t have PF, or if you’ve had it in the past and want to remain healthy now, certain prevention tactics are worth doing on a regular basis. Many of these strategies will not only help prevent PF, but make you a more injury-resistant runner in general (and may even make you stronger, faster, and more attractive…or something like that).

  1. Run barefoot strides 2-3 times per week on a synthetic turf or smooth grass field. PF is often caused by a weakness of the foot and lower leg musculature – barefoot work helps strengthen your feet.
  2. You can also do some easy barefoot running at the end of a typical distance run. Limit yourself to 2-10 minutes depending on your fitness level, weight, and experience with barefoot running. A little bit goes a long way.
  3. Embrace your foam roller and golf ball like good friends! If you’re more sore than usual, spend 5-10 minutes rolling out the soreness. Chronically tight muscles (the opposite of being supple) can lead to injury if you don’t take care of them properly.
  4. Make a slow transition to wearing more minimalist shoes. Note that I’m not recommending you do your runs in FiveFingers or racing flats. But the vast majority of runners don’t need bulky motion-control or stability shoes unless there’s a prominent biomechanical problem. Odds are, that’s not you. Note: watch my video on the spectrum of minimalist running shoes for shoe ideas plus recommendations for more minimalist casual shoes. Shoes with very high heels (for both men and women) should be worn in strict moderation.
  5. Beware of too much running on a road’s camber, or its slope toward the curb. When you always stay on the left side of the road (which is the safest way to run – toward traffic), your feet are always slightly tilted to the left which can result in a huge number of problems. Get on the sidewalk, switch sides if traffic permits, or better yet….
  6. Run more trails! The undulating terrain, roots and rocks, and uneven surface stresses your feet in many different ways. Unlike the road, which is a much more predictable surface, trails aren’t as likely to contribute to overuse injuries.
  7. If you can’t do any barefoot work or lack access to a trail system, keep up with the foot exercises mentioned above. You need a way to develop additional strength in your feet and lower legs.
  8. Of course, no injury discussion is complete without this reminder: don’t run too much, too soon, too fast. Recognize your limits and be cautious about how and when you add mileage and intensity to your program. If you don’t know where to start, be safe and get a custom training plan so you don’t have to worry.

Naturally, different things will work better for different runners. It depends on why you developed PF in the first place, your stride pattern, and training history. Experiment with both the recovery routine outlined above and the prevention strategies.

Remember, a runner who only runs is bound to get hurt. The strength work, self-massage, and training variety will do wonders in keeping you healthy over the long-term. And even more strategies are included in this comprehensive injury prevention program.

These “little things” maybe aren’t so little. After all, they enable you to run consistently and ultimately, healthier and faster.

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