Plantar Fasciitis in Runners: Fix Heel Pain & Return Stronger

That sharp heel pain with your first steps in the morning or after sitting is classic plantar fasciitis (often called plantar heel pain). The goal isn’t only to calm symptoms it’s to restore the foot’s load tolerance so you can run comfortably again.

At The Recovery Room (Southampton & Romsey), we build runner-specific rehab that targets the cause, not just the pain.

What Is Plantar Fasciitis?

The plantar fascia is a thick band under the foot that helps your arch store and release energy while you run.

With spikes in load or reduced tissue capacity, it can become irritated especially at the medial heel attachment.

Typical Signs

First-step pain in the heel on waking or after sitting (“start-up pain”)
Worse after long standing, hills, or speed sessions
Tenderness at the inner heel; may ease as you warm up, then return later

Look-alikes: heel fat-pad irritation, tibial nerve entrapment, or calcaneal stress fracture.

We’ll rule these out during our assessment.

Why Runners Get It

Training spikes: sudden volume, hills, or speed
Calf/soleus capacity: under-trained reduces shock absorption
Foot mechanics: limited big-toe extension, stiff ankle, weak foot intrinsics
Gait: overstriding/low cadence increasing impact at heel strike
Shoes & surfaces: worn shoes, abrupt shoe changes, hard cambered roads
Recovery: low sleep, high stress, inadequate energy/protein

First 72 Hours: What To Do Now

Modify load: reduce impact volume; avoid speedwork and steep hills short-term
Shoe strategy: wear supportive, cushioned shoes indoors/out; avoid prolonged barefoot on hard floors
Taping: low-Dye or fascial taping can settle symptoms to enable training
Pain-guided rule: aim for ≤ 2/10 during activity and back to baseline within 24 hours
Self-care: heat/ice as preferred; OTC analgesia per pharmacist/GP advice

Our Runner-Focused Approach

1) Assessment

Training review (volume, terrain, footwear rotation, recent changes)
Palpation to confirm site; big-toe extension, ankle dorsiflexion, calf/soleus strength
Foot intrinsic tests; hop tolerance; single-leg control
Gait analysis: cadence, stride length, step width, posture
Clear diagnosis + phased plan with weekly actions and return criteria

2) Treatment & Rehab

Progressive loading: plantar fascia-biased calf work + soleus strength (cornerstone)
Foot intrinsics: short-foot holds, toe control (“toe yoga”)
Gait tweaks: +5–7% cadence, smoother loading, manage camber
Taping/orthoses: short-term symptom relief if clearly beneficial
Shockwave therapy: adjunct for stubborn cases alongside loading
Night comfort: consider a night-splint if morning pain is severe

Home Exercise Progression (Guide)

Progress only if pain ≤ 2/10 during and settles within 24 hours.

Phase 1 — Settle & activate (Days 1–5)
- Isometric calf holds (straight- and bent-knee) 5 × 30–45s daily
- Seated towel scrunches / short-foot holds 3 × 6–8 slow reps daily
- Plantar fascia stretch (gently pull big toe into dorsiflexion) 3 × 20–30s, 1–2×/day
Phase 2 — Strength foundations (Week 1–2)
- Calf raises (double → single-leg), slow 3–4 × 8–12, 3–4×/week
- Soleus raises (bent-knee or seated) 3–4 × 10–15
- Toe-elevated calf raises on a small book to bias the fascia (windlass), 2–3 × 8–10
Phase 3 — Heavy slow resistance (Week 2–4)
- Loaded calf work (dumbbells/backpack/seated machine) 3 × 6–8 heavy
- Endurance set (single-leg calf raises to near-fatigue), 2 rounds
- Plyo prep: gentle pogos 2 × 10–15s if symptoms calm
Phase 4 — Plyo & run-specific (Week 3–6+)
- Hops/skips low → moderate volume, 2×/week
- Strides (technique focus) when criteria met

Return-to-Running Plan (Example)

Start when: brisk 30-min walk is pain-free; 20–25 single-leg calf raises each side with ≤ 2/10 pain; hopping tolerated.

Week 1: Flat route — Walk 4 / Run 1 × 6 (3 sessions)
Week 2: Walk 3 / Run 2 × 6
Week 3: Walk 2 / Run 3 × 6 or 20–30 min continuous easy
Week 4: 30–40 min easy; add 4–6 relaxed strides
Week 5–6: Reintroduce hills or tempo—one variable at a time

Footwear tips: consider slightly higher heel-to-toe drop short-term; rotate pairs; replace at 500–800 km depending on wear.

Prevention & Long-Term Care

Keep soleus/calf strength 2×/week during training blocks
Small cadence increase (5–7%) if you overstride
Gradual load changes (~10% average); schedule deload weeks
Manage long standing on hard floors; use supportive footwear
Prioritise sleep, protein, and overall energy intake

Book Your Heel Pain Assessment

Initial assessment and treatment from £49. Clinics in Southampton & Romsey with early and evening appointments.

Call: 07748 483639
Email: enquiries@the-recovery-room.co.uk
Online bookings: the-recovery-room.co.uk

FAQs

How long does plantar fasciitis take to improve?

Many runners improve within 6–12 weeks with progressive loading and sensible training tweaks. Long-standing cases can take longer but still respond well.

Should I stretch my calves and foot?

Gentle mobility is fine; avoid aggressive end-range stretching if it increases pain. Prioritise strength and load tolerance first.

Shockwave Therapy