A lot of triathletes have/had Plantar Fasciitis. Tatiana and I decided to share our experience through it and asked anyone with some experience/knowledge on this topic to contribute to this document. 

Then multiple member contributed: Raj, Marie, Kathy, Debbie, Bryant Thanks! 

Causes

Body issues

• Uneven leg length: Training turned Jerome’s legs into mismatched twins. He is doing PT exercises to realign them. He recommends consulting with Movement Health Science if you can. He discovered them in 2023, and everything has just gotten better since. Unfortunately, he cannot recommend a PT, as he just moved to Kansas City.
• Marie doesn’t have uneven leg length but has curvature in the spin, which causes one leg to start higher than the other
• Feet arch extreme (flat over arched). Shoes do not always provide enough arch support.
• Tight calves is considered to be a possible cause - Marie has tight calves so that tracks
• Overtraining: the body sends you a signal that it is too much. 
• This is what happened to Jerome after shockwave therapy. He restarted too fast and without fixing the cause and still used the wrong shoes! 
• Too high mileage or too steep increase in speed work. Tatiana had 1st plantar issue after IMAZ/Turkey Trot week and 2nd after marathon tempo training followed by track.
• Debbie had her first symptom after increasing to 4 days of running per week (from 3) during the marathon ramp-up
• Wrong shoes
• Carbon shoes. A PT suggested they ease plantar strain but might do the opposite. Jerome would use carbon shoes only for race prep and/or one a week at the track, for example. 
• Marie got PF the second time while wearing shoes with a carbon plate (Saucony Endorphin Pro)
• Jerome’s feet rotate inside (pronation) when he runs, which stresses the plantar, which is aggravated with
• Non-supportive shoes, ie, with no arch
• For stable shoes, see Guide to Stability Running from Doctor of Running 
• Jerome is using 
• ASICS Gel-Kayano 2 9.5 with insole
• HOKA ONE ONE Stinson 7 without insole
• HOKA ONE ONE Clifton 9 with insole 
• Tatiana is using 
• Nike Free Run 5.0, minimal shoe for foot strength, 90% of my runs
• Nike Vaporfly only for races
• Trail still testing: Altra Lone Peak 6 have wide toe box, zero drop but too soft sole; Norda 002; Speedgoat 5
• Shoes with high mileage will eventually have cushion fatigue and will not support like they were new and may cause plantar fasciitis. Bryant had shoes that gave out as early as 200 miles but generally last 300-400 miles before replacement. Keep track of your shoe mileage!
• The first time Marie got PF, she was standing for 16 hours for 2-4 days over a weekend in shoes pressing against her arch (Danskos). The second time, her running shoes were pressing against her arch.

Treatments

Below are some treatments that work for some of us, but you need to find your own, try different things, and identify what helps you. You will even find opposite views.

