If you’ve got plantar fascia problems you’ve probably been doing a lot to try and heal your feet. Maybe foot and calf stretches, ice and ice massages, maybe sleeping in special socks, and maybe taking anti-inflammatories. And you’ve probably cut back on your running or even taken time off. Progress probably seems really slow or maybe nonexistent.
There are two reasons why this path to healing is slow at best. First, most of these treatments have actually been shown to interfere with healing rather than promoting it. Doctors can be slow to pick up on new information in their field, particularly when it directly contradicts things they’ve been recommending for decades, and the internet is full of outdated information.
Here’s the update you need on stretching, ice, and anti-inflammatories.
The other reason you’re only getting better slowly if at all is that healing is only part of what’s needed—and it’s the lesser part at that!
Plantar fascia problems are generally overuse injuries, meaning they develop over a long period as a result of running in a way that stresses the soles of your feet. So returning to running pain-free means you need to change the way you’re running.
Rest does little to help that. In fact being sedentary and in pain is likely to make your form worse when you do run, not better.
In my practice working one-to-one with runners I’ve consistently gotten those with plantar fascia problems back to running comfortably within a 1-2 month period and sometimes even faster. And let me emphasize it’s not because I’ve healed their feet—I’m not a medical professional. Instead I’ve helped runners take the critical step of changing how they run so they’re not stressing their feet any more.
How to Cause Plantar Fascia Problems
Nearly every runner I’ve seen with PF pulls their pelvis backwards, so it’s behind their foot in midstance instead of over the foot where it should be. It’s a bit as if they were sitting in a chair.
Usually they’re doing this by rounding their back and keeping their hip joints too flexed.
The combination of having their overall body weight behind where it should be and having a flexed and thus rigid torso means that as the runner approaches toe-off and tries to move forward and up off the foot, their whole body is fighting the action.
This creates a kind of tug-of-war on the sole of the foot, with the bodyweight pushing the foot backwards as the heel lifts and the forefoot is firmly stuck to the ground.
If you do this on a slippery surface your whole foot will slide slightly backwards as you approach toe-off. And in fact if you run this way you might also find that when you walk in socks on a slippery wood floor your feet slip backwards as you step forwards. This is a movement pattern people have throughout their daily activities, not just in running.
This tug-of-war stresses the plantar fascia and perhaps even puts microtears in it, which your body tries to heal—hence the inflammation—and fails to complete because you continue to create the same stress every time you run. Hence the chronic inflammation.
How to Relieve Plantar Fascia Stress
The simple answer is that you need to move your weight forward so it’s over your foot at midstance. This means it’s farther forward throughout your whole gait cycle (midstance is just a particularly convenient and important reference point).
However this isn’t so easy as just moving your pelvis forward and straightening up a bit. If you try to do those things you’ll significantly increase your muscular tension and make yourself even more rigid and hard to move.
In running the two sides of your body are always doing opposite things. When this is allowed to happen really well and freely it becomes impossible to pull your weight back too far behind your feet, and your feet are able to work they way they’re supposed to.
I call that your core action, and you can learn more about it here and get better at it with this lesson.
Improving your core action tends to also help you extend your hip joints better—a critical step for reducing your foot stress. However you may also need extra focus on hip extension. I have a lot of ways to accomplish that in my practice, but you can start working on it on your own by simply doing some glute exercises that extend your hip joints regularly, especially pre-run. Even simple bridging is helpful as long as you don’t try to tighten your abs at the same time. Focus on squeezing your butt as you do it (but not when you run!)
And finally, people with plantar fasciitis/fasciosis often feel the urge to stretch their calves and feet all the time, keeping their heels down and avoiding the sensation of the heel lifting, the arch shortening, and the weight going onto the toes. It feels protective to the feet and the stretching feels kind of good.
However you may be realizing as you read this that this movement pattern is actually the heart of the problem. It means having your weight too far back on your feet with every step, and each stretch sensation you have is actually stress and possibly damage to your feet.
As you improve your core action and ability to let your hip joints extend as you move, your weight will come farther forward on your feet and bring with it the opposite sensation, of your ankle extending, your calf shortening, and your arch contracting. This is progress towards healthy foot movement. Embrace it.
That doesn’t mean overdo it or force it, of course! But when it appears let it happen, and let go of the idea that keeping your heel down and your toes lifted ever so slightly as you walk and run is good for you. It isn’t.
To Sum Up
The three keys to relieving plantar fascia stress are:
- improving your core action
- learning how to let your hips extend better
- allowing your foot movement to return to normal
Together they will get you well on your way towards forgetting you ever had plantar pain.
In addition to the resources I’ve linked to through this article, I have one more to give you. A couple of years ago I created a lesson specifically to help runners with plantar and achilles problems.
The lesson is called Free Your Feet, and here it is.
It will temporarily make you run a little slower but it will help you do all three key elements I've listed and can give you a lot of relief. Just go back and do Mobilizing Your Core to Run the following day to restore your speed.
Post your questions below and let me know how it goes for you!
I’ve tried EVERYTHING to help heal my PF and stumbled across your website last night! It’s so opposite from most of what I’ve been hearing (to ice, stretch, rest, etc.), but it does seem to make sense. I went through this lesson last night and felt difference just in walking so far, realizing I’ve been adjusting my plant, stride not in good ways due to the pain. I look forward to continuing with this as I get back into running. I’ve been avoiding the running mostly as it tightens me up so fiercely and then I’m in pain for days. I think the key is to start back more gradually, but consistently and to figure out the whys behind all the tightness. I’m training for triathlon and think the extra biking has tightened up my hips, flexors and I’ve been stretching (rather than strengthening) to try and alleviate it. Also, note: before my recent PF started in February I battled tightness behind my knee, toward the inside which seemed to wrap around the whole knee. When I sit back on my knees there’s still a serious tightness that I feel all the way around the knee but esp in that back inner muscle/tendon(?). I’ve been doing ice baths with my feet a LOT and have decided to lay off that for a while to see if your method helps me more. Do you have an idea of what’s causing the knee tightness and what exercises I can do to fix it? Thanks SO MUCH for the info. provided here…I’m desperate for healing!!
The sports medicine doc I saw about my PF, which I’ve had for >6 mos. now (not running at all for the last two months and less than once a week for several months before that), said I probably had micro tears that needed to heal since I was having sharp pain when she palpitated the area as well as morning pain. Does this mean I need to rest before trying to get back to running, to allow the tears to heal? (Also when I try to run I start having intolerable pain pretty quickly, though I’m able to walk around for short periods of time without any pain and an xray back in June showed no stress fracture or heel spur.)
Lin, my understanding is that PF is currently considered to always involve microtears, so it’s not necessarily that your situation is worse than usual in nature. In my experience, you can feel better more quickly than it takes to actually heal those tears by changing the way you move so the tissues aren’t so tight and repeatedly traumatized every time you get up in the morning and start walking. Try the free lessons at the bottom of this blog post and see if you don’t feel an improvement. In my experience, using a magnesium oil spray on your feet and calves can also be very helpful in your recovery. Best of luck!
Jae, I’m so grateful for your work. I’ve recently been introduced, and I can already feel improvements. I was recently diagnosed with a 50% plantar fascia rupture. I would imagine the ortho will suggest a boot, which I am more than happy to follow orders. But, I was curious, have you ever worked with runners who have been able to heal with your work and not take such drastic measures, such as immobilization/PRP/etc? Very grateful for your thoughts.