Plantar Fasciitis Stretches to “Heel” Your Pain

Plantar fasciitis is the most common cause of heel pain in both athletes and older adults.  It is characterized by degenerative changes in the plantar fascia of the foot.  The plantar fascia is a thick band of ligament which supports the arch of the foot.  The most common symptom of plantar fasciitis is heel pain during the first few steps of walking.  The disorder affects 10% of the population at some time in life.  Two million Americans are treated for plantar fasciitis every year.  Plantar fasciitis stretches are one effective form of conservative treatment.

Deficits in the lower leg and foot muscle strength contribute to the development of this condition.  However, research has found inconsistent results when treatment includes strengthening exercises only.  Plantar fascia stretches have been proven to be more useful for helping people with plantar fasciitis.   The remainder of this article discusses how people can alleviate pain from plantar fasciitis through regular stretching.

Plantar Fasciitis Stretches

A 2016 study performed in Brazil compared the effects of 3 different treatment approaches.  One group performed stretching exercises alone.  Another group performed stretching plus strengthening exercises for the foot.  The third group performed stretching plus strengthening for the foot and hips.   All 3 groups showed significant improvements in pain and function after 8 weeks of treatment.  However, there were no differences between groups.  This suggests adding strengthening exercises to a program of stretches confers no additional benefit.  The principle improvements occur due to regular stretching of the plantar fascia and calf muscle.

Seated Plantar Fascia Stretch

This exercise should be performed first thing in the morning before stepping out of bed.  Sit on the side of the bed with the leg to be stretched crossed over the other.  Grasp the heel with one hand.  Grasp the toes with the other hand.  Pull the toes back towards the top of the foot until a mild to moderate stretch is felt in the bottom of the foot.  Hold this stretch for 30 seconds and perform 3 repetitions.

Calf Muscle Stretch

The plantar fascia tissue is continuous with the Achilles tendon and calf muscle complex.  Therefore stretching should be directed towards both of these areas.   Stand with the affected foot back.  The heel remains in contact with the floor as you lean towards the wall or a counter.  The knee remains straight to stretch the larger gastrocnemius muscle.  Slightly bend the knee to stretch the deeper soleus muscle.  It is important to stretch both muscles.  Hold each stretch for 30 seconds and perform 3 repetitions.

High-Load Heel Raises

This exercise is a hybrid stretching and strengthening exercises.  It utilizes the higher-load of your body weight to stretch the plantar fascia and provide a stimulus for the tissue to become stronger. This exercise is more effective for people who have been experiencing heel pain for 3 months or longer.   Expect some pain initially when performing this exercise.

Stand with both feet on a step and the heels hanging off the edge.  Place a small towel roll under the toes to help provide a stretch to the plantar fascia.  Rise up onto both toes over a period of approximately 3 seconds.  Remove the unaffected foot from the step once at the top of the movement.  Hold this position for 2 seconds.  Slowly lower the affected heel over a period of approximately 3 seconds.  Place the unaffected foot back on the step and repeat the sequence.  Typically 3 sets of 12 repetitions are performed every other day.  The exercise is progressed by incorporating a back pain with weights.

Closing Thoughts

It is common for plantar fasciitis to last up to one year.  Thankfully, performing regular plantar fascia stretches can alleviate pain and speed up your recovery.  If you are experiencing heel pain, start with these 3 stretches.  Perform the first 2 daily, and the high-load heel raises every other day.   Your physical therapist can also design an individualized exercise program tailored to your unique goals.  Give us a call if you need some help.

References

  1. Kamonseki DH, Goncalves GA, Yi LC, Lombardi Junior I. Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: A randomized controlled single-blind clinical trial. Man Ther. 2016;23:76-82.
  2. Rathleff MS, Fredberg U, Kaalund S, et al. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2015;25(3):292-300.

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