Ask the physio: Plantar fasciitis

Our resident physio Paul Hobrough talks through the nasty affliction that is plantar fasciitis.

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Q. I’ve been told I have plantar fasciitis and to stop running until it eases off. Is there anything I can do? - Jon, Guildford

A. Plantar fasciitis is a condition characterised by pain when you take those first few steps in the morning or after you’ve been sitting down for a while. 

The plantar fascia is a flat length of connective tissue that runs from your heel bone (calcaneus) to the base of your toes (it splits into five ‘digital slips’, one for each toe). Its main roles are supporting the long arch in your foot and helping with the toe-off when you’re walking or running.

The condition can prevent you running for a while, though in extreme cases it can mean the end of a running career. Plantar fasciitis may resolve itself, although there are forums filled with stories of people spending thousands of pounds on treatments – including night splints, orthotics and injections. 

You probably do need to stop running to allow the injury to heal, but there are plenty of simple steps you can take to speed up the recovery process a little. 

The fix

The following technique has been successful for an extremely high percentage of my patients. The aim is to lengthen, strengthen and support the plantar fascia. It’s wise to stop running until you can press quite hard without feeling pain in the affected area.

1. Foot ‘writing’

Working from your ankle, write the alphabet with your foot before walking in the morning. 

2. Towel grabbing

Pull a towel along a smooth floor using your toes and forefoot. Do for two minutes twice a day.

3. Calf stretches

Do them for 60 seconds, six times a day, against a wall so your toes are in extension (bent upwards).

4. No barefoot walking.

5. Wear orthotic supports in your shoes. 

6. Pull your big toe into extension for as long as you can during the day.

7. Wear a Strassburg sock at night (£34.99 from This provides a gentle stretch to the fascia.

8. Ice your heel for 10 minutes after any prolonged period on your feet. You can also roll your foot over a bottle of frozen water. 

9. Where possible, wear your trainers. 

Weekly physiotherapy treatments will also help. Each week the amount of soft-tissue work on the calf and forefoot will be increased, easing the pull on the plantar fascia origin (the heel bone). The work will focus closer and closer to this painful spot, but never directly over it. 

These sessions, which feel like a deep sports massage, may be painful. Between sessions five and 10 most clients are given running workouts to try (right).

Building back to running

To begin with, jog for a minute, then spend two minutes stretching your calf muscles. You may be able to repeat 
this as many as five times, providing the pain doesn’t escalate above a four out of 10 (with 10 being the worst pain imaginable). If this goes well, repeat it after a two-day rest (i.e. run on Monday and Thursday). If it is still too painful, stop running and do nothing until your next physio session.

The running can be built up until you can complete three times 15 minutes with pain below two out of 10. Once this stage has been reached you will be set training sessions for the next month before a review, following which you will, hopefully, be discharged from treatment. 

If you have never been struck down by plantar fasciitis, building the three exercises on this page into your routine will help guard against suffering in the future. 

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Discuss this article

Hi Paul,

Nice concise overview of PF management for runners. I am pleased to see you are an advocate of the Strassburg Sock. I have prescribed this for a number of years for my patients and after receiving some critical feedback from one patient I decided to redesign my own night splint - the PF Sock. It is very similar to the Strassburg Sock with a minor adjustment at the stiching across the toes so that it provides improved 1st MTPJ dorsiflexion. It is also cheaper as well at £29.95.

You can find the product here -

Kind regards,

Benn Boshell

Musculoskeletal and Sports Podiatrist

Posted: 20/11/2014 at 21:07

That should be

Posted: 20/11/2014 at 21:09

Is it usual to get swelling on the inside of your foot with this?

Posted: 09/11/2015 at 20:51

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