On this page
- What is plantar fasciitis?
- Symptoms
- Why it happens
- How long does plantar fasciitis last?
- Treatment: what the evidence supports
- A 12-week plan for plantar fasciitis
- Can you keep running with plantar fasciitis?
- Things that make it worse
- Preventing plantar fasciitis
- When to see a professional
- The bottom line
- FAQ
- Sources
The short version
- Plantar fasciitis (plantar heel pain) is pain under the heel, usually worst with the first steps in the morning or after sitting.
- Tight calves, reduced ankle flexibility, higher body weight and long hours on your feet are common risk factors.
- Plantar fascia stretches and high-load calf raises both have good evidence. Combining approaches works best.
- Insoles, heel cups and supportive shoes can reduce pain in the short term.
- Most cases improve within 6 to 12 months, many much sooner with consistent treatment.
You swing your legs out of bed, stand up, and a sharp pain shoots through the bottom of your heel. After a few minutes of hobbling around, it eases. Later in the day, after sitting at your desk for a while, it happens again. You might be able to run on it, but it aches afterwards, and every morning starts the same way.
That pattern is the classic sign of plantar fasciitis, now often called plantar heel pain. It's one of the most common causes of foot pain in adults, and it affects runners, walkers, people who stand at work all day, and plenty of people who don't exercise at all.
It's also notoriously slow to settle if it isn't managed well. The good news is that most cases improve with simple, consistent treatment. This guide explains what plantar fasciitis is, why it happens, which treatments have the best evidence, and how to keep running while it heals.
What is plantar fasciitis?
The plantar fascia is a thick band of connective tissue that runs along the bottom of your foot, from your heel bone to the base of your toes. It supports your arch and helps your foot act like a spring when you walk and run.
Plantar fasciitis is pain where the fascia attaches to the heel bone, usually on the inner side of the bottom of the heel. Despite the "-itis" in the name, long-lasting cases show more signs of degeneration and thickening than ongoing inflammation. That's why some clinicians prefer terms like "plantar fasciopathy" or simply "plantar heel pain".
The American Physical Therapy Association's 2023 clinical practice guideline on heel pain, led by Thomas Koc, uses the term plantar fasciitis but describes it as a problem of overload rather than simple inflammation.
Symptoms
- Sharp or stabbing pain under the heel, usually on the inner side.
- Pain with the first steps in the morning, easing after a few minutes.
- Pain after sitting or resting, then standing up.
- Pain after long periods of standing or walking.
- Pain that may ease during exercise, then return afterwards.
- Tenderness when you press on the bottom of the heel.
When heel pain might be something else
Heel pain started after a fall or a jump, there's significant swelling or bruising, you have numbness, tingling or burning in the foot, pain is worse at night or at rest, both heels hurt with no obvious reason, or you feel generally unwell. These can point to a stress fracture, nerve problem, inflammatory condition or other cause that needs a different approach.
Why it happens
Plantar fasciitis develops when the load on the fascia exceeds its ability to cope. Several factors make that more likely.
Known risk factors
A 2003 case-control study by Daniel Riddle and colleagues identified three main risk factors:
- Reduced ankle dorsiflexion: limited ability to bring your toes towards your shin, often from tight calves. People with the most restricted ankles had a much higher risk.
- Higher body mass index: a BMI over 30 was strongly associated with plantar fasciitis.
- Spending most of the workday on your feet.
Training-related triggers in runners
- A sudden increase in mileage or speed work.
- More hill running.
- Switching to lower-drop or less supportive shoes.
- Running in worn-out shoes.
- Spending more time barefoot on hard floors.
- Weak calf and foot muscles.
How long does plantar fasciitis last?
Longer than most people would like. Many cases improve within a few months with consistent treatment, and most resolve within 6 to 12 months. Some people have symptoms for longer, especially if the problem isn't managed well early on. Starting the right treatment early, and sticking with it, makes a real difference.
Treatment: what the evidence supports
No single treatment works for everyone. A 2019 network meta-analysis by Opeyemi Babatunde and colleagues compared many treatments for plantar heel pain and found that several approaches, including orthoses, exercise and shockwave therapy, could help, but that the evidence for any single option being clearly superior was limited. The 2023 clinical practice guideline recommends combining treatments.
