Plantar Fasciitis: Causes, Symptoms, Treatments + Best Shoes

Plantar Fasciitis can be a stubborn injury that causes intense heel pain for runners. It can lead to extended time off running and even disrupt normal life activities. Let’s review what you can to do prevent it and recover.

As a runner, you’re at a greater risk of suffering from plantar fasciitis than the average person. And so, I highly recommend all my runners learn more about this injury even if they’re not currently suffering from it.

There are things you can do to prevent it, and in case you’re currently suffering from it, I have Jessica Nicolosi Slaven, Master of Physical Therapy, here today help share more about stages of recovery and what are the best treatment options out there for Plantar Fasciitis.

In this article, you’ll also learn exactly what Plantar Fasciitis is, and what are its symptoms and causes. And importantly for many of you, some of the best running shoes for plantar fasciitis (jump to the end for this info).

What is Plantar Fasciitis?

Plantar Fasciitis is essentially an inflammation of the plantar fascia, which is a fibrous band of tissue along the sole of the foot that connects the heel bone to the toes.

It can cause intense heel pain and is one of the most common causes of heel/foot pain as well. Plantar fasciitis can manifest as stabbing pain that is usually be felt with your first steps in the morning.

The pain normally subsides after getting up and moving, but it may return after long periods of standing or standing up after sitting for a while.

It’s a problem many runners face, in fact you’re more likely to suffer from plantar fasciitis if you’re a long-distance runner. This is due to the repetitive stress we place on that ligament.

To try and understand this injury a bit more, let’s take a look at its symptoms.

Symptoms of Plantar Fasciitis

Not sure if your pain is Plantar Fasciitis?

Here are some common signs and symptoms:

• Sharp stabbing or aching pain in the heel
• Sharp stabbing or aching pain in the arch (location depends on cause)
• Trouble walking after getting out of bed in the morning
• Same issue after sitting for long periods, but pain dissipates with movement

As a reminder, there are other potential causes of heel pain after running, so if this doesn’t seem to quite fit check those out.

Can You Run with Plantar Fasciitis?

As with any injury this is going to be a bit of trial and error. If you can run without pain then enjoy the miles, but as soon as it starts to act up stop. KEEP going with all of the physical therapy exercises whether there is pain or not to keep it at bay.

Some people find that with a solid warm up and taping, they can continue to run.

Others find that they immediately have heel pain when running and that’s a sign to stop and get some lasting treatment.

Most importantly I want you to know that is IS A PROBLEM To take pain relievers before running. It can cause a host of issues, so you need to find the cause of your pain.

Causes of Plantar Fasciitis

The plantar fascia supports the arch of the foot and absorbs shock when we walk. Repetitive strain and tension on it can cause micro-tears to develop. This repeated tearing and/or stretching of the fascia can lead to irritation and inflammation.

When the fascia is irritated and inflamed in this way, it can lead to intense heel pain and manifests as plantar fasciitis.

Previously, doctors thought that bony growths in the feet called heel spurs were the cause of pain. Now it’s widely believed that heel spurs occur as a result of plantar fasciitis and are not the cause of it.

Causes of Plantar Fasciitis in Runners

Plantar fasciitis in runners is usually caused by:

• A sharp increase in mileage
• Big increase in speedwork
• Weak feet or arches
• Runners with flat feet
• Improper shoes for your strike and foot (pronation)
• Tight calf muscles (lack of stretching)
• Tight Achilles tendon

Risk Factors for Plantar Fasciitis

You are at a greater risk of developer plantar fasciitis if:

• You’re a long-distance runner
• You’re overweight, which puts increased pressure on your plantar fascia ligaments. This is especially true if you have experienced sudden weight gain
• Your work involves being on your feet for most of the day, nurses, servers, cooks
• You have structural foot issues, such as low arches or flat feet (pes planus) or high arches (pes cavus)
• You often wear shoes that have soft soles and provide poor arch support
• You have tight Achilles tendons or ‘heel cord’
• You often wear high-heel shoes
• You have tight calf muscles, which makes it difficult to flex your foot and bring your shoes towards your shins

How to Get Diagnosed

If you suspect you have plantar fasciitis, I recommend heading to your doctor. You need to know what this is to start appropriately treating it right away.

Physical therapists are trained to tease out injuries of the plantar fascia itself from those mimicking it such as flexor hallucis tendinitis, interdigital neuroma and injuries to the joints of foot. So expect them to put you through a few movements to land on the correct diagnosis.

You may be asked to flex your foot while they push on the plantar fascia to check if the pain gets worse as your flex and better as you point your toes.

