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Running is a heart-pumping, freeing, and exhilarating workout, though it can also be a challenge. This may be especially true for people with plantar fasciitis.
If you have plantar fasciitis — degenerative irritation of your plantar fascia, the ligament that connects the front of your foot to your heel — then you know how much this heel discomfort can hurt when you hit the pavement or even get out of bed!
While rest is typically best, many runners wonder if they can continue putting in the miles when dealing with a bout of plantar fasciitis.
Here’s what the experts have to say about the safety of running with plantar fasciitis, how to keep running if you have mild pain, and ways to treat this common orthopedic condition.
If you’re a runner with plantar fasciitis, the big question on your minds is likely this: “Can I still run?”
In the short term, it’s possible to continue running if you’re dealing with a mild to moderate case of plantar fasciitis, said Sean Joyce, PT, DPT, a physical therapist with Hudson Medical + Wellness.
But, he said, you must also have a plan to rehabilitate the lower extremity, otherwise you risk becoming sidelined entirely.
If you’re dealing with a mild case of plantar fasciitis, Joyce said you’ll likely feel pain at the start of the exercise, but it often fades away as your run continues.
“This means that your discomfort is likely due to muscular tightness, and it is okay to continue running as long as you also take time to work on your calf tightness, ankle mobility, and hip strength,” he said.
However, this isn’t the time to increase the volume and intensity of your runs.
If you have persistent pain from start to finish: Stop running.
Joyce recommends that you stop running if you have persistent pain from the beginning of your run to the end. “In this circumstance, you may begin to cause tissue damage, develop abnormal movement patterns, increase your risk for serious injury, or at the very least increase inflammation,” he said.
When it comes to more severe cases, Rachel Triche, MD, an orthopedic foot and ankle surgeon at Cedars-Sinai Kerlan-Jobe Institute, says a high-impact activity like running should be avoided. It’ll likely be painful and can make your symptoms worse and more prolonged.
No matter the severity of your plantar fasciitis, Joyce said it’s important to understand that continuing to run without addressing the source of your symptoms is a recipe for future complications.
If your case of plantar fasciitis is mild and you plan to continue your training, consider the following tips before you head out the door.
Support your feet
According to Fletcher Zumbusch, PT, DPT, CSCS, at Providence Saint John’s Health Center’s Performance Therapy, the first step to supporting your feet is wearing good shoes with arch support.
Zumbusch said taping and orthotics can both help support your arches by decreasing stress and aggravation to your plantar fascia.
A physical therapist or athletic trainer, or a similar healthcare professional, should be proficient at these taping techniques.
Taping is also a great way to decide whether adding arch support would helpful before you spend money on an expensive pair of orthotics, Zumbusch said.
Daily stretching exercises
Being diligent about stretching multiple times per day — your ankle, calf, and plantar fascia itself — can keep you running.
In 2020 study, researchers observed a strong connection between tightness of the gastrocnemius (your main calf muscle) and the severity of heel pain in cases of plantar fasciitis.
If your symptoms are controlled and you’re following a daily stretching regimen two to three times per day, Triche said that starting to run in easy intervals is reasonable.
In addition to stretching, Joyce recommended increasing or maintaining good ankle mobility, especially dorsiflexion and inversion.
You should spend at least 5 minutes warming up before any type of physical activity. If you’re going for a run, focus on dynamic stretches and exercises that activate your:
- hip flexors
After your body is warmed up, spend a few minutes stretching your feet, including your heel and arch area.
Add in cross-training sessions
Aqua jogging is a great alternative, if you have access to a pool. Triche said it’s good to mix in an activity like this as you’re returning to running or if your symptoms are more intense and running isn’t an option yet.
You can also try these six low-impact cardio exercises at home to get your heart pumping and your muscles moving without irritating your plantar fasciitis.
Additionally, Zumbusch said that monitoring the volume and intensity of your training is important — and you shouldn’t increase your mileage (totals per week, as well as per run) and frequency by more than 10 percent per week.
“Increasing the training too aggressively can oftentimes be the spark that starts the fire and eventual injury,” he said.
Ice after running
After your cooldown stretches, it’s time for some ice. Ideally, you should spend 10 to 15 minutes icing your plantar fascia after any type of activity, but especially after running.
Ice packs and bags of crushed ice work well, but if you really want to attack the heel pain, try an ice bottle massage.
Ideally, Triche said, taking some time off from running — and even walking for exercise — will help improve your symptoms, along with:
- the use of appropriate footwear
- stretching exercises
- arch support
- physical therapy (for some people)
“If walking is painful even after the ‘start-up’ pain subsides, it’s probably wise to cross train for a while to get symptoms under control,” she says. Triche recommends low impact alternatives like swimming, using the elliptical, biking, or even rowing.
When the pain improves enough to allow walking without discomfort, you can gradually ease back into running, according to Triche.
“Start with a walk-jog, or something quite a bit easier than you would normally do first, and see how it goes,” she said. “It’s important to listen to your body — and if the pain increases, your body is telling you that you are not ready yet.”
There’s no one-size-fits-all solution for plantar fasciitis. That’s why Joyce recommends seeking advice from a doctor or physical therapist to assess the cause of your plantar fasciitis. They can work with you to put together a plan to resolve your symptoms, so you can return to running when it’s safe.
“In the long run, taking a few weeks off to solve your physical issues in the front end is far better than pushing through and risking an injury that may keep you out of the game for months or longer,” said Joyce.
- at the bottom of your heel
- along the arch of your foot
- at the bottom mid-foot area (not as common as heel pain)
- when you first get out of bed in the morning (becoming less severe after a few steps)
- during the push-off phase while running
- that develops gradually over time
- that’s dull or sharp
- that worsens after activity
Heel pain that doesn’t respond to a few days’ worth of rest may need a comprehensive treatment plan.
According to the American Academy of Orthopaedic Surgeons (AAOS), simple methods such as stretches, over-the-counter pain medications like ibuprofen or naproxen, supportive shoes, and night splints are all excellent treatment options, especially if you catch plantar fasciitis early.
More specifically, the exercises should involve stretches that target the arch of your foot and Achilles tendon.
A night splint is a device you wear at night to stretch your Achilles tendon and plantar fascia while you sleep. The goal is to ease morning heel pain.
Although they do offer relief, Zumbusch points out that night splints shouldn’t be regarded as the only treatment for plantar fasciitis — rather, they’re an important part of a comprehensive treatment plan.
If your pain continues after the initial treatment period, your doctor or physical therapist may talk with you about other options, such as:
- custom orthotics
- night splint or strassburg sock
- casting and walking boots
- corticosteroid injection
The good news is that the outlook for plantar fasciitis is excellent. An initial treatment plan generally improves symptoms in 2 to 3 months. In fact, the AAOS says more than 98 percent of people get better without surgery.
That said, if your symptoms don’t improve after 6 to 12 months of treatment, your doctor may consider surgery.
Continuing your running routine while dealing with plantar fasciitis is possible, as long as your pain is mild. But if you’re experiencing moderate to severe discomfort, hanging up your running shoes temporarily might be in order.
Talk to a doctor or a physical therapist about treatment options, including specific stretching and strengthening exercises, orthotics, supportive shoes, ice therapy, and night splints.