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Found a very interesting study on Plantar fasciitis. Currently been dealing with it again since mid-winter when had to go back to more regular shoes, boots and sprinting in shoes.



I figured someone or a bunch of other someones on my list and in their life are going through it, so I thought I'd share it with my thoughts along the way.


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BTW- new group for June starting up: I'm inviting a small group of busy adults who want to turn a health issue or more around permanently. Normally my Total Circadian Health Reset is a one-on-one program but I am going to be running it as a group for the next month for 50% off and together we’ll install your Summer Circadian Reset.

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Just comment below with HEALTH RESET or DM for details.

If you already responded I'll be sending over the details soon.
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Full research paper is here for anyone who wants to read it. The references alone can help as well, not just plantar fasciitis but any type of foot or ankle pain.

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Foot characteristics and running biomechanics in shod populations (shoe wearers and exercisers) are associated with the aetiology of plantar fasciitis, the most common musculoskeletal disease of the foot.



I did have PF back in both feet, not at the same time back in my mid-30's. But back then made more sense since I was always in shoes, even for my workouts.



Mounting evidence suggests that it is caused by repetitive tensile loads applied to the plantar aponeurosis due to excessive deformation of the foots longitudinal arch [2,3,4,5]. Excessive deformation of the arch is facilitated by weakness of the intrinsic foot muscles [2,3,4,6,7]. Modern footwear use is associated with weaker intrinsic foot muscles [7,8] a greater prevalence of flat feet [9] and changes to the shape of the foot that are not seen in habitually barefoot or minimally shod populations [7,10,11].

My belief for getting again is that I pushed the barefoot track sprinting too fast. Just went from grass to the track--full speed. Plus I've been wearing minimal shoes for almost a decade now and 2024 added the Konjoun Super Sock as one of my go to 'shoe'



The failure to achieve optimal outcomes in those suffering with plantar fasciitis is especially true in runners who experience a median recovery time of 5 months [16].

Conventional treatment of plantar fasciitis includes, but is not limited to, manual therapy, stretching [17], taping [18], dry needling of myofascial trigger points in the triceps surae region [19], proximal and distal lower limb muscle strengthening [20], orthotics and nights splints [21], shockwave therapy and injection therapies [22]. fact, 54% of all patients followed for ~10 years reported symptoms of ~2 years in duration and the remainder were still symptomatic at follow up [22].



This study was approved by the College of Medicine and Health Sciences Research Ethics Committee at the National University of Ireland, Galway.



Compliance to the intervention was 76.2% (16.1 ± 3.0 running sessions, maximum = 21). Compliance to 3 days per week was 88.9%



The mean or median relative percentage change in pain score from baseline is displayed in Figure 2. The difference from base line at week 2 (−5.1 ± 26.6%), week 3 (−4.8 ± 28.2%), week 4 (−11.2 ± 34.5%), week 5 (−21.4 ± 27.4%), week 6 (−38.8 ± 21.5%) and 12 (−58.3 ± 34.8%) are displayed, respectively.



Eighteen out of 20 participants would recommend the intervention to someone else with their condition.

FYI, so far I have done 2 sessions. One Friday and another Sunday. I was on the beach and not grass though. I ran 4 100-125's so no distance running and ran completely on forefoot...my heel didn't touch.

The pain waking up is much less and subsides much quicker and pain after being dormant for awhile is about 80-90% less. It is hurting a little bit more now, due to an earlier workout that had an exercise jumping in it :(

I still strongly recommend NOT running distance. Especially as a weight loss technique....running is not for weight loss....you must get in shape and learn how to run if you are going to to do it. Here is my blog post on Cardio is Making You Fat



Eighteen out of 20 participants would recommend the intervention to someone else with their condition. Twelve of the participants were running at least 5 km twice weekly, in shoes and on the road at the 12-week point. One participant continued to run barefoot on the grass at the 12-week point.



Plantar fasciitis is associated with increased time spent standing, walking and running, particularly on unyielding surfaces [27,28].

This also makes sense for me since I stand at a standing desk for work.

Individuals with a greater mass or those with ‘heavier’ running mechanics may be particularly at risk [27,29]. The symptoms of plantar fasciitis are most noticeable after prolonged activity or during the first steps after a prolonged period of rest, i.e., when seated or sleeping [21].

Therefore, it is highly counterintuitive to both patients and clinicians to prescribe or adopt vigorous loading activities (running) on a regular basis and without shoes when symptomatic. However, our case series demonstrates that this approach in combination with a natural pliable (grass) surface is not only well tolerated but appears to reduce pain whilst maintaining or increasing running load



Additionally, whilst all participants included in the case series were habitually shod, the time spent barefoot whilst completing other activities was not record. The time spent barefoot in other activities may have a confounding effect on the observation made.



