The problem with running with a sore plantar fascia is that the inflammation associated with the pain causes the tendon to be less elastic and more stiff, eventually yielding poor impact absorption (Rome et al. 2002; Mahowald et al. 2011; Sahin et al. 2010). Rest, is therefore, a good treatment option, or you can switch to forefoot running to reduce plantar loading on the heel as high heel plantar loads is a risk factor for plantar fascia strain.
How to Avoid Inflamed Plantar Fasciitis While Running
Heel strike running increases the risk of injury to the plantar fascia tendon because of the high amounts of impact on the heel at touchdown, which leads to plantar fascia degeneration and fragmentation as well as reduced thickness and atrophy of the fascia (Chang et al. 2012). The result: plantar fasciitis turns into a chronic condition (Lemont et al. 2003; Schepsis et al. 1991). Another study found that plantar loading is higher over the calcaneal area in heel strike runners and again, was found to be a major risk factor for plantar fasciitis injury (Ribeiro et al. 2015).
- Heel strike running creates an unfavorable landing environment on the heel because at heel strike, an impact transient and a braking force is generated which leads to deposited fibrosis of the heel pad, causing the heel pad to lose elasticity and shock-absorbing capacity –this is what initiates plantar fascia degeneration and pain.
Therefore, reducing impact at the heel when running is crucial for staving off plantar fasciitis and many of us are familiar with the idea that forefoot running reduces heel pressure impact simply because the heel is the last part of the foot to connect with ground, and by this time, the center mass is well positioned a head of the heel, thereby reducing damage to the heel pad.
Research shows that runners without an inflamed plantar fascia have less plantar loading on the heel, so it would make sense that a forefoot strike landing is better on the plantar fascia because less force filters through the heel pad.
Here are other lasting health benefits related to forefoot running:
Chang R, Kent-Braun JA, Hamil J. Use of MRI for volume estimation of tibialis posterior and plantar
intrinsic foot muscles in healthy and chronic plantar fasciitis limbs. Clin Biomech. 2012; 27(5):500 – 505.
Davis, I. What can we learn from watching children run? AAMA J Fall, 2011; 7-8.
Ribeiro et al. Dynamic patterns of forces and loading rates in runners with unilateral plantar fasciitis: a cross-sectional study. PLOS ONE, 2015; DOI:10.1371/journal.pone.0136971.
Rome K, Campbell R, Flint A, Haslock I. Heel Pad Thickness — A Contributing Factor Associated with
Plantar Heel Pain in Young Adults. Foot & Ankle International 2002; 23(12):142 – 7.
Lemont H, Ammirati K, Usen N. A Degenerative Process (Fasciosis) Without Inflammation. J Am Podi-
atric Med Assoc. 2003; 93(3):234 – 7.
Mahowald S, Legge BS, Grady JF. The correlation between plantar fascia thickness and symptoms of
plantar fasciitis. J Am Podiatr Med Assoc. 2011; 101(5):385 – 389. PMID: 21957269.
Sahin N, Ozturk A, Atici T. Foot mobility and plantar fascia elasticity in patients with plantar fasciitis. Acta Orthop Traumatol Turc. 2010; 44(5):385 – 391. doi: 10.3944/AOTT.2010.2348 PMID: 21343689
Schepsis AA, Leach RE, Gorzyca J. Plantar fasciitis. Etiology, treatment, surgical results, and review of the literature. Clin Orthop Relat Res. 1991; 266:185 – 96. PMID: 2019049
BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
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