Imaging tests, such as an X-ray or MRI, may also be used to correctly diagnose plantar fasciitis. Although you can really get a good look at soft tissues with an X-ray, it can be helpful when trying to rule out other possible causes of heel pain such as bone fractures and heel spurs.

Why Do We Get Heel Pain from Running?

Heel pain from running is a common complaint in a Physical Therapist’s office. It’s often blamed on heel striking, but for all the reasons note above we can easily develop heel pain.

Go through the checklist to see if your symptoms match those of PF. If they do then use this guide to start getting some relief, but if not then it’s important to keep digging to find out why.

Make sure you don’t have a running stress fracture or a bone bruise.

Stages of Recovery for Plantar Fasciitis

Before you read on, it’s good to know that recovering from an injury moves in stages: acute, rehab and then prevention.

And, it’s also good to know these stages don’t always move in a forward direction. Expect a circuitous course with ANY injury. Our bodies are not easily “fixed”.

So how long does plantar fasciitis take to go away…it can take a very long time.

But don’t get frustrated, just keep following these tips!

{Amanda’s note: boy do I feel this!! Recovery from knee surgery was slow, then speedy, then a little setback, then on the road again. Do your best to take it one day at a time and know that it CAN and WILL get better if you persist with finding the right info for your body.}

So, which stage are you in?

ACUTE – your injury is recent and it’s quite painful, it’s difficult to walk and/or run

REHAB – your pain is intermittent and moderate to mild, you’re feeling able to get back to exercise

PREVENTION – you’re running pain free and loving life. In this stage, you’ll do some routine maintenance to keep it that way.

Plantar fasciitis is one of those lingering nagging injuries that make runners insane. But you can treat and prevent it with these tips! #runchat Share on X

Acute Stage: Begin Recovery Process

In the ACUTE STAGE, you’re going to be begging for exercises, but your injury needs active movement, compression, protection and ice before you can begin to rehab it.

Can I say that again for the folks in the back? Many ask for exercises and stretches at this stage, but ankle/foot stretches and strengthening exercises need to wait a bit.

Ice

Your number one goal when pain is high and you’re having trouble walking is to get that pain under control. Ice the bottom of your foot with a frozen water bottle or dunk it in ice water for up to 15 minutes then let it come back to a normal temperature. Repeat as needed.

This is also the time to start doing all those anti-inflammatory things Amanda preaches!

Compression

Use a compression sock for comfort and to decrease excessive swelling. Compression socks are designed to reduce inflammation and these particular socks help to provide additional ankle and arch support.

Feetures Plantar Fasciitis socks are HIGHLY recommended by runners dealing with this issue. As I tested them out, I could see why. They are providing that compression feel along side what feels like some arch support.

100% worth adding them to the rotation as you try to find a solution.

Sensible Shoes

Wear what your Grandma would call “sensible shoes” – sneakers, hiking boots, cushioned slippers – something that allows you to walk pain free, even when just walking around your home.

At night, keep a pair of slippers or flip flops at your bedside for bathroom and snack trips. Most running stores carry “recovery flip flops” that can also be used around the house. In essence, you want SUPPORT.

Taping for Plantar Fasciitis

Amanda is a massive fan of RockTape as it made running with her knee injury possible, so we know it’s a great option.

But as will all things, careful not to overdo it just because it makes things seem like they’re better. There are a lot of techniques for taping to relieve foot pain, you’ll have to experiment to see which one works for you. Read more on the example above.

Fight the Urge to Stretch!

Most stretch too aggressively and this can make the injury worse.

Initial plantar fasciitis recovery plan:

• Make slow circles or letters with your foot throughout the day.
• Move your toes up and down as far as you can.
• Use your fingers to stretch your toes apart or consider purchasing a toe spreader, carried at most pharmacies.
• Bridges and clam shells for strengthening are ok

Stay in the pain free zone with everything.

Find a type of cardio exercise that’s pain free – cycling or swimming are usually tolerated well – to maintain your fitness.

Rehab Stage: Evaluate

In the REHAB STAGE, slowly move into different shoes. Meaning you can start to leave behind the sensible…but really should consider upgrading or changing our your shoes to ensure they aren’t part of the issue.

Let’s go through some ideas for shoes and exercises that you can start to utilize immediately.

Lever Running

When elite athletes return to workouts after an injury, Plantar Fasciitis or otherwise, they often utilize tools that reduce their body weight. In the past this meant an AlterG which is insanely expensive and only available in Dr’s office, but now we have Lever Movement system for at home.

