Plantar fasciitis is one of the most limiting orthopedic conditions of the foot, commonly causing severe heel pain. It is defined by inflammation of the plantar fascia, a tough, fibrous tissue that runs from the toes to the base of the heel, and its surrounding fascial structures. The plantar fascia itself is a passive structure with its main job to help support the arch of the foot while in a weight-bearing position. It becomes increasingly taut as a person bears weight and transitions to pushing off the ball of their foot. With repetitive, excessive loading and tension however the plantar fascia can develop microtears and become inflamed. Risk factors for developing plantar fasciitis include increased body weight, tendency for flat feet (overpronation), a sudden increase in the length or intensity of an activity, and decreased calf flexibility. The most common symptom of plantar fasciitis is a stabbing pain on the underside of the heel, and a sensation of tightness and/or tenderness along your arch. The pain is typically worse first thing in the morning, after periods of inactivity, after climbing stairs or periods of increased weight-bearing activity, or after walking barefoot or in shoes with poor arch support.
Although it can be a nagging condition, research shows that 90% of diagnosed plantar fasciitis cases improve over a period of 6-12 months with conservative treatment. Surgery is rarely required. Stretching the calf complex, strengthening small, intrinsic muscles which support the arch of the foot, and improving ankle/big toe mobility are some key treatment areas commonly targeted. The following are 6 recommended exercises that can easily be performed at home:
Calf stretch off step- Begin in a standing upright position on a step. Place the front of one foot on the edge of the step. Slowly let your heel drop toward the floor until you feel a stretch in the back of your calf. Hold this position for 30 sec- 1 min, 3 times. Make sure to keep your knee straight and maintain an upright posture during the exercise.
Calf stretch at wall with knee bent- Begin in a standing upright position in front of a wall. Place your hands on the wall and extend one leg backward with your knee bent. Lean forward into the wall, until you feel a stretch in your lower calf. Hold this position for 30 sec- 1 min. Perform 3 times.
Seated ankle dorsiflexion stretch- Begin by sitting upright in a chair with your feet positioned shoulder width apart with one foot forward. Keeping both feet flat on the floor, move your other foot back until you feel a gentle stretch across the front of your ankle. Make sure to keep your foot on the floor and pointing straight forward. Hold this position for 3 sec, 10 reps.
Seated plantar fascia stretch- Begin sitting in a chair with one leg crossed over your other knee. Use one hand to hold your ankle, and the other to hold your toes. Gently pull your toes backward until you feel a stretch in the bottom of your foot and hold, placing the most attention on your great toe. Make sure to keep the stretch slow and controlled. Hold 30 sec- 1 min. Perform 3 times.
Toe Yoga- Begin sitting upright in a chair with your feet resting flat on the floor. Remove the shoe on your affected foot. Lift your big toe straight up, keeping your other toes flat on the ground. Then, keeping your big toe on the ground, lift your four smaller toes up into the air. Pause, then return to the starting position. Repeat. Make sure to keep the muscles in the arch of your foot active during the exercise. Make sure not to dig your toes into the ground to complete the motion. Perform 10 reps of each.
Seated arch lifts- Begin sitting upright in a chair with your feet flat on the ground. Lift up the arch of your foot, keeping your toes and heels in contact with the ground. Make sure to avoid gripping with your toes and do not press your ankles outward. Perform 20 reps.
If you are dealing with plantar fasciitis, give these a try! Exercises however are often just a small piece, and a full evaluation is always recommended. Our physical therapists can develop an individualized program, including manual treatments, full kinetic chain strengthening, gait training, dry needling, and further education/footwear recommendations. Call 757-578-2958 or visit our website to book a PT for plantar fasciitis appointment and let Restorative Therapy Co help you Feel Well and Be Well!
Contributed By Dr. Kirkland Tucker, PT, DPT
Restorative Therapy Co