Don’t let plantar fasciitis stop you from running (complete week 1 rehab guide)

Plantar fasciitis is one of the most common sources of pain in the feet for runners and triathletes.

It can set you back for weeks if not taken care of properly.

I’m going to give you me week 1 program to get rid of pain (and decide if you need professional help).

What is the Plantar Fascia?

I’m not going to give you a complete anatomy class but it can be helpful to understand where the plantar fascia is.

The plantar facia covers the bottom of the foot (the “plantar” surface).

It acts like a big spring to propel you forward with walking and running.

Commonly we see it irritated right at the attachment point to the heel.

Common symptoms and other issues to be aware of

The common location of pain and discomfort is going to be along the medial arch or into the heel as above.

Plantar fascia will hurt with:

1. First step in the morning or after prolonged sitting
2. During walking or running (especially barefoot)
3. Will “warm up” with movement and feel better after you walk for a period of time

Before we go much further though it’s important that we rule out other issues.

3 other issues that can be in a similar area of your foot include:

1. Fat pad issues (this usually has pain in the central part in the heel and is worse if you directly load that, step directly on the heel)
2. Nerve issues (this usually has numbness or tingling, sometimes weakness, or “weird” symptoms).
3. Bone stress injuries particularly the calcaneus (heel bone) (these will feel progressively worse and every step will hurt - as opposed to warming up as you get going).

If you seem to be noticing things more consistent with other complaints that’s probably a sign you need an in-person rehab pro to help you rule out other issues.

3 big reasons why you might have plantar fasciitis:

In my clinical experience there are 3 big reasons you might develop plantar fasciitis:

1. Changes in footwear: adding new shoes into the mix with different support on the foot or prolonged running in worn-out shoes are both common causes of plantar pain.
2. Shifts in training load or terrain: as with many endurance injuries big changes to volume, intensity or terrain can all trigger plantar fasciitis.
3. Lower extremity imbalances: issues in other areas of the lower body can lead to issues in the arches (think calf tightness, limited ankle mobility, poor loading with posterior chain).

These are all things you should consider in your long-term management of plantar fasciitis.

Some basic tests you can do at home to be sure we’re dealing with plantar fasciitis

As a final little check here are some tests you can do to be sure we are dealing with plantar fasciitis:

• Windlass Mechanism: Assess pain or tension in arch during when you lift up your big toe with your hand. If that recreates pain then we are looking at the medial arch.
• Towel Heel Raises: Check strength/endurance in foot and calf with one of the exercises. If that reproduces pain we are looking at the arch as well.
• Hop Test: Try a single leg hop. If the pain seems to get worse with this then we need to rule out a stress fracture or reaction. It’s still probable to be plantar fasciitis but it’s not worth messing around with.
• Walking + Running Tolerance: When do you notice the onset of pain (at the start, middle or end) and does it seem to get better with time or get worse? If it’s at the start and seems to warm up we are likely dealing with plantar pain.
• “Poke Test”: Not exactly a test but palpation and poking of the plantar fascia will recreate the pain. If there is no pain along that medial arch then we need to rule out other causes of your pain.

Let’s talk about management now.

Week 1 Self-Management Plan

Here is everything I would do myself if I woke up with plantar fasciitis as a runner or triathlete:

1. Reduce or modify training load

The first thing I would do is drop running down and substitute a little more cross-training. My goal is always to find something that does not aggravate the arches.

This is a good time to reflect on if you have crossed a breakpoint in your training.

2. Footwear Adjustments

Next I would find the most supportive shoe I own or buy a cheap pair of insoles.

This will temporarily offload the arches and allow things to calm down.

This is not our long-term solution just a way to get us back to work and doing our daily activities.

3. Begin gradual loading of Plantar Fascia

Once some pain has reduced we can begin to load the area.

2 categories of loading:

1- Specific arch strength:

• Toe-Elevated Heel Raises: Strengthen both foot intrinsic muscles and calf.
• Toe “Scrunches” or Towel Curls: Target the arch and foot intrinsics.
• Arch Winding: Encouraging active control of the foot’s arch.

2 - Calf and post-chain work

• Single-Leg Calf Raises: Build calf and Achilles capacity to handle load.
• Single-Leg RDLs (Romanian Deadlifts): Focus on balance and posterior chain strength.
• Hops and Jumps: Start easy and progress up to single leg hops.

4. Monitor your morning pain

This is one of our big targets with early management.

We should see this gradually get better over the week and you can return to training.

If it’s not changing (or getting worse) after a week then you should consider a personalized assessment to rule out other issues.

5. Decide if you need professional help

We have talked about this already but it’s worth a reminder. If you have:

1. Persistent or worsening symptoms
2. Signs of other conditions
3. Chronic plantar pain

Then it’s going to be worth seeing a rehab pro to build a custom plan.

This plan will help in week 1 with plantar fasciitis but there are many other conditions we also need to rule out.

That’s all for today!

Remember, catch plantar fasciitis early, drop your running load, get the arches moving and you can prevent a lot of bigger issues.

If you have any questions about your arch pain reply to this email and I’ll point you in the right direction.

Chandler