Still Hurting in the Morning? How Runners Should Treat Early-Stage Plantar Fasciopathy

“Looking for advice away from all the noise. Feels like when I go on YouTube or search for results, there’s so much conflicting advice… I’ve now had it for 2.5 months… I’ve stopped running altogether and I’m getting desperate now.” 

Sound familiar?

Because yes, a lot of what the internet serves up as "rehab advice" is outdated, unhelpful, and doesn't work.

So no matter how long you doom scroll, searching for answers, you end up seeing the same stuff you've already tried:

• rolling the bottom of your foot out (you and your lacrosse are basically in a formal relationship)

• night splints (I hate these things)

• compression socks (very meh...)

• rest (sort of)

• stretching (feels good at the time...)

But regardless of how many fancy contraptions you try or stretches your pretzel your foot into, you still dread the first few steps in the morning, maybe your first mile or maybe the heel pain that always seems to start around your fifth mile.

And the next morning after your last speed session or hill workout has you swearing those off for weeks.

So what's a runner to do?

You're in pain, annoyed at your lack of progress, missing your miles, and becoming increasingly frustrated.

We get to work.

Let's answer your most common plantar fasciopathy and get you the exercises that will finally start to make a difference you can feel, decrease your pain, and get you back to running strong and niggle free.

I’ve tried compression socks, a night splint, and rolling my foot. Why does it still feel the same?

My runner friend, those are the top internet contenders for "quick fixes" and I hate to break it to you, but they don't really do anything.

This is good news:

because it means you're not crazy. You're not doing anything wrong.

But I understand the disappointment of lost time and effort.

However, I will say, rolling your foot out on a lacrosse ball, bottle, whatever your implement of choice is, isn't always a waste. I can get behind rolling as it works great as a gentle mobilization and massage for the heavy concentration of small foot bones and muscles in that plantar area.

It can often provide a "deep pressure" stimuli that encourages relaxation of any muscles that are too tight helping to decrease that overall sensation of pain, while also encouraging blood flow to an area that isn't heavily vascularized, meaning not great blood supply. And when we don't have a great blood supply, healing takes SO MUCH longer.

It's a good warm up to use first thing in the morning when things are more tender and even before rehab exercises, but realize, it's still not a solution.

I took a week off running and it didn’t fix anything. Did I rest wrong… or is this not a rest issue?

Short answer: you didn’t rest wrong, but plantar fasciopathy isn’t a rest problem.

The plantar fascia behaves much more like a tendon than a mystery foot issue. And tendons don’t heal by unloading forever. They heal by being loaded gradually and consistently.

Short-term rest (a day or two) can absolutely help calm a flare and make walking tolerable again. But longer stretches of rest don’t rebuild the tissue. In fact, too much rest can lower the amount of load your plantar fascia can tolerate, so when you return to running, it flares right back up.

Think of your plantar fascia like a tendon, because functionally, that’s how it behaves.

Tendons respond well to load they’re prepared for, but they strongly dislike sudden increases in:

• Volume (more mileage)

• Intensity (hills, speed work)

• Or both at once

  
  

That’s why plantar heel pain often shows up after hill work or mileage increases, both dramatically increase the amount and force of toe extension with each step, placing higher strain on the fascia.

To actually heal plantar fasciopathy, the goal isn’t more rest.

It's progressive, daily, runner-specific exercises that load and retrain the plantar fascia to tolerate impact and foot strike again.

How Runners Should Start Rehab for Plantar Heel Pain

Circuit 1: Warm up

Inline lunge

• 2-3 x 10 (painful foot in back; don't let the heel pop up!)

Runners Stance on Step Iso Hold

• 3-4 reps X 45 sec hold

• start with body weight and then hold heavy weight in one hand (easier in hand opposite of working foot; harder in same side hand as working foot)

Circuit 2: Strength for the Spicy Stage

Cross Body Band Pulls (foot inversion vs eversion focus)

• 3 x 12 ea direction (medium to heavy resistance band)

• stand on single leg, shoe OFF!

