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Preventing heel injury

David Lux explains the cause of plantar fasciitis and the preventative actions that athletes can take.

One of the most common injuries that can develop as a result of recurring stress on the heel of the foot is plantar fasciitis (pronounced PLAN-tar fashee-EYE-tiss). It is the most common cause of pain in the foot and is particularly susceptible to occur among athletes and runners. Although the treatment methods for this condition are usually relatively conservative, the pain that results from this condition can often greatly affect the athlete's performance and inhibit them from any physical activity.

Plantar fasciitis often develops gradually from overuse. The plantar fascia ligament attaches to the heel bone and runs the entire length of the foot. When weight is applied to the foot, it causes the ligament to flatten out and become taut. With excessive, repetitive stress, the plantar fascia starts to pull away from the heel bone, which is when tears and inflammation can develop (plantar fasciitis). Chronic cases of plantar fasciitis can also lead to heel spurs, which are bony fragments that grow from the heel bone and can cause significant pain as they dig through tissue during movement. These types of injuries are particularly prone to occur among runners as well as other athletes.

Symptoms of plantar fasciitis may include a dull aching or sharp pain in the heel as well as throughout the foot. When moving the plantar fascia during running, jumping, or moving the toes upwards, pain can become very noticeable. Pain is also present after the weight is placed on the heel after long periods of rest, such as after waking from bed in the morning or standing up after prolonged sitting.

During walking, the plantar fascia "warms up" and lengthens, reducing some symptoms of pain. Factors that can lead to this condition are an arch that is either too high or too low, having a tight Achilles tendon, obesity, or exercising with unsupportive shoes.

Treatment for plantar fasciitis can often be done through simple means. Rest is a key treatment method, making sure to avoid, or at the very least limit exercise to help the fascia heal. Foot orthotics are among the most successful treatment options and can provide significant relief while helping to treat and reverse the condition.

Some orthotics are specifically designed to add structural support to the foot and help to stretch the plantar fascia to reduce pain and inflammation. Physical therapy is also a treatment option and can offer many techniques to relieve pain and facilitate healing. Other treatment methods may include losing weight, icing the heel, using anti-inflammatory medications, or massaging the inflamed area.

Despite being such a common condition, some of those that have plantar fasciitis may not even be aware that they have the condition, which is why it is important to not only realize the signs of the condition but also become familiar with the ways to prevent plantar fasciitis and to avoid injury from overuse.

Although conservative treatment of plantar fasciitis is successful in most cases, the condition can also deliver severe pain and can significantly interfere with your daily lifestyle which is why the necessary precautions should be taken when exercising to ensure the health and well-being of the feet.

Runners should always begin a run by stretching. Often stretching can easily be forgotten when being involved in a habitual exercise routine, but it can be the most important way to prevent potential injury to the foot.

Stretching the plantar fascia, as well as other muscles and ligaments throughout the body, helps to loosen the ligament before running, easing tension before it has to operate at a more active pace.


In addition to stretching, stress on the plantar fascia can be relieved through other means as well. First, it is important to ease into an exercise or running routine. Sudden, intense exercise, particularly when following times of lethargy, can be extremely stressful on the plantar fascia. It is also important to avoid a sudden increase in distance or difficulty. Instead, increase the difficulty or intensity gradually to allow the plantar fascia to get used to the routine and to keep it from becoming overworked. Also, when running long distances, it is good to stop and stretch periodically to give the plantar fascia time to recoup from the stress. Running up hills can also be painful when having plantar fasciitis or heel spurs. Although running up hills can add resistance and helps to build muscle which appeals to many runners, it can also cause the strain on the plantar fascia to become intensified which makes easing into such a routine crucial. A cooling down period following an exercise routine is also a good time to stretch since the ligaments and muscles in the foot are still warm and, by doing so, you help to improve flexibility over time.

Shoes also play a critical role in injury prevention. Shoes worn during any exercise should fit well. Many athletes make the mistake of training in shoes that are too old or do not fit properly. In some cases, athletes who have suffered from plantar fasciitis had improved symptoms by changing their shoes.

Shoes should be supportive and apply adequate pressure around each part of the heel, ankle, and forefoot. It is also important that they have ample cushioning in the fore and mid-foot, which can absorb shock and therefore decrease stress on the plantar fascia. The perfect shoe is capable of being flexible while also maintaining adequate support throughout the foot with good cushioning in the heel and arch.

When suffering from heel pain, there is a high probability that plantar fasciitis may be the culprit. Often those who have plantar fasciitis either do not know that they have it until the pain gets too intense to ignore, or they exercise through the pain anyway.

This can become very dangerous because continuing exercise with an injured fascia ligament, or exercising before it has healed properly, adds to the risk of rupturing or completely tearing the ligament. When this occurs, more serious treatment methods must be considered, and instead of modifying exercise routines, an athlete may have to refrain from exercise entirely.

Additionally, when plantar fasciitis is left unchecked, other negative conditions may develop. As the pain continues, it may cause you to change the way your foot hits the ground, also referred to as gait. Some irregular gait is normal, however as plantar fasciitis worsens it could cause extremely abnormal gait as you try to compensate for the pain.

Continuing exercise and sports with abnormal gait can lead to injury and pain in places outside the foot, such as in the knee or hip since the change in the mechanics of the foot can alter the movement and function not only of the foot but also the leg and the rest of the body.

Luckily, for those athletes who suffer from plantar fasciitis or related heel pain conditions, there are ways to continue exercise without adding significantly to further risk of injury. Swimming and bicycle riding are two activities that allow athletes to continue the physical activity, without having considerable weight-bearing on their feet.

There are also stretching exercises available that can help the fascia recover from plantar fasciitis while working to maintain the strength and flexibility of the ligament. Some of these stretches also work on stretching and lengthening the Achilles tendon which can often take some strain off of the fascia.

The last thing athletes want to hear is that they have an injury that will affect their performance. Sometimes there are tell-tale signs that athletes may be headed towards injury, but they often are ignored. Determined athletes choose to increase the intensity of their training or decide to exercise through any pain that might develop. Unfortunately, this can harm performance in the long run if a foot injury develops. Plantar fasciitis has become the number one cause of pain in the heel of the foot. With such a high occurrence, it has become essential for athletes to be more aware of the heel pain conditions and practice the prevention techniques that have been discussed above. When athletes pay more attention to proper exercise and injury prevention techniques, they can reduce their chances of developing injuries, allowing them to stay on top of their game.

Plantar Fasciitis Splint

The Night Splint is by far our most effective treatment for Plantar Fasciitis. The splint is worn overnight and gently prevents the plantar fascia from tightening up overnight causing that familiar morning soreness. Also excellent for the treatment of Achilles tendon and calf muscle injuries.

Article Reference

This article first appeared in:

  • LUX, D. (2007) Preventing heel injury. Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 40/ March), p. 1-2

Page Reference

If you quote information from this page in your work, then the reference for this page is:

  • LUX, D. (2007) Preventing heel injury [WWW] Available from: [Accessed

About the Author

David Lux is a heel-pain treatment specialist for Heel That Pain Inc, the industry leader in providing clinically proven solutions for heel ailments. He has written several articles regarding foot injury prevention on a broad range of topics from marathon training to surgery alternatives. For the past year, he has been researching better ways to treat such foot-related injuries as plantar fasciitis, heel spurs, and other chronic forms of heel pain.