• Ditch the shoes at home. Barefoot or minimal shoes strengthen your feet (e.g. Xero). Save those cushy recovery shoes for post-run. [DebbieP - this varies per person. I stopped walking around barefoot, esp when I had PF. Have a pair of ‘house shoes’ so they are clean etc] Marie’s podiatrist told her to always wear shoes in the house and when she gets heel or arch pain, she does that and it helps
• Shockwave Therapy: Zapped pain away after 3 or 4 sessions/weeks! More at Revolution in Fitness Shockwave Therapy. But it does not fix the cause; you still need to find what causes it to avoid it from returning. That is what happened to Jerome until he found the leg length issue. [Competitive Edge PT also has shockwave, as does Dr. James Ratcliff]
• Stretching, Here are some great resources from
• Doctors of running.
• Doc on the run. 
• A simple stretch Marie does is to curl her toes. It reduces pain immediately
• Massage gun (HSA/FSA eligible): 
• (Jerome) use it on the plantar; it can hurt but helps heal. Use it either directly, at a 90-degree angle, or sided, at a 45-degree angle. At an angle, it is more tolerable in some areas and provides relief by warming up the area.
• (Tatiana) In context of breaking up scar tissue and adding flexibility - e.g. (likely my issue) if the calves are tight and causing the issue by pulling on the Plantar Fascia, the gun helps on the calves as well. Using it on my entire legs actually. 
• video help with how to use a massage gun for this type of issue (Kathy H)
• Ice: after runs for acute pain. [DebbieP: frozen water bottle, roll your foot on it, sitting sometimes, standing sometimes with pressure]
• Warmth for healing at other times.
• Orthotics/Insoles. They provide support if the shoe does not. The one that works best for Jerome is: 
• The Protalus T-100 Elite, but you should use their insole finder.
• My Podiatrist at KP recommended super feet green orthotics. If they provide stability, they are hard on the heel. Marie uses the raspberry ones.
• Stability Shoes (see above)
• Get fitted for the right shoe, even if you pay more, it far outweighs the months of rehab from plantar fasciitis Example: Running Revolution in Campbell will scan your feet and film you when you run to ensure you have a good fitting shoe.
• Tying your shoes in a way that maximizes the shoe features, such as utilizing the Heel Lock technique for optimal foot support. See Heel Lock/Runner’s Loop/Runner’s Tie/Lock Lacing
• Night splint. Jerome used this one. Debbie used this one Find one you can handle. Not too extreme or you won’t be able to sleep with it.
• Used Mobo Board to warm up before running (only about 2 mins balancing on each side) to warm up the feet and calves. This is only after everything starts to feel better (KathyH)
• Continue running unless the pain is higher than five over 10. See more here. 
• Strength training helped Tatiana fix other injuries (IT band issues, shin splints, shoulder issues while swimming,..). Some examples she’s following right now for Plantar Fasciitis ~2x/week are 1 | 2 | 3. Other strength resources, anyone? 
• DebbieP: The thing that finally solved my PF (after 1.5yrs of PT, shockwave, etc) was foot strengthening exercises. Standing on one foot - increase duration as you can, doing clock exercises to shift weight around. I used to try brushing my teeth standing on one foot.
• Normatec compression boots, pumps more blood into inflamed areas, causes faster regeneration (HSA/FSA eligible)
• Toe separators here, some hypotheses about Plantar Fasciitis claim it's related to reduced blood flow, these increase blood flow and a natural posture.
• Climbing on the bike trains the right muscles, was also Muddy's advice.

Remember, everyone's different. Try stuff out and see what clicks for you. You might even stumble upon conflicting advice – it’s all part of the journey. Stay strong and keep tri-ing! 🏊‍♂️🚴‍♀️🏃‍♂️

Here is a good blog from one of SVTC’s sponsors Competitive Edge PT https://compedgept.com/blog/plantar-fasciitis-overview/

Raj have had plantar fasciitis a number of times. Unfortunately the worst was due to a peronsal tendon partial tear. I ended up in a cast/boot for 8 weeks and another 8 weeks of PT. I thought I may never run again or compete, especially at my age. I still occasionally get flare ups. The most inopportune is right before a race. The best success I have had is as follows: 

1. Hot tub sauna for ten minutes with jets on feet, ankle and calf muscles while doing range-of- motion exercises. If no spa is available a bathtub or a bucket of hot water and epsom salts is also pain relieving. I am not sure why physical therapists don’t emphasize hydrotherapy more.7
2. Follow this with a cool pool range of motion exercises for five minutes immediately after.
3. Followed by a massage ball or theragun on lowest settings for five to ten minutes.
4. Followed by a soft crushed ice or the reusable soft gel frozen wraps for five to ten minutes with legs elevated.
5. When done I apply Rock or LT Tape or equivalent. I usually don’t wear this during the race but with the waterproof version it is possible. Practice this first.
6. I repeat this two to three times a day if a race is a few days away or I am feeling the pain.
7. I will also apply an OTC topical NSAID and Arnica as labeled combined at night.
8. I usually start and finish races pain free now. I am just not as fast as before the injury. I believe this is an age, strength and training deficit more than anything.
9. Easing back into training via swimming, biking and weight-lifting has helped bullet proof my foot. However when running or hiking on uneven surfaces I protect my feet and ankles with high top shoes.
10. Good luck fellow PF sufferers!

~Raj