Windlass Raises

• 3 x12 reps, single leg.

• toes on towel roll, ascend for 3 seconds, hold at top for 2 seconds, descend for 3 seconds

Weighted Calf Raises: 2 Legs

• 3-4 x10 @ RPE 8 if tolerable

• decrease number of reps to 6-8 and see if you can keep the same weight

Early Plantar Fasciitis in Runners: How to Load the Foot Without Making It Worse

Circuit 1: Warm up

• I know, I kind of went crazy with this one. But I wanted you to have actual answers

• PRO TIP: gunky, stiff ankles make plantar fascia pain worse. Yup. So it is well worth your time warming up your ankle joints and helping them glide smoothly like butter. That's why I've included some easy, self mobilization exercises in addition to chill isometric exercises. Puh-lease do them in the order their written! I don't get that specific too often, but this is one of those times.

• Also, it's ok if the runner's stance on the edge of the step feels a little spicy at first. I promise the bottom of your foot is perfectly safe and no damage is being done to it. We know from extensive research that isometrics, especially ones in this particular foot position, help decrease the pain with plantar heel pain. And when pain is managed successfully and all the muscles in your foot and ankle are recruited and engaged, you can run pain free.

• These exercises make phenomenal pre-run warm up exercises. I've given this combo to countless runners in the clinic and also my online strength and rehab coached runners. Once you learn them, they take maybe 5 minutes.

Circuit 2: Strength for the Spicy Stage

• I need you to remember: just because you start to feel better, doesn't mean you stop doing these.

• THE REASON: when we're first rehabing your plantar heel pain, we start with a focus on the itty bitty foot muscles called the intrinsic foot muscles. It's similar to getting everyone on the same page for a massive group project. However, we don't stop there. We need to also directly load the irritated tissue in question: your plantar fascia and that means traveling through it's entire range. That's where the windlass exercise comes in. Your plantar fascia is stretched further when your toes are pulled up to the sky or are in extension. But in this position, it's naturally VERY difficult to move heavy weight.

• So instead, we leave the heavy lifting to slow, heavy calf raises. Because the stronger your calves and remaining plantar flexor muscles are, the quicker you recovery and prevent a return of plantar heel pain.

WRAPPING UP

If there’s one thing I want you to walk away with, it’s this:

Plantar heel pain in runners isn’t random, and it isn’t a sign that you should stop moving altogether.

Rolling, stretching, compression, and rest can help manage symptoms, especially early on, but they don’t actually rebuild the tissue that’s irritated.

Your plantar fascia behaves like a tendon, which means it needs consistent, progressive load to heal.

Not too much. Not too fast. But not zero, either.

That’s why taking a full week (or two) off often doesn’t fix anything.

And why hill work, speed sessions, or mileage bumps tend to flare things up when your foot isn’t prepared for that level of demand yet.

The path forward isn’t fear-based rest or endless gadget hopping. It’s:

• Calming pain first

• Protecting the tissue while it’s spicy

• Strengthening the intrinsic foot muscles and the calves

• Gradually teaching your foot and ankle to tolerate load again in positions that look like your running stride

  
  

When you do that, consistently, morning pain fades, runs feel smoother, and your confidence comes back.

Want a Simple Next Step?

If plantar heel pain has been hanging out alongside calf tightness or Achilles irritation (which is very common), you’ll love my Calf & Achilles Cure.

Many of the exercises that help runners heal plantar fasciopathy overlap directly with Achilles-friendly loading and ankle strength, making it a perfect next step as you build back toward stronger, pain-free running.

Grab the Calf & Achilles Cure here and start rebuilding your foot and ankle strength the runner-specific way.

Access the Calf & Achilles Cure Here!

Until next time running fit fam...

Dare to Train Differently,

Marie Whitt, PT, DPT //@dr.whitt.fit