Every marathon runner knows the pain that comes with pushing the body to its limits. But few things can derail a race faster than the sharp, intense heel pain of plantar fasciitis.
The sensation is often described as a stabbing pain that feels worse with each step, particularly during the early moments of the run or right after you’ve been sitting for a while. For a runner, it can feel like your body is betraying you in the middle of the race you’ve trained so hard for.
If you’ve ever had plantar fasciitis flare up during a race, you know that it can be a game-changer. This condition can make every mile seem longer and every step painful. But don’t worry—there are ways to manage the pain, adjust your strategy, and even continue running with this issue.
In this blog, we will explore several effective methods to cope with plantar fasciitis during a marathon, from techniques you can apply on the fly to long-term strategies that can help you avoid future flare-ups.
What Is Plantar Fasciitis and Why Does It Matter in a Marathon?
Before diving into solutions, it’s important to understand what plantar fasciitis is. The condition involves inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of your foot, connecting your heel to your toes. It’s a common overuse injury for runners, caused by repetitive stress and strain on this tissue, leading to small tears, inflammation, and pain.
For many marathon runners, plantar fasciitis becomes a real issue during longer runs, when the foot is under greater pressure. The repetitive pounding, particularly when running on hard surfaces for hours at a time, can cause the plantar fascia to become irritated. Add in the effects of tight calves or poor running form, and you have a recipe for a painful race day.
Now that we know what plantar fasciitis is and how it can impact your marathon, let’s look at some of the most effective ways to handle it when it strikes mid-race.
1. Shockwave Therapy
While shockwave therapy isn’t something you can apply during a marathon, it’s a highly effective treatment to consider before your race. This non-invasive therapy involves using high-energy sound waves directed at the affected area. The sound waves stimulate circulation, promote healing, and reduce inflammation in the plantar fascia, providing both pain relief and encouraging tissue repair.
Shockwave therapy is typically administered by a physical therapist or a sports medicine specialist, and while it might not be an option for immediate relief during a race, it can help you in the days leading up to your marathon. If you have a history of plantar fasciitis, scheduling a few shockwave therapy treatments in advance can reduce the chances of a flare-up during the race. It’s a great preventative measure and can be part of a solid treatment plan.
2. Push on the Tibialis Anterior
Plantar fascia pain can result from injury to the connective plantar fascia tissue itself and result from tightness and overuse of other arch stability muscles like the anterior tibialis and posterior tibialis.
When either of the tibialis muscle become overused or restricted they can hurt at the site of the muscle itself or through the tendon structure that extends under the foot and runs near the plantar fascia. It can be tricky figuring out which tissue it is and how to treat it.
One pain relief strategy you can try is performing a trigger point release to the tibialis muscles. Now, you don’t need to be a massage wizard to perform this technique on yourself, but you do need to have some moxie because it’s not the most comfortable treatment.
By pressing along either the posterior tibialis or anterior tibialis you’ll eventually come to a “hot spot” where the tissue feels tighter and brings on pain. This “trigger point” responds well to pressing into the knot and holding for 10-15 seconds. You should feel the tissue release resulting in less pain at the trigger point and along the muscle and tendon. As you find trigger points, press and hold to release. This often can be a very fast relief of pain.
3. Glute Activation
When you’re running, your entire body works together to propel you forward. One often overlooked factor in the development of plantar fasciitis is muscle imbalances. Specifically, weak glutes, hips, and core muscles can cause abnormal loading patterns that place excess pressure on your feet, contributing to the development of plantar fasciitis.
Specifically, weakness or poor activation of the gluteus maximus and medius can result in excessive internal rotation at the thigh which then creates increased pronation at the foot. Everything is connected!
The goal is to “turn on” your glutes so they are active at critical loading phases during your running gait to unload the plantar fascia and other foot tissues.
The best time to start activating your glutes is now! The earlier you start activating your glutes the more you will be able to reduce the strain on your foot and improve your overall running efficiency. Plus, it takes time to develop the skill of using your glutes while you run.
Glute activation training often involves band work, strength work, and single leg training in running specific postures. Over time, your body will engage your glutes naturally without having to work hard or focus on it.
4. Use an over-the-counter Orthotic Temporarily
Orthotics can be your best friend in the early stages of plantar fasciitis. By supporting your foot arch, you’ll reduce the load on the tissues under your foot allowing them to run through their healing cycle. With just 3-6 weeks of orthotics usage runners can experience significant pain relief.
Now, and this is important, orthotics were never meant to be used long-term. For those of you who love your orthotics, I get it. Here’s the thing, over time orthotics created “lazy” feet. The human foot is an incredible structure that’s designed for shock absorption, elasticity, recoil, and propulsion. It needs to be able to deform without being impeded for proper loading. Orthotics get in the way of this natural mechanism.
To reduce plantar fasciitis pain, use an over-the-counter orthotics. There’s no research showing a “custom” orthotic is necessary. Just be sure to ditch the orthotic once your pain is gone. In fact, you can wean off using the orthotic over a three week period to give yourself time to transition.
4. See a Physical Therapist: The Best Long-Term Solution
Plantar fasciitis can occur due to many factors, and figuring out the exact root cause will speed healing and reduce down time from running training.
Here’s a list of possible causes for plantar fasciitis to give you an idea…
- Weakness in the calves
- Weakness in the plantar foot muscles
- Poor dynamic foot arch control
- Poor glute activation and strength
- Poor lower leg alignment
- Asymmetrical pelvic control
- Excessive rotation of the foot
As you can see, treating the root cause of plantar fascia pain isn’t as easy as some ice and rest (which doesn’t work!).
A skilled physical therapist, who specializes in working with distance runners, is your best bet to figure out the root cause and create a custom treatment plan. By addressing the root cause you will avoid treating the symptoms and having set backs in your training.
A skilled physical therapist will assess running form to figure out asymmetries and key areas for form training. They will assess your range of motion, strength, alignment, balance, and nerve function. You will have a complete clinical picture of not only your foot pain but also your running movement in general.
Working with a skilled physical therapist will give you the piece of mind that you’re not missing any key elements of your recovery. Plus, they can work with you for running performance after your foot pain is gone!
The Bottom Line
Plantar fasciitis is one of the most common running injuries, and sadly, lasts longer than it has to.
Early diagnosis and treatment is your key to ending pain fast and getting back to marathon training. By using innovative treatments like shockwave, proven solutions like glute activation, strengthening, and physical therapy, you will ensure you make it to race day ready for action.
Foot pain doesn’t have to sideline you from running for weeks or months. If you’ve had PF pain for some time, schedule a running evaluation with your local physical therapist who specializes in working with distance runners. This will identify the root cause of your foot pain while providing you fast recovery techniques.
Although foot pain seems like it will last forever, it won’t with the right plan and treatment. Use this guide to get started on your recovery today!
