Plantar Fasciitis Explained: Causes, Treatment, and Prevention for Runners

If you are a runner, you have likely heard of plantar fasciitis – that sharp, stabbing pain under your heel that greets you first thing in the morning or mid-run. It is one of the most common causes of heel pain and a frustrating setback for many athletes.

A review by Tingan et. al (2024) indicates that in the running population, up to 17.4% may be affected by plantar fasciitis or related injuries — a significant number for a condition that is often preventable with proper care and attention to training, footwear, and biomechanics.

But what exactly is plantar fasciitis , and how can you manage or avoid it?

What is plantar fasciitis?  

Plantar fasciitis is an overuse injury involving inflammation or degeneration of the plantar fascia — a thick band of tissue running along the bottom of your foot, connecting your heel bone to your toes. This structure supports your foot arch and absorbs shock when you walk or run.

When the plantar fascia is overloaded or repeatedly strained, tiny tears can develop, leading to pain and inflammation. The discomfort often starts near the heel and is most noticeable with your first steps in the morning or after long periods of rest.

Causes and contributing factors

Plantar fasciitis doesn’t only affect elite athletes — anyone who puts repetitive stress on their feet can develop it. But certain factors make runners especially vulnerable:

• High training volumes: Rapidly increasing mileage or intensity puts extra strain on the fascia.

• Foot structure: Flat feet or high arches alter how your weight is distributed, increasing tension on the heel.

• Tight calves or Achilles tendon: Limited ankle mobility adds stress to the fascia during push-off.

• Age: Most common between 40 and 60 years old, though active younger runners aren’t immune.

• Worn-out or unsupportive shoes: When cushioning and arch support wear down, the fascia takes the impact.

• Sudden terrain changes: Hill runs or trail routes can load the heel differently, leading to irritation.

• Poor running mechanics: Overpronation, hip weakness, or other biomechanical imbalances affect how forces travel through the foot.

• Overtraining and poor recovery: Repeated microtrauma without enough rest can easily tip the balance.

Treatment and physiotherapy management  

Managing plantar fasciitis begins with alleviating pain, reducing inflammation, and restoring the normal range of motion in your foot. Your physiotherapist will develop a treatment plan to suit your specific needs, which may include:

• Manual therapy: To release tension in the fascia and calf muscles.
• Stretching and strengthening: Especially for the calves, Achilles tendon, and intrinsic foot muscles.
• Taping: To offload pressure from the heel.
• Shockwave therapy: A non-invasive treatment that promotes healing by stimulating blood flow and tissue regeneration.
• High-power laser therapy: To reduce inflammation and accelerate tissue repair.

 How to prevent plantar fasciitis  

When it comes to plantar fasciitis, prevention starts with smart training and a solid foundation. A few small habits can make a big difference in keeping your feet strong and pain-free:

• Build up gradually: Increase your mileage and intensity slowly to give your feet time to adapt.
• Choose the right shoes: Wear running shoes that match your foot type and replace them before they lose their support.
• Strengthen and stabilise: Focus on building strength in your feet, calves, and hips — this helps absorb impact.
• Don’t skip rest days: Recovery is just as important as training. Allow your body time to repair between runs.

At Hein Viljoen Physiotherapy, our team works with runners of all levels to treat and prevent overuse injuries, such as plantar fasciitis, helping you return to the road or trail stronger than before.

Take the first step toward pain-free running — your feet deserve it. Book with us today.