Addressing Plantar Fasciitis in Runners Over 40
Running offers numerous health benefits, from improved cardiovascular fitness to reduced stress, but it also comes with its challenges. Among the most common complaints faced by runners over 40 is plantar fasciitis—a painful condition affecting the bottom of the foot. If you’ve felt a stabbing pain in your heel during your first steps in the morning or after a run, you’re not alone. Plantar fasciitis can be frustrating, but the good news is that it’s treatable and often preventable with the right approach.
This blog will explore the signs, causes, evidence-based treatments, and strategies to manage and prevent plantar fasciitis, with a focus on recreational runners in their forties and beyond.

What Is Plantar Fasciitis?
Plantar fasciitis is an overuse injury affecting the plantar fascia, a thick band of connective tissue running from your heel to your toes. This tissue plays a crucial role in supporting the arch of your foot and absorbing the shock of walking and running. When it’s subjected to repeated stress without enough recovery, micro tears can develop, leading to inflammation and pain.
For runners, especially those over 40, plantar fasciitis is a common issue. As we age, the tissues in our feet lose elasticity and resilience, making them more vulnerable to overuse injuries. Coupled with factors like reduced flexibility, poor biomechanics, or increased training intensity, the risk of developing plantar fasciitis increases.
Signs and Symptoms
The hallmark symptom of plantar fasciitis is pain on the underside of the heel, often described as sharp or stabbing. It’s typically worse during the first steps in the morning or after prolonged sitting, as the plantar fascia tightens during rest. The pain may improve slightly as you move around, but it often returns after a run or extended periods of standing.
You might also notice tenderness along the sole of your foot or stiffness in the arch, particularly after physical activity. In some cases, the discomfort can radiate toward the toes, making even simple movements uncomfortable. Ignoring these symptoms can lead to chronic pain and prolonged recovery time, so it’s essential to address the issue early.

What Causes Plantar Fasciitis?
Plantar fasciitis often develops due to a combination of factors rather than a single cause. For runners, these can include:

Overtraining: Rapid increases in mileage or intensity without adequate recovery time can overload the plantar fascia.
Biomechanical Issues: Overpronation (excessive inward rolling of the foot), tight calf muscles, or a stiff Achilles tendon can alter how force is distributed across the foot.
Footwear: Worn-out running shoes or those lacking proper arch support and cushioning fail to absorb impact effectively, placing extra strain on the fascia.
Age-Related Changes: Reduced flexibility, loss of fat padding under the heel and decreased strength in the plantar fascia make older runners more prone to the condition.
Running Surfaces: Hard surfaces like concrete or uneven terrain increase impact forces, contributing to stress on the foot.
Treatment of Plantar Fasciitis
Addressing plantar fasciitis requires a multifaceted approach, combining rest, targeted therapies, and gradual return to activity. Here are evidence-based strategies for treating the condition:
1. Rest and Load Management
One of the first steps in managing plantar fasciitis is to reduce or modify your running routine. Temporarily decreasing mileage, avoiding speed work, or switching to low-impact activities like swimming or cycling can help reduce stress on the fascia. Complete rest isn’t always necessary, but it’s essential to listen to your body and avoid activities that exacerbate pain.
2. Stretching and Flexibility
Tight calf muscles and a stiff Achilles tendon can increase tension on the plantar fascia. Stretching these areas can provide relief and prevent recurrence. Calf stretches, wall stretches, and toe stretches are particularly effective. A simple exercise is to loop a towel around your foot, gently pulling it toward you to stretch the arch and Achilles tendon.

3. Strengthening Exercises
Strengthening the muscles that support the foot, and ankle is crucial for long-term recovery. Exercises like heel raises (with toes dorsi flexed), toe curls, marble pickups, and resistance band exercises targeting the intrinsic muscles of the foot can improve arch stability. For runners over 40, incorporating these exercises into your routine helps counteract the natural weakening of muscles with age.
4. Footwear and Orthotics
Investing in proper running shoes with good arch support and shock absorption is essential. Shoes should be replaced every 300–500 miles to maintain their supportive properties. Custom orthotics or off-the-shelf insoles can provide additional support and redistribute pressure away from the plantar fascia.
5. Pain Management
Ice therapy is an effective way to reduce inflammation and ease pain. Rolling your foot over a frozen water bottle for 10–15 minutes can provide immediate relief. For more persistent discomfort, over-the-counter anti-inflammatory medications may help, but they should only be used as directed and not as a substitute for addressing the root causes.
6. Manual Therapy and Massage
Techniques like deep tissue massage or using a massage ball under the arch can improve circulation and alleviate tension in the plantar fascia. A physiotherapist can also use manual therapy to target tight structures contributing to the condition.
7. Shockwave Therapy
Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment that uses acoustic waves to stimulate healing in the plantar fascia. Studies have shown it to be effective for chronic cases resistant to other treatments.

Preventing Plantar Fasciitis
Once you’ve recovered from plantar fasciitis, taking steps to prevent its return is vital. For runners over 40, this involves a combination of smart training, proper footwear, and maintaining flexibility and strength.
Gradually increasing your training volume and intensity allows your body to adapt without overloading the plantar fascia. The 10% rule—increasing mileage by no more than 10% per week—is a helpful guideline. Including cross-training activities like cycling or swimming reduces the repetitive stress on your feet while maintaining fitness.
Stretching and strengthening exercises should become a regular part of your routine, even when you’re not injured. Dynamic warm-ups before a run and static stretching afterward can help maintain flexibility. Strengthening exercises for the calves, feet, and ankles provide the stability and support needed to absorb impact forces efficiently.
Choosing softer running surfaces, like grass or trails, over concrete can also reduce the strain on your feet. And don’t underestimate the importance of your shoes—replace them regularly and ensure they fit well, offering adequate support and cushioning.
When to Seek Professional Help
If the pain persists despite conservative treatments, it’s time to consult a professional. A physiotherapist can assess your biomechanics, identify contributing factors, and design a tailored treatment plan. In some cases, imaging like an ultrasound or MRI may be necessary to rule out other conditions.

Conclusion
Plantar fasciitis can be a frustrating obstacle for runners over 40, but with the right approach, it’s manageable and often preventable. By addressing the underlying causes, committing to proper treatment, and making smart adjustments to your training, you can recover and get back to enjoying the many benefits of running.
Remember, running is a lifelong pursuit, and taking the time to care for your body ensures that you can keep doing what you love for years to come.
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