Update, July 2023: At this point, I’ve found the most effective combination to be:
- Never going barefoot and wearing supportive footwear. Chacos in particular seem to really help me. I used to be barefoot indoors all the time. I now wear my Chacos indoors and it’s made a tremendous difference.
- Calf muscle, plantar fascia, and plantar flexion stretching daily. Keep those lower legs limber!
- One set of eccentric heel drops daily. Performed wearing shoes.
With that simple combination my plantar issues have been reduced dramatically to the point that plantar health is a non-issue for me at this point. I do still have some discomfort in the morning, but once my feet are warmed up I’m good to go.
I’ve been dealing with (what I believe to be) plantar fasciitis issues for over a year. Since the issue first cropped up in early 2022, I’ve gone through several changes to try and address the problem.
I’ve tried reducing my mileage and frequency of running. I’ve taken a couple weeks off of running entirely. I’ve tried using Heel That Pain heel seats. I’ve switched from zero-drop shoes like the Altra Escalante to more traditional running shoes like the Nike Pegasus. I’ve tried incorporating lower-leg exercises. I’ve tried foot massage and stretch techniques. And I’ve tried all of these different techniques in different combinations.
Through it all, my feet have continued to hurt.
However, over the last week I’ve started to have hope that I’ve found a winning combination. On Monday I started a new combination of techniques and I can say with confidence that my feet feel dramatically better today than they did on Monday. So in this post I’m going to share the combination of techniques I’m using right now and then I’ll come back to this post in the future to provide updates on how effective this combination has proven to be.
Disclaimer: I’ve self-diagnosed myself with plantar fasciitis. While my symptoms appear to be a textbook case of plantar fasciities, it’s possible I have something else going on. So bear in mind that no health professional has been involved in my diagnosis or treatment. I’m purely sharing my own experience.
My Current Plantar Fasciitis Treatment Strategy
My current strategy for treating my foot issues includes three different elements:
- Foot and lower leg strength
- Ankle and foot mobility
- Plantar fascia massage and stretching
Let me explain each in brief.
Foot and Lower Leg Strength
Once my feet are finally better, I want them to be fixed permanently (as much as that’s possible). So I’ve incorporated a few exercises to build foot and lower leg strength. I’m doing these exercises every single day. This routine isn’t intense. I’m thinking of it as conditioning rather than strength training. Here’s my routine:
- Tibialis raises: 25 to 30 reps, slow and controlled
- Single-leg calf raises: performed with the front of my foot on a step, 2 sets of 10 reps per foot (20 reps total, each side), slow and controlled and dropping down as low as possible on each rep
- Peterson step-ups: 15 to 20 reps each side, slow and controlled. I can’t find a great video for this one. All the videos I can find show to drop your heel as you step up. However, what I do is stay on my toes as I step up and then push off my toes at the top of the step so that my heel is at maximum height when I’m at the top of the step up. This is a technique that Ben Patrick uses in his ATG Zero program.
Ankle and Foot Mobility
As soon as I’ve finished my foot and lower leg strength routine I take just three minutes or so to work on ankle and foot mobility. I believe that a lack of ankle mobility is at the root of my plantar fasciitis issues, so maximizing ankle mobility will be important to solving this problem long-term. There are three simple exercises I include to address ankle mobility.
- Kneeling plantar fascia stretch: hold for 60 seconds, then immediately transition to the kneeling plantar flexion stretch
- Kneeling plantar flexion stretch: hold for 60 seconds
- Wall ankle stretches: 30 stretches per leg
Plantar Fascia Massage and Stretching
The next step in my plantar fascia treatment routine is to massage and stretch my plantar fascia in both feet three times per day. I do this first thing in the morning, after a workout or exercise routine, and later in the evening.
Before I massage my plantar fascia I warm up my feet with ten quick calf raises. Next, working on one foot at a time, I start with my foot in a relaxed position and use my Sharper Image massage gun to gently massage the sore portion of my foot, gradually increasing pressure as discomfort eases. I work back and forth along my foot using the foam ball attachment for two or three minutes. Next, I flex my ankle and pull my toes upright with my hand so that my plantar fascia is at a pretty full stretch and then very very gently repeat the massage, gradually increasing pressure from very light to light provided my discomfort is manageable.
This entire process takes about eight to ten minutes (four to five minutes per foot).
So Far, So Good
I haven’t run for three weeks. For the first two weeks I did nothing at all: no running, no exercise, and no plantar fascia rehab. Believe it or not, my feet felt far worse after those two weeks than before. So a week ago I instituted the regimen described above, and also returned to exercise (though not to running) and my feet have improved dramatically over the past week.
This coming weekend I plan to go for my first run in three weeks and I’ll see how my feet respond. If they respond well, I’ll probably resume running two or three times per week and keep an eye on how my feet feel. If they don’t respond well, I’ll continue with my rehab regimen but avoid running for another week or two and see how things go.
Update: May 19, 2023
It’s been about a month since I wrote this post. So, how are things going?
Following writing this post I did resume running. However, I put in four hard runs in my first week back to running and hurt the peroneal tendon in my left foot (self-diagnosed, so take that for what it’s worth). I believe this happened because I was subconsciously compensating for my plantar fasciitis pain by rolling my foot outwards (supinating).
Following that injury I took another two weeks off of running to let my foot recover. Then I resumed running once again two weeks ago but took a decidedly cautious approach and so far I’m running comfortably.
When resuming running this most recent time I started by running just 20 minutes at a pure easy pace. For reference, all-out I could probably run about a 6 minute mile. My pure easy pace for these runs has been between 10 and 11 minutes per mile. This is an absolutely no push pace for me.
At the recommendation of an ultra coach I reached out to, I also bought some Superfeet Run Comfort insoles which I’ve been pairing with my Hoka Speedgoats for maximum cushion. This week I’ve run 30 minutes each weekday, at a pure easy pace, and my feet are definitely trending in a positive direction.
Lastly, for the last two weeks I’ve been wearing a pair of Chaco sandals inside the house to provide some support to my feet. This was also done at the recommendation of an ultra coach I had reached out to a couple of weeks ago.
I haven’t declared victory yet, but my right foot feels about 80-90% improved and my left foot feels about 50% improved compared to six months ago.