Autumn training has a rhythm I love. The heat drops off, the trails firm up, and my callanetics room fills back up with people who spent summer walking barefoot on holiday and now cannot get out of bed without wincing on the first step. Plantar fasciitis season, right on schedule.
If you have been anywhere near running Instagram or physio TikTok this September, you have seen the same protocol pop up again and again: high-load heel raises. Weighted. Slow. Every other day. And people are stunned that this — not stretching, not rolling a frozen bottle, not another set of insoles — is what finally moves the needle.
It is not new. The original research (Rathleff and colleagues out of Denmark) landed back in 2014 and showed high-load strength training beat plantar-specific stretching at the three-month mark. What is new is that the running community has finally caught up. And honestly, autumn is the perfect window to run the 12-week block before winter racing.
Let me walk you through exactly how I coach it.
Why plantar fasciitis is a loading problem, not a stretching problem
For years, the standard advice was: stretch your calves, roll your arch, wear a night splint. Some of that helps a bit. None of it rebuilds the tissue.
The plantar fascia is a thick band of connective tissue that runs from your heel bone to the base of your toes. When it becomes painful and thickened — usually after a training spike, a summer of flat sandals, or a job that keeps you on hard floors — the tissue is not "tight." It is under-conditioned for the load you are asking of it. Stretching a de-conditioned tendon is a bit like massaging a wall you actually need to reinforce.
High-load strength work does something different. It gently, progressively demands that the fascia and the small foot muscles carry heavier and heavier loads. The tissue responds by remodelling. That is the whole game.
I wrote a longer piece on the sneaky reasons this condition sticks around — worth a read if you have been fighting it for months: Why Your Plantar Fasciitis Won't Heal: 7 Hidden Reasons the Pain Keeps Coming Back.
The protocol, exactly as I teach it
Here is the version I give runners, callanetics students, and honestly my own mother when her heel flared up last November.
The movement: single-leg heel raise on a step, with a rolled towel under the toes.
- Stand on the edge of a step, single-leg (good leg dangling off).
- Roll a small towel and place it under your toes so they sit in maximum dorsiflexion (toes pulled up toward your shin). This is the non-negotiable part.
- Slowly raise up onto the ball of your foot: 3 seconds up.
- Hold at the top: 2 seconds.
- Lower slowly back down, letting the heel drop below the step: 3 seconds down.
- Every other day. Not daily. The tissue needs the rest day.
Total time under tension per rep: 8 seconds. That is the whole point.
Why the towel matters (the windlass mechanism)
If you skip the towel, you are just doing a calf raise. Fine exercise, wrong target.
When your toes are pulled up into dorsiflexion, the plantar fascia wraps tighter around the metatarsal heads — think of a windlass, or the way rope wraps around a capstan. This mechanism tensions the fascia. Now when you heel-raise on top of that tension, the fascia itself is being loaded, not just the calf.
That is the difference between a general lower-leg exercise and a plantar fascia rehab exercise. The towel is the whole reason this works.
The 12-week progression
This is a framework, not a prescription. Adjust based on pain response (a 0–3 out of 10 during the exercise is fine; that is the "acceptable pain" window).
Weeks 1–2: Bodyweight, learning the movement.
- 3 sets of 12 reps, every other day
- No load yet. You are grooving the pattern and confirming your foot tolerates the position.
- Pain should settle within 24 hours after each session.
Weeks 3–4: Add light load.
- 3 sets of 10 reps
- Grab a backpack. Start with 5–8 kg of books or water bottles.
- Slower is better than heavier. Do not sacrifice the 3-2-3 tempo to chase weight.
Weeks 5–6: Build load.
- 4 sets of 8 reps
- Backpack up to 10–15 kg for most people.
- You should feel this. It should feel like work. That is the point.
Weeks 7–8: Heavy phase.
- 4 sets of 6 reps
- Backpack loaded heavier — 15–25 kg depending on your size and strength. Runners are often surprised how much they can handle here.
- If a gym is available, a Smith machine or dumbbells at your sides work beautifully.
Weeks 9–12: Consolidation.
- Alternate between the 8-rep and 6-rep schemes across the week.
- Start reintroducing running (if you paused it) or increasing volume (if you kept a small amount going).
- Keep the heel raises going as maintenance — twice a week is enough by this stage.
By week 12, most people I coach are either fully back to their normal training or very close to it. Some need 16 weeks. A few need to also address footwear, running form, or work standing habits. Nobody I have seen commit to this protocol properly has come out the other end worse.
The "backpack of books" question
Nine out of ten people ask me the same thing: do I really need a gym?
No. A backpack works. Here is how to load it sensibly:
- Hardcover books wrapped in a towel so they do not slide around
- Sealed water bottles (1 kg per litre, easy math)
- A sack of rice or flour laid flat against your back
- Weight plates if you have them, but really — a backpack is fine
Wear it high on your shoulders, close to the body, chest strap done up if it has one. The load should sit above your hips, not slung low. You want vertical load through the foot, not a pendulum swinging behind you.
If you cannot balance on a single leg yet, start with two-legged raises on the step (same tempo, same towel-under-toes setup), and progress to single-leg as soon as you can hold it without wobbling.
