That stabbing pain on the bottom of your foot near the heel usually indicates the common running injury plantar fasciitis. The pain is usually worst with the first few steps after getting out of bed, although it can occur after long periods of standing or getting up from a seated position.

The cause can be overuse from running, improper footwear, or foot stabilization issues such as excessive pronation or supination. The repetitive stress from the rolling of the foot when heel striking will cause irritation to the tissue. Sometimes a heel spur can also form. Plantar fasciitis injury will usually involve other areas of the kinetic chain – the ankle, calf, knee, hip and lower back. The ankle can become unstable, the calf could be tight. The knee can develop soreness, the hip can be sore and restrictive. The lower back can develop instability and muscle spasms.

Rest, ice, orthotics or shoe inserts, and stretches for toes and calf can help minimize symptoms. More serious treatment includes surgery or corticosteroid injections. Injecting the plantar fascia with drugs should be avoided since it weakens connective tissue and increases the risk of rupturing the plantar fascia and/or damaging the heel’s protective fat pad. Surgical intervention should always be a last resort because cutting the plantar fascia results in a gradual destruction of the medial arch (the plantar fascia is an important stabilizer of the arch and when it is surgically cut, the arch eventually collapses.

An effective alternative is to perform deep tissue massage to the arch and calf. Many runners have had excellent outcomes with ART therapy and/or shock wave therapy. This intervention is performed in-office and unlike cortisone, it stim­ulates repair and accelerates healing. Most importantly, starting treatment when you first notice symptoms is more successful and takes less time than treatment that is delayed.