1. Plantar fascia stretching
In 2003, Benedict DiGiovanni and colleagues compared a stretch that specifically targets the plantar fascia with a standard Achilles tendon stretch in people with chronic heel pain. After eight weeks, the plantar fascia stretch group had better outcomes for pain and function.
How to do it: sit with the painful foot crossed over your other knee. Hold your toes and pull them back towards your shin until you feel a stretch along the arch. Hold for 10 seconds. Repeat 10 times. Do it before your first steps in the morning, before standing after long sitting, and a few times through the day.
2. High-load strength training
Strength work has become an important part of treatment. In 2015, Michael Skovdal Rathleff and colleagues compared a simple high-load strength exercise with plantar fascia stretching, with both groups also using shoe inserts. After three months, the strength group had significantly better outcomes. By 12 months, both groups had improved similarly, but strength training offered faster relief.
How to do it (Rathleff protocol):
- Stand on a step with a rolled-up towel under your toes, so they're bent upwards.
- Rise slowly onto your toes on the painful leg over about 3 seconds.
- Pause for 2 seconds at the top.
- Lower slowly over about 3 seconds.
- Start with 3 sets of 12 repetitions, every other day.
- Add weight in a backpack as it becomes easier, reducing reps to 10 and then 8.
Some discomfort is acceptable during the exercise, but it shouldn't leave you significantly worse the next morning.
3. Calf stretching
Because tight calves and limited ankle movement are risk factors, calf stretches are usually included:
- Straight-knee calf stretch: hands on a wall, painful leg behind, heel down, knee straight. Hold 30 seconds.
- Bent-knee calf stretch: as above, but bend the back knee. Hold 30 seconds.
- Repeat 3 times on each side, twice a day.
4. Insoles and heel cups
Orthoses can reduce load on the fascia. A 2006 randomised trial by Karl Landorf and colleagues found that both prefabricated and custom orthoses produced small improvements in function in the short term compared with sham insoles, but there was no significant difference after 12 months.
The practical takeaway: an off-the-shelf arch support or heel cup can ease pain while you build strength, and it's usually worth trying before expensive custom orthoses.
5. Taping
Low-dye taping, a technique that supports the arch with tape, can reduce pain in the short term. A physiotherapist can show you how to apply it.
6. Footwear
- Wear supportive, cushioned shoes, including at home.
- A slightly raised heel often feels more comfortable.
- Avoid walking barefoot on hard floors while it's painful.
- Replace worn-out running shoes.
7. Night splints
Night splints hold your foot in a gently flexed position while you sleep, preventing the fascia and calf from tightening overnight. Some people find they reduce morning pain, though they can be uncomfortable. The 2023 guideline suggests considering them for people whose morning pain is a main problem.
8. Shockwave therapy
Extracorporeal shockwave therapy (ESWT) uses pressure waves on the painful area. It has reasonable evidence for chronic plantar heel pain that hasn't responded to simpler treatments, and is usually offered after several months of conservative care.
9. Injections
Corticosteroid injections can reduce pain in the short term, but the benefit often fades within weeks to months, and there's a small risk of fascia rupture and thinning of the heel's fat pad. They're usually a later option rather than a first-line treatment.
A 12-week plan for plantar fasciitis
| Weeks | Daily | Every other day | Activity |
|---|---|---|---|
| 1 to 2 | Plantar fascia stretch before first steps and after sitting; calf stretches twice a day | Double-leg heel raises with towel under toes, 3 × 12 | Reduce running; cross-train with cycling or swimming; supportive shoes and insoles |
| 3 to 6 | As above | Single-leg heel raises with towel, 3 × 12 | Easy running if within pain limits; avoid hills and speed work |
| 7 to 10 | As above | Single-leg heel raises with backpack weight, 3 × 10 | Gradually increase running volume |
| 11 to 12+ | Stretches as needed | Weighted heel raises, 3 to 4 × 8 | Reintroduce hills and faster running one at a time |
Can you keep running with plantar fasciitis?
Many runners can, with adjustments. Use these guidelines:
- Pain during running stays mild, around 3 out of 10 or less.
- Morning pain the next day is no worse than usual.
- Symptoms aren't getting worse week by week.
