Why Your Plantar Fasciitis Isn't Getting Better

Plantar fasciitis can be the WORST. It is a super stubborn and persistent injury and can feel elusive to cure. I spent four years struggling to heal PF in both of my feet. Along the way, I made tons of mistakes and learned a lot. There is no one magical way to cure it, but I hope my experience can help you in healing from your plantar fasciitis:

My Tips for Healing Your Plantar Fasciitis

  1. There is growing evidence that plantar fasciitis (which means an inflammation issue) is in fact plantar fasciosis (which means there is dead tissue in/around the plantar fascia). This is important because dead tissue is caused by lack of circulation, so part of the cure is to increase blood flow to the area. Many of the ways to do that are actually the opposite of a lot of standard plantar fasciitis protocol. Watch this video by the foot experts at NW Foot and Ankle to learn how to treat yourself for plantar fasciosis.

Immediate Pain Relief for when you’re in the thick of it:

  1. Don’t Run: Know the difference between soreness and pain - this takes a lot of trial and error, but likely your plantar fasciitis needs a break. Even if it doesn’t hurt on your run, if it is hurting significantly after - that’s a problem. Remember, there ARE other things to do besides run.

  2. Vary Movement: Just because you can’t run doesn’t mean you can’t exercise. You can bike, swim, aqua-jog, elliptical, kayak, row, do low-impact (aka no jumping) strength training, rock climb, do yoga or pilates … there are SO many possibilities! Not only will these activities keep you sane and healthy when you can’t run, but also these are great practices to keep even when you start running again. Our bodies thrive on variety.

  3. Consider A New Approach to Self Massage: I used to looove grinding my foot into a golf ball. I’d hear all the popping sounds and say, “I’m working out the knots, I’m loosening my fascia!” Wrong-o! What I learned is that I was actually reigniting my injuries every time I did this.

    Self massage is an incredible tool for an athlete but must be executed with caution. Rolling an injured area on hard surfaces like golf or lacrosse balls damages those tissues more and activates our sympathetic nervous system - our “fight or flight” response. In this state, our bodies experience stress and cannot recover.

    When we roll gently on softer, squishier surfaces like tennis balls, soft foam rollers, or Yoga Tune Up balls, we activate our parasympathetic nervous system - entering our “rest and digest” state that supports recovery, builds muscle tissue, restores our hormone balance, and boosts immunity and digestion.

    It’s also important to only roll sparingly, or perhaps not AT ALL, on injured areas. So I stopped rolling the sole of my foot completely and instead started rolling out my whole body, with an emphasis on my calves and between my metatarsals.

  4. Active Recovery: An injury in one are is always linked to issues elsewhere. So assume you need to roll out/do yoga/active stretches more often for your whole body, and take this on like it’s your job. If you’re being really serious, set aside 2 times each day where you do a combination of yoga and rolling out for 10-20 minutes. Try these 5 essential stretches for plantar fasciitis relief.

  5. Strengthen your feet: Your feet have to work so hard to keep you moving, and likely you’ve never worked on intentionally strengthening them. Make the time to perform these exercises for 10-15 minutes, 3 times each week.

  6. Comfort First: If your feet feel best in crocs, wear crocs. If they feel best barefoot, go barefoot. Whatever will keep your feet as pain-free as possible, do that! Later when you are pain free you can reconsider your footwear.

How to transition back to running:

  1. Strength Training: It’s essential that ALL runners establish a regular strength training routine. At minimum, take 15-20 minutes, 3 days/week to go through some basic strength training that targets your glutes, core, and shoulders. Strengthening these muscles will enhance your stability and form while running.

  2. Consider Your Shoe Choices: The most important thing about a shoe is that YOU feel good in it. There is no universal shoe knowledge that everyone can use. It’s more important to have a strong body than to have the “right” shoe.

    Learn more about picking out a shoe and how to minimize your injury risk by rotating your shoes here.

    For some people, highly supportive orthotics keep their feet healthy and happy. For others, like me, the minimal and “natural” shoe approach may be better (I only wear Altras). The key is to experiment and to do so GRADUALLY. Never jump into a new shoe style on day one (more on breaking in shoes here).

    If you want to learn more about “minimal shoes” that feature a wide toe box and zero drop, keep in mind it could take years to adapt to this type of footwear. I recommend learning from the work of Dr. Ray McClanahan at NW Foot and Ankle and Katy Bowman, the author of "Whole Body Barefoot.”

  3. Go Slow: Transition back to running with run-walk combos. Yes, walking! Be patient. Take a few weeks to gradually increase the amount you run, as you decrease the amount you walk, by following a plan like this (“normal” or “full” pace refers to the average pace of your easy runs before injury. Don’t worry about being too specific, just run slow and easy to start!):

Being injured can feel like a dark and lonely place sometimes, so try your best to keep your spirits up and remember that you can do hard things. Perhaps take the time you would’ve been running to start a new hobby like painting, playing an instrument, or reading. Find the opportunity!

For more injury support, check out the Running Injury Encyclopedia from Recover Athletics.

Questions about how to deal with your plantar fasciitis? Email me, I’d love to help!