Whether you’re clocking up training runs for Round the Bays, jogging to unwind after work, or chasing a new PB on the waterfront, nagging heel or arch pain can quickly take the joy out of running. But here’s the good news: you don’t have to put up with it. Most runners can recover, rebuild strength, and keep running without pain with physiotherapy .

Let’s talk about what causes foot pain in runners, what plantar fasciitis is, and how a solid physio plan can keep you running stronger for longer.

So What’s That Pain in Your Foot?

That stabbing pain under your heel when you first step out of bed? Or the deep ache after a long trail run? That’s probably plantar fasciitis, though many professionals prefer the broader term plantar heel pain.

The plantar fascia is a thick band of tissue stretching from your heel to your toes. It supports the arch and helps you transfer the load through your foot. But if it’s overloaded, particularly by repeated strain , it can start to degenerate. It’s not inflamed, despite the name. It’s more of a tissue breakdown than a traditional injury.

Common symptoms include:

• Pain under the heel or through the arch

• A sharp pulling sensation  first thing in the morning

• Increased discomfort after standing or running

• Stiffness  after sitting for a while

• Relief with movement  that slowly fades as pain returns later

Why Runners Get It

Running itself isn’t the villain. It’s how and how often you run that usually tips things over. Risk factors include:

• Rapid increases in training volume  or intensity

• poor  footwear that lacks structure or cushioning

• Stiff ankles or tight calves

• A rigid or weak plantar fascia

• Flat feet or very high arches

• Imbalances  or weakness in your foot and hip muscles

• Running exclusively on hard or unstable surfaces

Even subtle aspects like stride , posture, or cadence can load the foot more than it’s ready to handle. Runners are often guilty of pushing through early warning signs, which means tissue damage can build slowly before the pain really shows up.

When Should You Get Help?

If you’ve had foot pain for more than ten days, if it’s worsening, or if you’re changing your gait patterns to avoid it, it’s time to see a physiotherapist. At Pōneke Physiotherapy, we’ll run through a full biomechanical screen.  That means checking:

• Foot and heel tenderness

• Ankle mobility and role  and strength

• Gait and running mechanics

• Calf flexibility

• Shoe wear patterns

• Training history  and terrain

This gives us a clear picture of what’s happening and how best to help.

What Does Treatment Look Like?

Treatment is always personalized, but the key elements often include:

1. Load Management
   We’ll help you find the threshold your foot can tolerate. That might involve temporarily cutting back or swapping some runs for cross-training , such as cycling or deep-water running.

2. Manual Therapy
   Hands-on work like soft tissue release , joint mobilizations, or trigger point therapy helps reduce stiffness and improve mobility in the surrounding structures.

3. Targeted Stretching
   We’ll teach you how to stretch the plantar fascia itself, along with the calf and Achilles tendon, which often pull on the heel and worsen symptoms.

4. Progressive Strengthening
   Exercises like slow eccentric heel drops , toe curls with a towel, and single-leg calf raises help rebuild strength and load tolerance over time.

5. Gait Retraining
   If your running style places excessive load on the foot, we might tweak cadence, stride, or landing patterns to improve efficiency and reduce strain.

6. Shoe and Orthotic Advice
   We’ll evaluate your shoes and may recommend temporary orthotics if you need extra arch support during recovery.

7. Supportive Taping  and Night Splints
   These tools can reduce stress on the plantar fascia, especially first thing in the morning.

8. Extracorporeal Shockwave Therapy (ESWT)
   For tougher cases, we sometimes turn to ESWT. It’s a non-invasive treatment that uses high-energy sound waves to target the painful area. This helps improve blood flow, encourages healing , and can lower the area’s sensitivity to pain. It’s often useful when heel pain hasn’t improved with more typical treatments.

Can you keep running?

You might not have to stop completely. If your pain stays below a certain threshold, doesn’t flare up later, and doesn’t change your gait, you’re probably okay to keep running in moderation. But if every session sets you back, you may need to pause and focus on healing first.

We’ll help you adapt your training, find safe cross-training alternatives, and guide your return to running. It’s about building capacity while protecting the tissue that needs time.

How Long Until It Gets Better?

Mild cases can settle in a few weeks. More established ones usually take a few months. Either way, improvement happens faster when treatment starts early and is consistent. Avoiding overtraining and wearing proper footwear will also go a long way.

Final Thoughts from Pōneke Physiotherapy

If you’re a Wellington runner with foot pain, know you’re not alone. This is one of the most common running injuries we treat and, thankfully, one of the most manageable. With expert guidance, a tailored rehab plan , and a realistic outlook, you can return to doing what you love.

At Pōneke Physiotherapy, we help you feel stronger, move better, and stay running. Whether chasing finish lines or just the sunset around the bays, your feet deserve the proper support. Get in touch with us, and let’s sort it out together.