We make this suggestion based on the following observations:

(a)

the existing outcomes associated with the conventional management of plantar fasciitis are poor

(b)

the median recovery time in runners is 5 months [25] and can be 2–10 years in the general population [12]

(c)

the outcomes achieved in this case series occur in as little as 1.5 months

(d)

the uniform (19 out of 20 runners) improvement in the sample studied at 6-weeks and 12-weeks (18 out of 20 runners)

(e)

the improvement in the condition despite using the activity (running) that often brought on the condition

(f)

the known changes in intrinsic foot muscle morphology that occurs due to altered kinematics and kinetics associated with this type of training

(g)

the patient satisfaction that is experienced through immediately returning to their preferred activity as part of the rehabilitation process. This may also help to increase compliance to other aspects of advice and rehabilitation offered by the clinician.



it is tempting to assume that restoration of intrinsic foot muscle size and strength which better serves the integrity of the arch and therefore, reduces the repetitive tensile loading to the plantar fascia is the reason for the improvements shown. We suggest that this plays a role in the results observed at week-6 and 12, but our experience with some individuals show an almost instantaneous resolution of symptoms that cannot be explained by changes in muscle size and strength [24]



4.1. Short-Term Factors That May Alter Pain Sensitivity

The loading impulse experienced during walking is 2–3 greater in footwear compared to walking barefoot [30]. Runners who rearfoot or midfoot strike (most shod runners) experience greater tibial shock with increasing running speed relative to forefoot strikers during a marathon [31]. Higher impact kinetics, such as these, are associated with the most common running injuries [1,32]. Most runners alter running kinematics and kinetics when first exposed to barefoot running [33]. Therefore, it is possible that the mere introduction of change in relation to running biomechanics could introduce sufficient variability into overused patterns and or lower impact kinetics enough to create immediate pain change. Linked to this explanation is the runner’s acute exposure to a new foot-surface environment via the pliable (grass) surface used. Plantar pressure and external ankle joint moments are lower running on a pliable surface relative to firm surfaces [34,35]. This is coupled with the knowledge that runners, whether habitually shod or barefoot, use a more varied foot-strike pattern on soft surfaces [36]. This type of running may allow runners to capitalise on the inherent variability of the foot (33-joints) and the natural surface to produce a consistent action (running) via different patterns of tensioning, stiffening and joint relations. Indeed, the energy return from connective tissues associated with the medial longitudinal arch [2], transverse arch [37] and heel [38] make a significant contribution to energy turnover during running [4]. It may be that liberating the foot from the shoe and the almost permanent state of ‘windlass’ associated with the upward curvature of toe springs [2] allows runners make greater immediate use of their foot arches, thereby reducing overload to the plantar fasciitis and the symptoms associated..



4.2. Longer-Term Factors That May Alter Pain Sensitivity

Healthy feet (i.e., not flat footed) are characterised by stiffer arches [7] that undergo less deformation during dynamic activities as a result of strong intrinsic foot muscles functioning in concert with passive tissue restraints [38]. This is evident from habitually barefoot populations having a lower prevalence of flat foot and larger abductor hallucis and abductor digit minimi muscles [7,9,42,43]. Furthermore, shod populations who demonstrate the reverse in terms of arch integrity and foot muscle morphology, can develop functional foot characteristics more in likeness to habitually barefoot populations after a period of barefoot or minimally shod walking and running [8,44]. It may be these adaptations that have contributed to the sustained reduction in pain in the runners in this study at 6 and 12-weeks. This explanation is supported by the findings of Cheung et al. [6] who report runners with chronic plantar fasciitis to have smaller intrinsic foot muscles than their healthy counterparts.



Intrinsic foot muscle dysfunction (resulting in excessive arch deformation) may be one of the reasons that muscles such as tibialis posterior and passive tissues such as the plantar fascia become overworked in shod runners [28,45].



Differences in ankle and foot dynamics will influence the entire kinetic chain. Runners who respond positively to a barefoot running training programme demonstrate increased pre-activation of the gluteus medius and biceps femoris muscles and a reduction in re**us femoris activation [46

Before starting functinoal patterns and hyperarch fascia training I never felt my sprint sessions in my butt. Now I do. Glute dominant athletes = faster. Quad dominant athletes = slower.



This time period was associated with unseasonably warm weather in Ireland which led to firmer than normal ground. Based on our previous clinical experience, changes in symptoms may have occurred sooner had the surface been more pliable, as it was midway and toward the end of the intervention.

Another reason I believe I got it was winter came in Ohio and I had to go back to shoe sprinting. It does feel remarkably different in shoes than barefoot. I can still feel my glutes in shoes but not nearly as much as barefoot.



Changes in running biomechanics and foot morphology have been associated with barefoot running. Barefoot running on grass appears to be well tolerated by runners with symptomatic plantar fasciitis. Within this case series pain associated with plantar fasciitis appeared to become lower while running load increased in a group of recreational runners completing a barefoot running intervention.

Let me know your thoughts or comments especially if you are currently going through plantar fasciitis or similar foot issues.

Getting it again has certainly made me more conscious of my running and walking technique. I now tend to focus more on forefoot striking and even do so when walking especially when the PF is flaring up.

If you haven't seen the Aussie, Gout Gout, set the 200 meter record for an 18 year old (crushing Usain Bolt's) here it is: https://www.youtube.com/shorts/Py25wbNB4yk......notice his heel never touches the ground---that is super elastic recoil of the fascial system.

Become harder to kill.

Thoughts/questions/comments

Share this one out with anyone you know with PF

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