Plantar Fasciitis: An Unconventional Cure by Running Barefoot


People often ask why I run barefoot.  Even complete strangers.  No shoes, no “foot gloves” or socks, nothing, nada, just bare-naked feet.  A cop once pulled over and got out of his car just to ask me that question.  

It began while training for a marathon, an unlucky break, and a bad case of plantar fasciitis.

During training, I already ran two 20-mile long-runs, so I was ready and hoping to set a new PR (personal record).  One day I was preparing for a bit of speedwork on a nearby track, planning for several ¼ and ½ mile intervals at a fast pace, enough to reach the gut-wrenching anaerobic zone.  It was a normal day, nothing extraordinary, and I did my typical pre-interval routine: a 1-mile warm-up run, stretching, etc.

Then it struck.  “The horror, the horror,” I pictured Marlon Brando saying in the movie Apocalypse Now.  During my first ¼ mile interval, the bottom of my right foot hurt.  I tried to run it out, thinking it was one of those kinks that would resolve the more I ran.  Only it worsened, forcing me to stop.

I wore conventional, cushioned running shoes, with a stiff bottom sole to stabilize the foot.  I removed the shoe and massaged the aching foot.  After re-lacing, I jogged only to find the pain worsened.  Dejected and defeated, I headed home, cursing the heavens above.

I stopped running for a few days but the foot still hurt.  The pain extended from arch to heel.  I couldn’t walk without pain.  I realized I had plantar fasciitis (more on this later).  Having had this before I tried everything under the sun: ice, stretches, massage, a Strassburg Sock (a device that flexes the foot while sleeping, which worked wonders before), then a variety of insoles and arch supports.  Nothing helped.

The day of the marathon approached and I still couldn’t run.  My son, Nick, signed-up for the half-marathon, and so naturally we kept our hotel reservation and made the trip.  This was still a mini-vacation, but I’d be a spectator instead and root for Nick on the sidelines.

A funny thing happened on the morning of his race.  For reasons unbeknownst to me even to this day, I went out without shoes.  I trotted over grass, cutting across smooth fairways to cheer Nick along the trails that meandered through the golf course close to where we lodged.  It dawned on me.  My foot hurt less!

On the way home I got to thinking--which I’ve been told was dangerous for folks like me--but this time thinking lead to inspiration and ultimately to excitement.  What if running barefoot could help? 

The following weeks I ventured out without shoes, first walking and jogging on grass, then on smooth sidewalks.  I’d read about barefoot running before, in Born to Run by Christopher McDougall, so I knew there was data out there showing running shoeless could be beneficial. At first, I jogged a 100 yards at a time.  The unseen little rocks on sidewalks were very painful.  I alternated walking and slow jogging, stayed on my toes, which was unconventional, since I always was a heel-striker before like most long-distance runners.  In fact, running shoes were designed with extra cushioning under the heel for this purpose.  But things changed: I shortened my stride, kept on my toes, and in two weeks I could run two miles straight.  And my plantar fasciitis was gone!  

Plantar Fasciitis: What is It?

I hope my podiatry and orthopedic colleagues will forgive my ultra-simple explanation, but here it goes.  The plantar fascia is a wide sheet of tough fibrous tissue at the bottom of your foot.  Deep to this are a bunch of muscles and tendons that help to flex and extend your foot and toes.  Look at the title picture.

Your foot has a natural arch.  There’s a purpose for this arch.  Some folks have high arches, some have flatter arches.  An arch serves to support the entire weight of the human body, much as an arch of a building does by evenly distributing the forces of gravity in ways which are far beyond the scope of this article to explain (and might stoke the ire of engineers, architects, mathematicians, etc.). 

Your foot naturally flexes and bends (again, see the title picture).  Only with the typical shoe—and most running shoes included—the natural flexion of the foot is prevented.  The result: wimpy foot muscles and a weak arch.  The plantar fascia gets weak and hence prone to injury and inflammation. 

I’ve already extolled the virtues of running in bare feet in a prior post (Barefoot Running: It’s Good for the Soul/Sole).  In short, the arch strengthens (and it is said those with flat or no arches will actually develop an arch) and your foot muscles also strengthen when running without shoes.  The forces generated by the impact with running are great, and the natural flexion of the foot and its arch reduces the transmission of these forces up the leg, hips and pelvis, reducing potential injuries to those structures as well.  I’ve also noted the soles of my feet were getting really tough and thick.  I’ve accidentally run over broken glass with no cuts on my foot.  I also can run in subfreezing weather and my feet surprisingly feel warm and comfortable.

For those with plantar fasciitis who’ve tried every imaginable remedy, going barefoot can help.  However, as with most things in life, you must individually tailor a regimen to your needs.  And take it slow.  I can’t emphasize this enough.  I’ve suffered injuries by doing too much too fast in my enthusiasm to improve.  So here it is again—TAKE IT SLOW!

Start by walking on smooth surfaces such as a sidewalk.  Stay on your toes—do not strike the ground with your heels.  It will feel unnatural at first.  Plan on a very short outing.  Walk a hundred yards or less and go home.  And always take your shoes with you, since you might encounter an unexpected situation when you need to slip them on (i.e., hot ground, sharp objects in your path, or dog poop).   On future outings, try jogging super-short distances.  Again, take is slow, and don’t stretch the running distances too long.  At first run about 100 yards or less at a time. Gradually increase the running interval on subsequent ventures.  I went out 3-4 days a week, taking a day off between to allow the feet and legs to rest and recover.  Again, it takes time.  In three weeks, I could run three miles without stopping, but in retrospect that might have been too much, too fast.  Don’t’ rush it. 

It took about 4 months before I could run more normally, doing 6 or more miles without stopping, some speed work, hill repeats and tempo runs.  I tried to follow the Ten Percent Rule, where your weekly mileage or total weekly running time should not increase more than 10% the following week.  Notice the emphasis on “tried.”  I was beset with injuries from over-use, doing too much too fast; a result of over-enthusiasm.

You’ll utilize your calf muscles more which in turn will pull on your Achilles tendon behind your heel.  Overdoing it can injure either (I’ve injured both at different times, due to stupidity and overdoing it).  Barefoot running takes a long time to master, since our feet were sheltered by shoes our entire lives.  Your body needs to adjust to the natural state that was rendered dormant from years and years of shoe-wearing. So again, take it SLOW.

Excellent books for this topic are: Barefoot Running by Michael Sandler, and Born to Run by Christopher McDougall.  I read both as I ventured out in bare feet and recommend you do the same.  Not only are they informational, but you’ll find they’re fascinating reads.

Like me, one day your plantar fasciitis hopefully will be cured.  Ultimately, you may find yourself running races in your bare feet, much to the surprise of the other runners and spectators.  It’s great to be unique, the rarity in the crowd.  My hope for the future?  There’ll be other naked-feet runners out there to keep me company.

©Randall S. Fong, M.D.


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