If any of these aren't true, cut back. Shorter runs, flatter routes, softer surfaces and slower paces all reduce load. Cycling, swimming and pool running keep your fitness up with much less stress on the heel.
Running form changes can help some people. Slightly shorter, quicker steps and landing closer to under your body may reduce the load on the foot. Make any changes gradually.
Things that make it worse
- Walking barefoot on hard floors, especially first thing in the morning.
- Flat, unsupportive shoes such as flip-flops or worn-out trainers.
- Sudden jumps in walking or running volume.
- Standing for long periods without breaks.
- Ignoring the problem and hoping it will go away.
- Stopping the exercises as soon as it starts feeling better.
Preventing plantar fasciitis
- Build running gradually, especially hills and speed work.
- Keep your calves strong and flexible. Our strength training guide for runners includes calf raises you can do year-round.
- Replace running shoes when they lose cushioning, often around every 600 to 800 km.
- Change shoes gradually if you move to a lower-drop or more minimal model.
- Manage body weight if it's a factor.
- Break up long periods of standing with short walks or sitting breaks.
When to see a professional
See a doctor, podiatrist or physiotherapist if:
- Pain hasn't improved after six to eight weeks of consistent self-management.
- You have any of the warning signs listed above.
- Pain is severe enough to stop you walking normally.
- You're unsure whether it's plantar fasciitis.
A professional can confirm the diagnosis, check for other causes, adjust your exercise programme and discuss options like taping, orthoses, night splints or shockwave therapy. Plantar fasciitis often shows up alongside other overuse problems such as shin splints, because they share the same root cause: load increasing faster than tissues can adapt.
The bottom line
Plantar fasciitis is common, painful and slow, but very treatable. The most reliable approach combines plantar fascia stretching, progressive calf and foot strengthening, supportive footwear and sensible load management. Start early, be consistent, and give it time. Most people get back to pain-free walking and running.
Frequently asked questions
Why is plantar fasciitis worse in the morning?
The fascia and calf tighten overnight while your foot points down. The first steps stretch it suddenly, which hurts. Gentle stretches before getting out of bed often help.
Can I run with plantar fasciitis?
Often, if pain stays mild during the run and doesn't get worse the next morning. Reduce distance, avoid hills and speed work, and keep up the exercises.
Do I need special shoes?
Supportive, cushioned shoes with a slightly raised heel usually feel best. Avoid walking barefoot on hard floors and very flat, unsupportive footwear while it's painful.
Are cortisone injections a good idea?
They can reduce pain in the short term, but benefits often fade and there's a small risk of fascia rupture or fat pad thinning. Most guidelines suggest trying exercise and other treatments first.
Is a heel spur the cause of my pain?
Usually not. Heel spurs are common in people without heel pain too. Treatment focuses on the fascia and calf, not the spur.
When should I see a doctor?
If pain follows an injury, if there's numbness or tingling, if both heels hurt with no clear reason, or if pain isn't improving after six to eight weeks of consistent treatment.
Sources and further reading
- Rathleff MS, et al. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scandinavian Journal of Medicine & Science in Sports, 2015;25(3):e292-300. DOI PubMed
- Koc TA Jr, et al. Heel Pain - Plantar Fasciitis: Revision 2023. The Journal of Orthopaedic and Sports Physical Therapy, 2023;53(12):CPG1-CPG39. DOI PubMed
- Riddle DL, et al. Risk factors for Plantar fasciitis: a matched case-control study. The Journal of Bone and Joint Surgery. American Volume, 2003;85(5):872-7. DOI PubMed
- DiGiovanni BF, et al. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. The Journal of Bone and Joint Surgery. American Volume, 2003;85(7):1270-7. DOI PubMed
- Babatunde OO, et al. Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis. British Journal of Sports Medicine, 2019;53(3):182-194. DOI PubMed
- Landorf KB, et al. Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial. Archives of Internal Medicine, 2006;166(12):1305-10. DOI PubMed
This guide is general education, not a diagnosis or treatment plan. If you have pain that is severe, getting worse or not improving after two to three weeks, see a doctor or physiotherapist. Read our full medical disclaimer.
Photography: Unsplash contributors. Published 14 October 2026, last reviewed 14 October 2026.
