If you’ve ever yelped in pain or felt a sharp or aching feeling on the bottom of your foot when you first step out of bed in the morning, you likely know the agony of plantar fasciitis.
This painful foot condition is caused by inflammation of the plantar fascia, the band of thick connective tissue that runs along the sole of your foot from the heel bone to the ball of the foot
While there is a lot of attention placed on how to treat plantar fasciitis, there is less discussion about signs plantar fasciitis is healing and when it’s okay to run with plantar fasciitis or resume whatever types of activities and exercises you used to enjoy before pain got in the way.
How long does plantar fasciitis typically last?
Physical therapist Damien Howell, DPT, OCS, says that there isn’t necessarily a “typical“ length that plantar fasciitis will last—it can vary anywhere from three weeks to two years or more.
“It depends on whether risk factors and contributing postures, positions, and activities are appropriately addressed,” says Dr. Howell. “It also depends on whether remedial exercises are under-dosed or overdosed.”
What are the key signs that your plantar fasciitis is getting better?
Dr. Howell says that a good indication that you’re healing is experiencing improvement in the signs and symptoms of plantar fasciitis.
1. You have happier mornings
If that first step in the morning is starting to feel less painful, that’s reason to celebrate. Decreased inflammation will make it hurt less when you step out of bed.
2. Your foot can move more
When you’re healing you’ll notice increased flexibility in the foot—you’ll be able to move your toes and your ankle through bigger ranges of motion.
“A standardized self-administered ‘knee-to-wall test’ can be used to compare the painful side to the non-painful heel (and there are norms available if heel pain is present on both heels),” says Dr. Howell. To do it, stand next to a wall and lunge forward (with your heel on the ground) until your knee touches the wall. The further away you can place your foot and still touch the wall, the more flexibility you have in the ankle joint. However, Dr. Howell notes that too much flexibility can also exacerbate plantar fasciitis, and if that’s the case, you’ll want to avoid stretching.
3. Your PT exercises are getting easier
Dr. Howell says that there are several different ways to assess weakness in the foot muscles associated with plantar fasciitis. If you have plantar fasciitis on just one foot, those muscles “will be smaller, softer, and less coordinated,” he says. You can also test the intrinsic foot muscle strength with short foot exercise, toe piano, or rock/paper/scissors with toes exercises, suggests Dr. Howell. “If foot muscle strengthening exercises are getting easier and closer to the performance level of the uninvolved foot, it is a sign of improvement.”
How can you speed up recovery?
In order to heal, you’ll need to address the root cause of the issue. Some of the common activities that can contribute to developing plantar fasciitis include standing, walking, or running with improper footwear, poor form, taking too long of a step, heel striking, or suddenly ramping up your physical activity level. Dr. Howell adds that kneeling for too long or repetitively standing on one leg, carrying a toddler on one hip, etc. can also be risk factors.
Dr. Howell also says you need to identify any contributing factors that you might be able to modify, like overtraining, excess body weight, hormonal imbalances, repetitive positions, or any other activities that are putting increased stress on the heel or plantar fascia.
One mistake that can set your recovery back? Putting too much focus on foot stretches. “In my experience, a common mistake is doing way too much stretching,” he says. “Often, plantar heel pain is related to the plantar fascia and tendons not being stiff enough.” Taking the wrong approach will not only be exacerbate the condition, but extend the amount of time it will take for plantar fasciitis to resolve.
How do you know when you can get back to normal activities?
The good news is that Dr. Howell says that ceasing all exercise is rarely needed in cases of plantar fasciitis. Instead it’s about making adjustments, and keeping activities that place stress on the heel in moderation.
“Participating in activities with a mild level of pain (three out of 10) is okay,” says Dr. Howell. “It is best to measure the pain the morning after activity with the first step out of bed. If the first step pain in the morning is worse than the previous morning, then the previous amount of activity was too much. If the first step of morning pain is the same as the day before, the amount of activity can be the same.” And if it’s less painful? You’ve got the green light to ramp things up a little more.
How can you prevent plantar fasciitis from coming back?
Once you’ve finally resolved the issue, you probably have no desire to experience it again. Dr. Howell says it’s vital to identify and address any modifiable risk factors that place stress on the plantar fascia. Essentially, if you don’t fix the causes, the condition is likely to return.
You may need to get more supportive footwear (make sure you’re wearing the best shoes for plantar fasciitis), increase your level of activity more gradually, or work with a podiatrist or physical therapist to identify biomechanical weaknesses or issues with your running or walking stride.
With the right changes, plantar fasciitis isn’t something you’re doomed to live with forever.