Ask Stew: Plantar Fasciitis — How to Keep Running

Plantar fasciitis is a very common, misunderstood injury among runners. However, it also can be exacerbated when standing on your feet all day in poor arch supports or in your dress or work shoes.

The combination of running significant mileage during the week with long work days on your feet in dress shoes with inadequate inserts for arch support can cause plantar fasciitis. This long-lasting injury often is confused with heel spurs, because the heel of the foot really hurts, especially in the morning immediately after waking.

Here is an email from a military member who likes to do obstacle course races (so he runs often), stands all day in combat boots and has to pass his PT test soon.

Hi, Stew. I spoke too soon about the no injuries after my recent obstacle course racing event. It appears I have plantar fasciitis in one of my feet. I woke up this morning and could not walk on my entire foot for about 20 minutes -- only the mid to forefoot. I am just wondering if you have any rehab ideas for that or just try to rest it when it happens. I cannot rest that long, I have a PT test coming up in 2 weeks.

Thanks, Barry

Barry -- first, the following answer is not medical or physical therapy advice. When in doubt, pains like these should first cause you to consider professional medical advance. However, if you are familiar with the injury from previous trips to the doctor, you may remember some of the therapies you have tried.

The classic rest -- ice -- Motrin is hardly medical advice, but a common-sense approach to any activity that causes pain. With any injury, rest from the activity that caused it is always a smart choice. Ice and anti-inflammatory medication will help with any internal swelling and ease some pain. 

So the classic rest, ice, Motrin is the first option. However, you can get a little aggressive with some therapy techniques if you have a mild case of plantar fasciitis. Many use a tennis ball or lacrosse ball and push hard against it with your foot against the floor. Roll from the bottom of your toes to the base of your heel. 

This likely will produce significant pain. Listen to your body and do not overdo it, but if you start to see decreased pain, continue with some rolling and some stretching of the foot and calf region.

Check out the Running Doctor’s advice: https://www.drpribut.com/sports/heelhtm.htm

You may find the most pain in the morning when you wake up. You can decrease that by sleeping in a boot that keeps the foot from dropping when sleeping.

Another idea is to sleep with a pillow under the covers (tucked in at the foot of the bed or against the wall) and push against it all night while sleeping. The boot device tends to work better, however, as it is the drop foot of sleeping that tightens the plantar fascia overnight.

You also may find that it hurts to run at first, but with about 5-10 minutes of warmup and during the run, you will feel no pain. Then it comes back after cooling down and walking/sitting in dress shoes or work boots. Make sure you have good inserts for your dress shoes, too -- the same ones as you run in to help you heal and prevent future injuries.

Hopefully, the combination of rest, ice, Motrin, rolling, boots and inserts will be part of the solution to fix the problem. Good luck.

Stew Smith is a former Navy SEAL and fitness author certified as a Strength and Conditioning Specialist (CSCS) with the National Strength and Conditioning Association. Visit his Fitness eBook store if you’re looking to start a workout program to create a healthy lifestyle. Send your fitness questions to stew@stewsmith.com.

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