The morning pain — what actually helps in the meantime
The first-step-out-of-bed pain is what makes this condition so miserable. Rehab takes weeks. You need something for tomorrow morning.
Three things that genuinely help while you are building strength:
1. Toe curls and toe spreads in bed, before you stand up. Thirty seconds. Wakes up the foot musculature and pre-tensions the fascia gently before you weight-bear.
2. Do not walk barefoot on hard floors first thing. This is where slippers with proper structure matter more than people realise. Not floppy hotel slippers — something with actual support underfoot. Our HYKLE Slippers were designed with this exact use case in mind (Joseph left a review saying his plantar fasciitis was "almost gone after just two weeks of wearing them" — I do not promise that to anyone, but the principle is right: your foot needs support the moment it hits the floor, not once you have already limped to the coffee machine).
3. Supportive daily footwear. Whatever you wear for eight or ten hours a day matters more than any single rehab exercise. If your work shoes are flat, dead, or older than your last passport, that is undoing your evening rehab work every single day.
For people who need serious daily support — nurses, teachers, warehouse workers, anyone on concrete — a well-designed orthotic insole inside a proper shoe changes the game. Our HYKLE Impact Pro insoles were designed for exactly that scenario. I trust the feedback we get on them — one of our customers, Gary, wrote that between high arches and right-foot plantar fasciitis they were "nothing short of amazing" for him.
That said: insoles are the surrounding infrastructure. The strength work is still the therapy. Do not swap one for the other.
What about running through it?
The honest answer: mostly yes, with modifications.
Complete rest is rarely necessary or helpful. What you want is to reduce the load while you rebuild capacity.
- Cut weekly volume by 30–50% in the first month
- Drop the hardest sessions (long runs, hill repeats, fast tempo) temporarily
- Keep easy running on soft surfaces if available
- Sanity-check your pain 24 hours after a run. If it is worse the next morning than baseline, you did too much
I have gone through my own version of this. Two winters ago, right before an early-season orienteering event in the Rhodope Mountains, I felt that classic pin-prick under my left heel getting up from the sofa one Sunday evening. I knew instantly what it was, and I knew instantly what I had done wrong (a summer of sandals, followed by a very abrupt trail block). I ran the heel-raise protocol religiously for ten weeks alongside reduced training volume. I made the race. Not my fastest, but healthy, which is the version of me my husband Deso prefers to drive home.
More on how to rebuild after any setback here: Restarting Training After a Setback: A Physio's Honest Framework.
The autumn-specific reasons this is the moment
A few reasons autumn is the sweet spot for starting this protocol:
Racing pressure is lower. Most northern-hemisphere runners are between seasons — a spring marathon or ultra is far enough away that 12 weeks of focused rehab does not derail anything.
Footwear transitions happen now. People shift from summer sandals and flip-flops into proper shoes. If you can build the fascia's strength while also going back into supportive footwear, you get a compounding effect.
Standing time creeps up. Colder weather means more time indoors on hard kitchen floors — cooking, baking, hosting. That surface exposure catches a lot of people out.
The "new year's resolution" runner is still four months away. If you start now, you finish the block before that population floods every gym and trail in January. Selfish physio advice, but real.
Common mistakes I see
- Skipping the towel. Whole point of the exercise. Do not do this.
- Rushing the tempo. Three seconds up, two seconds hold, three seconds down. If you cannot count it, count out loud. Ego wants to move faster; tissue remodels slower.
- Going daily instead of every other day. The tissue needs the rest day to adapt. More is not better here.
- Loading too heavy too soon. Weeks 1–2 are truly bodyweight. Do not start the backpack until week three.
- Quitting at week 4 because it feels better. Feeling better at week 4 is normal. Stopping at week 4 is why the pain comes back in six weeks. Finish the block.
- Ignoring the rest of life. Rehab happens in one hour a week. What happens in the other 167 hours — your shoes, your standing surface, your training load, your sleep — matters more.
When to actually see someone in person
Ninety percent of straightforward plantar fasciitis responds to the protocol above plus sensible footwear and load management. But some cases are not straightforward, and pretending otherwise is dishonest.
See a physiotherapist or podiatrist in person if:
- Pain is not better after 6–8 weeks of consistent, correctly-performed rehab
- You have numbness or tingling into the foot (may not be plantar fascia at all)
- The heel bone itself is exquisitely tender to touch (rule out stress reaction)
- Your gait has visibly changed and it is affecting the other leg, knee, or hip
Rehab protocols on the internet — including this one — are a starting point, not a diagnosis.
The short version
- Single-leg heel raise on a step, towel under the toes for dorsiflexion
- 3 seconds up, 2 second hold, 3 seconds down
- Every other day
- Progress bodyweight → backpack → heavier backpack over 12 weeks
- Sort your daily footwear out at the same time
- Do not stop at week 4 just because it feels better
This is one of those rare situations in rehab where the boring answer is also the best one. No gadgets, no injections, no miracle insole (though a good insole helps). Just heavy, slow, patient loading of a tissue that had been asking for it. Give it the autumn. Your winter self will thank you.