Returning to running post plantar fasciitis

This is a great question, and it’s even better that you’re already thinking about how to return to running safely after an injury like plantar fasciitis.

As you probably already know, plantar fasciitis can be a stubborn injury to rehab. Before you start thinking about running again, it’s important to have it properly assessed and managed by a physiotherapist and/or podiatrist to make sure you’re on the right track.

For anyone unfamiliar with this injury, the plantar fascia is a thick band of connective tissue that runs along the bottom of your foot, connecting your heel (calcaneus) to your toes. It plays an important role in supporting your arch and absorbing load during walking and running. Because it takes a lot of repetitive stress, especially in runners, it can become irritated when the load exceeds what the tissue can tolerate.

Plantar fasciitis typically presents as pain under the heel or along the arch. A classic sign is pain with the first few steps in the morning, which may ease as you move around. In more persistent or severe cases, it can remain painful with walking and standing, making it a frustrating injury to deal with.

Why does it happen?

In most cases, plantar fasciitis develops due to overload, either from doing too much too soon, or not allowing enough recovery between sessions. Other contributing factors can include:

• Footwear that doesn’t provide enough support (or a sudden change in shoes)
• Tight calf muscles
• Reduced strength in the foot, ankle, and lower limb
• Rapid increases in running volume or intensity

How to manage plantar fasciitis

Initial rehabilitation usually involves reducing aggravating activities, sadly this often includes running. Following this a gradual and progressive rehab programme is ideal. This should focus on building strength through the foot, calf, and lower limb, while also addressing contributing factors like footwear, running technique, and training load.

A good sign you’re ready to think about running again is when:

• You can walk pain-free (or with minimal discomfort)
• Morning pain has significantly improved
• You can perform calf raises and hopping (especially single-leg) without pain

Returning to run

Once you and your health professional feel you’re ready, the key is to return gradually and avoid overloading the tissue too quickly - even though I know it’s very tempting to jump straight back in.

A helpful guideline is to keep pain during and after running at a low level (e.g. no more than 2-3/10), and ensure it settles within 24 hours. If symptoms flare up, that’s a sign you may need to scale things back.

My top tips for returning to running after plantar fasciitis:

• Check your footwear

  Make sure your shoes are supportive, comfortable, and appropriate for your foot type and running style.

• Start with a walk/run program

  Begin with short intervals (e.g. 1-2 minutes running, 2-3 minutes walking) and gradually increase the running portion over 4-6 weeks.

• Hold off on speed work

  Avoid intervals, hills, and faster running for at least 6-8 weeks while your tissues adapt.

• Keep up your strength training

  Include exercises like single leg calf raises and foot strengthening. Introduce higher impact work like plyometrics gradually and with guidance.

• Don’t ignore early warning signs

  A slight return of morning stiffness or heel pain is often the first sign you’re doing too much- adjust early rather than pushing through.

Additional treatment options

There is some good evidence supporting the use of shockwave therapy to help stimulate healing in persistent cases of plantar fasciitis. Many sports doctors and podiatrists offer this, and it can be worth discussing if your symptoms are not improving with rehab alone.

Conclusion

Returning to running after plantar fasciitis requires patience, but with the right approach, it’s absolutely achievable. Take your time, build gradually, and listen to your body along the way. I hope this helps, and I wish you all the best with your return to running!