I use this and a large number of athletes from the everyday to elite have started using it at home as well. Specifically for Plantar Fasciitis this is going to reduce the weightload on the foot, which means the muscles won’t be spreading out so much with each step.

By reducing this amount, you can ease your body back in to running with less chance of inflamming the Plantar Fascia.

Too many runners try to jump back in to normal training and quickly end up in pain again. Whether you feel in a hurry because you have a race or simply can’t wait to get going, this is a smart way to get started.

Checkout the full Lever Movement System >>

Lever Movement Discount Code: Runtothefinish for 20% off

Good news, you’ll continue to get usage out of this even after injury. It’s great for increasing mileage or even getting in a few more speedy miles to help the legs feel the turnover without a big jump in HR.

1.  If you’ve been off running for more than a month, you might choose to start with all Lever runs. Take off the maximum amount of weight and then each week take off less weight.
2. If you’re just trying to avoid a full blown injury you might try substituting Lever for a couple of runs each week. Play with the weightload to find what gives you the most relief while still being a good workout.

Plantar Fasciitis Exercises for Re-Hab

• Begin stretching toes against a wall
• Use a tennis ball or a can to massage the bottom of your foot
• Begin single leg balance (stand on single leg while holding the other at 90 degrees, advance to standing on a pillow)
• Use a Strassburg sock or boot for gentle Achilles stretching. Pro tip: these devices are better tolerated during the day while at work or while watching TV than when sleeping. 
• Start towel curls and isolated movement of the toes

If you can’t move your big toe up and down independent of the little toes, keep trying!

It’s like figuring out how to ride a bike. One day your brain will “get it”, your muscles will learn to do these movements and become stronger, protecting your foot from re-injury.

Once your foot is pain free, ease back into walking for exercise and then running. Note this didn’t stay start running right away, it said fix the issue then walk…then run.

What are the Best Running Shoes for Plantar Fasciitis?

Pain from plantar fasciitis can make it difficult to play sports, run, or even stand for long periods of time. Picking the proper shoes for your feet is essential if you have plantar fasciitis pain. You will notice that many of these are stability shoes, which means they’ll have more arch support.

All of these recommended shoes have been around for many, many iterations. They are beloved running favorites.

Here are my top four picks as a running coach:

#1 Asics Gel Nimbus

ASICS makes a variety of running shoes that may be suitable for people suffering from plantar fasciitis. The Gel Nimbus is consistently deemed as one of the most well-liked ones.

Running long distances requires a shoe with good cushioning and durability, and Asics’ Gel-Nimbus fits the bill. It is padded with foam and gel to cushion your steps. The mesh upper is made of a breathable, soft mesh that is made from recycled materials.

The thick knit fabric used for the tongue adds a welcome layer of protection to the top of the shoe, which is one of the top reasons runners love it.

Even though this pair is made for runners with high arches, those with neutral arches can also benefit from its smoother stride.

• 8mm drop
• 8.7 oz women’s, 10.5 oz men’s
• $160
• Read my complete Asics Gel Nimbus review

#2 Asics Gel Kayano

The Gel Kayano from Asics is an excellent choice if you suffer from overpronation, flat feet, or a low arch. It is also one of my top picks as a running coaches.

It has enough cushioning in the midsole to better support the plantar fascia. As mentioned previously, this is the thick band of tissue in the arch of your foot that is inflamed in anyone suffering from plantar fasciitis pain.

It also has a great durable rubber outsole that is stronger in key areas to prevent excessive wear and tear.

These shoes are ideal for reducing the discomfort of plantar fasciitis in the feet because of its rigid stability and cushioning.

Gel cushioning in the heel helps to evenly distribute impact during running while also providing the right level of shock absorption.

If your feet sweat during long runs, this shoe has a breathable mesh upper to increase airflow. And for runners prone to blisters who still want a close fit, there is a low-profile heel counter, which is the part of the shoe that wraps around the heel.

Gel Kayano has been long thought of as the gold standard of stability shoes and one of the best Asics running shoes you can buy, and it’s definitely great for anyone suffering from plantar fasciitis pain.

• 10mm drop
•  9.3 oz women’s, 10.5 oz men’s
• $160

#3 Brooks Adrenaline GTS

If you suffer from chronic plantar fasciitis pain, the Brooks Adrenaline GTS may be the solution for you. Even though it’s not a max cushion shoe, the Brooks Adrenaline GTS gives you the support and comfort you need in a shoe for plantar fasciitis.

At its core, the Brooks Adrenaline GTS 23 features a DNA LOFT midsole that combines EVA foam and rubber with carefully placed air gaps for enhanced cushioning and better padding. This extra cushioning gives you the shock absorption you need to get through each day without foot pain.

