Running with Plantar Fasciitis: Training for HYROX Without Making it Worse
- Dr. Kelsey Changsing, PT, DPT
- Jul 29
- 5 min read
Plantar fasciitis, also called plantar fasciopathy, is an overuse condition that develops when the plantar fascia cannot tolerate the repetitive loading placed on it. For HYROX athletes, running, lunges, burpee broad jumps, and other movements can increase symptoms because they repeatedly load the foot and plantar fascia.
Managing symptoms during race preparation may involve modifying training volume, stretching the calf and big toe, adjusting footwear, and considering treatments such as shockwave therapy. HYROX Athlete Physical Therapy can also help determine which training modifications are appropriate while addressing the underlying problem.
After a race, gradually rebuilding training volume and continuing mobility and strengthening work can help improve the foot's ability to tolerate future training demands.
What Is Plantar Fasciitis?
Plantar fasciitis, or plantar fasciopathy, involves pain and structural changes of the plantar fascia on the sole of the foot. Updated research has found that plantar fasciitis is not typically caused by inflammation of the plantar fascia, as previously thought. Similar to tendinopathies, plantar fasciopathy is more likely caused by the plantar fascia’s inability to tolerate load.
The plantar fascia is a thick band of connective tissue on the bottom of your foot that runs from the bottom of your heel to the ball of your foot. It helps to support your foot arch and move you forward with walking and running by storing and releasing energy, similar to the Achilles tendon.
The most common symptom and classic indicator of plantar fasciopathy is pain and a feeling of “tightness” on the arch of your foot, especially near its attachment to the bottom of your heel, when taking your first step out of bed in the morning or after sitting for a long time. The pain improves after taking a few steps but gets worse again towards the end of the day or with activities such as running and repetitive jumping.
Like a tendon, the plantar fascia needs to be able to tolerate repetitive loading with activities such as walking, running, and jumping. Before you push off the ground, your big toe bends backward, stretching the plantar fascia and putting it under tension. As you push off, the plantar fascia releases the energy it stored and helps your foot transfer force to move you forward.
If the amount of repetitive loading exceeds what the plantar fascia can currently tolerate, it can become irritated and painful.
How Plantar Fasciitis Affects HYROX Performance
If you’re currently dealing with plantar fasciopathy, running is probably where you notice the pain the most. But with HYROX training, running isn’t the only movement that can aggravate your heel pain.
Movements that require you to push off with your big toe, such as lunges and burpee broad jumps, can also flare up your plantar fasciitis pain. This can make it harder to simply focus on reducing your running volume to address your plantar fasciopathy, since you will also be training other movements that place repetitive load through the plantar fascia.
Because of this, managing plantar fasciitis during HYROX race prep may require temporarily modifying more than just your running volume.
Managing Plantar Fasciitis During HYROX Race Prep
As an overuse injury, the first step to managing plantar fasciopathy is addressing your training volume and making sure it’s at a tolerable level. This can look like decreasing your run distance to what your foot can tolerate or adding more rest breaks. The goal is to not make your plantar fasciitis pain worse before your race.
Next is incorporating calf and foot/big toe stretching to help with pain relief and improving the plantar fascia’s tolerance to being stretched. Rolling the bottom of the foot with a lacrosse ball or frozen water bottle can also help with pain relief, but
stretching is important for long-term pain relief.
Changing your footwear can also help with decreasing strain on the plantar fascia. If your running shoes have about 300-500 miles on them, they may no longer be providing enough support, and getting new shoes may be a good idea. Orthotic insoles can also be helpful with providing a bit more support. And trying a shoe with more of a rearfoot-forefoot drop can also help decrease strain on the plantar fascia.
Going to a local running store with different brands and models of running shoes and insoles can be helpful when looking for new shoes. Just remember that the right shoe for you is one that feels comfortable to you from the beginning, not whether it’s marketed for a specific foot type.
Lastly, Extracorporeal Shockwave Therapy (ESWT) has been shown to help decrease plantar fascia pain. It might be worth considering if you’re having a lot of pain and your race is within a couple weeks.
If you decide to try shockwave therapy, keep in mind that more treatment isn’t necessarily better. The number of sessions you need can vary, so be cautious of expensive treatment packages that require you to commit to a large number of sessions upfront. Some physical therapy clinics also offer ESWT, which allows shockwave therapy to be incorporated into your overall rehab plan instead of as a standalone treatment.
Preventing Plantar Fasciopathy from Coming Back
After your race, continuing with your calf and big toe stretching can help maintain your ankle mobility and the plantar fascia’s tolerance to being stretched. Even if your pain improves once you decrease your training volume, you don’t want to completely stop addressing your plantar fasciopathy just because your race is over.
You can also add exercises to strengthen the small muscles within your foot that help support your arch. While strengthening these intrinsic foot muscles hasn’t consistently been shown to improve plantar fasciitis specifically, it may still be helpful if some of your foot pain is also coming from the muscles that support your arch.
Lastly, be mindful of your training volume when you start preparing for your next race or event. Plantar fasciopathy is an overuse injury, and increasing your running distance or training volume too quickly can cause your symptoms to flare up again.
Taking some time off after your race may help your pain go away, but that doesn’t necessarily mean your plantar fascia is ready to immediately return to the same amount of training. Gradually building your training volume back up can help prevent another flare-up.
When to See Physical Therapy
Plantar fasciopathy can take several weeks to months to fully improve. If your HYROX race is coming up within that time frame, seeing a physical therapist can help you come up with a plan to manage your pain and keep it from getting worse while you continue training.
A HYROX Athlete Physical Therapist can also make sure your pain is actually being caused by plantar fasciopathy and not something else. From there, they can help you determine what parts of your training you may need to modify before your race and what you can continue doing safely.
Then, once your race is over, the focus can switch to fully addressing your plantar fasciopathy and gradually building your foot’s tolerance back up for your next training cycle.
HYROX Athlete Physical Therapy in Nevada
If you’re located in Nevada and need help managing plantar fasciitis while continuing to train for HYROX, I specialize in remote physical therapy for HYROX athletes.
Schedule a Virtual Movement Assessment to get a personalized plan to manage your pain and keep training for your next race.
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References:
Monteagudo, M., de Albornoz, P. M., Gutierrez, B., Tabuenca, J., & Álvarez, I. (2018). Plantar fasciopathy: A current concepts review. EFORT open reviews, 3(8), 485–493. https://doi.org/10.1302/2058-5241.3.170080
Morrissey, D., Cotchett, M., Said J'Bari, A., Prior, T., Griffiths, I. B., Rathleff, M. S., Gulle, H., Vicenzino, B., & Barton, C. J. (2021). Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. British journal of sports medicine, 55(19), 1106–1118. https://doi.org/10.1136/bjsports-2019-101970
