Plantar fasciitis is a common and painful injury among athletes involved in high-impact activities like running, gymnastics, basketball, and cheerleading. It often begins as a dull ache in the arch of the foot or under the heel but can progress to sharp pain that limits training and performance. Understanding the causes, symptoms, and strategies for prevention is key to staying active and performing at your best.
What Is Plantar Fasciitis?
Plantar fascia is the thick tissue that runs across the bottom of the foot to help absorb force and maintain a foot arch. The calf muscles connect to the heel and then the tissues (fascia) continue underneath the foot all the way to the toes. Plantar fasciitis literally means inflammation of the plantar fascia, which occurs when the plantar fascia begins to tear or break down when it receives more stress than it is strong enough to withstand. Repetitive and high stress to the feet, especially with poor foot mechanics, is what leads to an injury to the plantar fascia. Athletes often experience plantar fasciitis when they do not improve the strength of their plantar fascia fast enough to accommodate for rapidly increased training volume or intensity, perform repetitive jumping or sprinting, or training on hard surfaces.
Common Plantar Fasciitis Symptoms
- Pain under the heel or along the arch of the foot, especially with the first steps in the morning or when standing up from prolonged sitting
- Tenderness when pressing on the bottom of the heel or along the fascia
- Pain that worsens with prolonged running, jumping, or prolonged standing
- Typical plantar fascia pain is the worst before warming up, improves as someone continues moving and getting warm, then worsens again with prolonged activity.
Risk Factors for Plantar Fasciitis
Any type of quick increase in stress to the plantar fascia increases the risk for plantar fasciitis. These include:
- Increasing training too fast: Sudden increases in mileage, jumps, or high-impact activity.
- Improper Footwear: Shoes lose arch support over time and might need to be replaced before outside signs of wear are present.
- Hard Training Surfaces: The harder the surface, the harder the stress on the plantar fascia. Pavement and gym floors have more stress to the fascia compared to grass or a track. Switching training surfaces can therefore lead to increased risk for injury.
- Poor Foot and Ankle Stability: Flat feet, weak intrinsic foot muscles, and decreased single leg balance and power all lead to increased stress on the plantar fascia.
Prevention Strategies
Preventing plantar fasciitis requires strengthening, single leg stability, and gradual progression:
- Progress Training Gradually
Avoid sudden spikes in training volume or intensity. Allow the fascia and supporting muscles time to adapt to increased demands. Limit the number of high volume or intensity training each week. Cross train with some days devoted to strength and stability to give plantar fascia a rest. - Prioritize Proper Warm-Up
Dynamic movements, such as calf raises, jogging, jumping, and hopping all prepare the foot and lower leg muscles for activity. Warm tissue is more pliable. Cold tissue is more likely to be stiff and tear. - Strengthen the Foot, Ankle, and Calf Muscles
Incorporate exercises that focus specifically on maintaining a good foot arch such as single leg balance, single-leg hops, double leg rebounds, and calf raises. This will improve foot intrinsic muscle strength and the durability of plantar fascia at the same time. - Use Support as Needed
Athletes that naturally have flatter feet may consistently benefit from orthotics, shoes with extra arch support, athletic tape, or KT tape to help reduce stress on the plantar fascia. These supports should complement strengthening exercises, not replace them. These supports can also be used for someone with an active injury to temporarily decrease stress on the plantar fascia while it is healing.
Treatment and Recovery
Early intervention is key for plantar fasciitis. The worse it gets the more sharp and limiting the pain becomes. A sports physical therapist can assess contributing factors and design a personalized recovery plan:
- Begin by Limiting Stress on the Plantar Fascia: This can be done by shoe inserts, KT tape, athletic tape, shoes with better arch support, and decreased intensity of training. *NOTE* Too many medical professions focus only on the last point of decreasing training (e.g. – Take a break from training for 2-4 weeks). Usually a complete break is not needed when combined with the other options here.
- Strengthening Exercises: Target intrinsic foot muscles, calf strength, and single leg stability while maintaining good foot arch position.
- Gradual Return to Sport: Create a plan for slowly increasing intensity and impact while gradually reducing the extra foot support described above. This is done to prevent re-injury and allow the plantar fascia to fully heal.
Stay Strong and Injury-Free
Plantar fasciitis doesn’t have to sideline athletes. With early recognition, smart training habits, and support from a skilled physical therapist, runners, gymnasts, and other athletes can recover fully and reduce the risk of recurrence. Consistency with strength, stability, and recovery strategies is key to long-term performance and foot health.
Need expert guidance on injury prevention? Contact us today to optimize your training and keep your feet—and your body—performing at their peak!