It also comes with Brooks’ GuideRails system that places two firm pieces of plastic along the outside of your heel to eliminate excess movement.

The Brooks Adrenaline GTS also has a heel made of HPR rubber, which is another great feature. People with plantar fasciitis often experience pain in the area around their heels and this rubber heel can help alleviate some of the impact by absorbing shock.

Even after a long run or several hours on our feet, rubber heel will help reduce overall foot pain. If you need a stability shoe for your plantar fasciitis, look no further than the Brooks Adrenaline GTS.

What’s best is that the Adrenaline GTS 23 has the APMA Seal of Acceptance, which signifies that the American Podiatric Medical Association has determined that it supports good foot health making it one of the best shoes for plantar fasciitis.

• 12 mm heel drop, good for those with Achilles issues
• 10.2 oz for women’s

#4 Saucony Guide

Saucony Guide is a highly cushioned shoe that may provide extra comfort while running for people with plantar fasciitis.

This running shoe is appropriate for people who have a neutral to high arch and mild to severe pronation, which is when the foot rolls inward.

The contoured footbed offers excellent support from the toes to the heels. The shoe’s wider fit also makes it more stable. Plus, the PWRRUN midsole, according to the company, increases durability. Its sock liner provides a bouncy underfoot feel with every step.

If you want a shoe that is lightweight, flexible, and comfortable, go with a Saucony Guide.

• 8mm heel drop
• 9.4 oz womens

Factors to Consider When Picking the Right Shoes for Plantar Fasciitis

If you’re already suffering from this painful condition, then making sure you’re wearing the right footwear can make a world of difference. Here are some factors to consider when picking the right shoes for plantar fasciitis:

1. Cushioning

Remember that a good level of cushioning will help with pain relief.

A cushioned running shoes will protect the plantar fascia from strain caused by repetitive impact while running. A good running shoe for plantar fasciitis should provide superior shock absorption upon impact.

At the same time, you shouldn’t wear shoes that are too cushioned because they could make your foot and ankle unstable.

In the case of plantar fasciitis, running shoes with balanced or firm cushioning are most preferable.

2. Arch Support

If you have plantar fasciitis, arch support is one of the most important things to look for. Without proper arch support, the problem will persist no matter how good or expensive the shoes are.

As your arch falls down during your foot strike, the entire foot rolls inward which is what your body then tries to correct by tightening up all those other foot and lower leg muscles. It’s also trying to protect you from knee pain.

Arch support comes in various levels depending on the severity of the condition. Some running shoes are better for high arches, while others are better for low arches. Therefore, it is essential to find a shoe that matches your arch type.

If you have low arches or flat feet and overpronation as well as plantar fasciitis, consider stability shoes for mild cases and motion control shoes for severe cases.

A neutral, softer shoe is preferable for those with normal or high arches.

3. Heel Counter

A firm heel counter reduces abnormal stretching of the plantar fascia. It also helps to stabilize and align the feet.

When combined with a sturdy heel counter, a shoe that has a flexible toe box gives the front of the shoe the ability to stretch while still allowing the back of the foot to remain strong and stable throughout the run

Shoes with deep heel cups offer runners with plantar fasciitis not only protection for the heel bone but also a reduction in pronation which can help if you have this painful condition.

4. Orthotics

Orthotics are custom-made shoe inserts that can help to reduce pain and improve the stability of your feet. They provide arch support and cushioning, as well as helping to distribute pressure evenly across the foot. If you have plantar fasciitis, orthotics can add extra cushioning to take pressure off of the affected area.

Or you can buy off-the-shelf insoles that provide arch support and cushioning, but they may not be as effective as custom orthotics.

Prevention Stage: Keep it From Coming Back!

In the PREVENTION STAGE,we’re committing to ongoing treatment protocols to prevent that pain from reappearing.

• do the toe spreading and toe movements two or more times each week
• continue the glut exercises too, to strengthen hips and glutes
• Work toward being barefoot in the house and then in your yard to develop balance and strength of the smallest muscles of your foot

If anything flares up, head right back to the acute stage strategies until it’s under control. Heel pain when running is NOT normal, don’t convince yourself that it is.

Does your pain persist after trying all of this?

Book a PT consult.

We can assess your posture, movement patterns, test for muscle imbalances, protect the foot with taping and even use dry needling to bring things into balance.

Looking for more tips?

• Common causes of running foot pain
• Should you get a cortisone shot? (A must read for PF)
• How does Kinesio taping work

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