Say Goodbye to Plantar Fasciitis: Exercises to Get You Out of Pain
Plantar fasciitis is the worst! If you've experienced it, you know it. It is literally the biggest pain in the... heel, and it never seems to go away! You've probably rolled the bottom of your foot on every lacrosse ball and frozen water bottle you can find, bought special socks, night splits, and footwear but you still have pain! All those things can help with some mild relief. But until you understand and address the cause of your pain, you are likely to remain stuck in this cycle.
Despite how bad it feels, there are ways that you can successfully address your pain and get out of this seemingly never ending cycle. By taking a proactive approach to self-care, individuals with plantar fasciitis can find relief and get back to doing things they enjoy!
What is Plantar Fasciitis?
Plantar fasciitis is a common and often debilitating condition that affects the foot, causing pain and discomfort. The plantar fascia, a thick band of tissue that connects the heel bone to the toes, becomes inflamed and can lead to intense pain, especially with the first steps in the morning or after periods of rest. While it may seem like the pain came on suddenly, it is often the result of underlying repetitive stress or strain on the foot that has occurred over time and is just now showing itself.
How do I know that I have plantar fasciitis?
Common symptoms of plantar fasciitis include:
- Pain on the inside edge of your heel, most commonly experienced with the first step out of bed in the morning or after being off your feet for a long period of time
- Pain the inside edge of your arch closer to your heel
- Increased bony deposits (bone spur) at the base of your heel where the plantar fascia inserts
- Your pain in that area will likely increase with weight bearing or pounding activities
Why do I have plantar fasciitis?
Like I mentioned above, this is commonly something that didn't happen overnight. It is largely due to long term stress and breakdown that has occurred at that foot/ankle complex over time. Some factors can include:
- Significant change or increase in activity, especially after a long period of less or no activity. Whether it's that you are going from the couch to doing a 5k, quickly ramping up mileage, experiencing an abrupt change in surfaces you are running on, adding a significant amount of inclines/declines in your run, or simply standing on your feet for longer periods of time, etc. The body, especially your feet, doesn't like change, and this increase and change in stress can cause wear and tear to the tissues in your foot.
- Loss of range of motion at your ankle. Whether this was due to an injury or decreased mobility you have acquired overtime, when your ankle doesn't bent and flex the way it is intended to, it increases the stress on your foot and its tissues that are working to produce and absorb force.
- Decreased foot strength. Our feet are built with essentially the same bones and muscles that your hands have. Think about how mobile and adaptable your hands are, now look at your feet. Many people with foot pain will tell you their feet look and function like pancakes. Most of us were not born with pancakes for feet, it's something we have acquired over time. Shoes, despite the fact that they help us do all the things we love, also de-train our feet because our feet learn to rely on the shoe to do the job and they start to lose their natural strength. Check out this great video where Dr. Sydney breaks down why you need good foot strength and what that should look like:
- Previous lower extremity injury or altered movement patterns. Often when we get injured, we lose strength and preferred movement patterns, which affects things up and down the chain and causes our body to compensate. When we have strength/movement that is compromised in our leg, the ball literally rolls downhill, the stresses get diverted down the chain and our foot/ankle take the brunt of the load. Increased stress = increased wear and tear!
I'm in pain when I move, and you're saying that exercise will help me feel better?
In one direct answer, yes! Research strongly shows that over 90% of people diagnosed with plantar fasciitis will recover in 6-12 months with conservative treatment (meaning physical therapy). Yes, that's a while, but if your foot has been breaking down for some time, it takes a while to build it back up.
The correct selection of exercises can have an analgesic (pain reducing) effect on the plantar fascia, improve your movement quality at your/foot ankle complex, as well as strengthen the involved area which stimulates the tissue to essentially rebuild. This will allow your plantar fascia to tolerate more stress again and ultimately get you back to normal activity.
Exercises for Plantar Fasciitis
Treating plantar fasciitis is more than just rolling your feet and stretching. Because so much happens at the foot/ankle complex, treating plantar fasciitis must have a comprehensive approach. It needs to include pain reducing exercises, mobility, foot and lower extremity strength, and much more!
Pain reducing exercises:
There are exercises than can reduce my pain? Yes! Plantar fasciitis is essentially a tendinopathy (like tennis elbow, jumpers knee, etc.) where the tendon responds well to long holds to warm up and engage the tendon complex before it moves. Isometric (or long hold exercises) have been found to reduce discomfort for up to 45 minutes! This movement/contraction is held for 5 sets of 45 second holds before and after activity to decrease discomfort!
Mobility exercises for plantar fasciitis:
Decreased mobility in your foot and ankle complex are often found in people who suffer from plantar fasciitis. Starting at as low as your big toe and working up through your calf should be assessed and mobilized depending on what your physical therapist finds. The more you can decrease tension on the plantar fascia and improve how your ankle moves the better! Give these mobility exercises a try!
Seated Plantar Fascia Stretch
Great Toe Mobility and Strength
1/2 Kneeling Ankle Mobility
Straight Leg Calf Stretch
Strength Exercises for Plantar Fasciitis
Working on strength from the ground up is a big part of the blueprint to address the causes of plantar fasciitis. Earlier in this post we discussed the decrease in foot strength that is commonly acquired over time. So, the first thing we do is re-educate the foot muscles to contract, grip and engage with the ground!
Arch Strengthening Exercises
Foot and Ankle Strength
Oftentimes, patients with plantar fasciitis have decreased strength in the details of how our foot and ankle are meant to function. Give this exercise a try to re-introduce some of some of those details in an easy way. Perform this exercise at a slower cadence. 2-3 seconds up and down, to help the tendon respond the best to this exercise.
Hip Strength Exercises for Plantar Fasciitis
Wait, did you just say hip strength for a foot pain problem?? Yes, I did. When we get a mechanical breakdown of our form, that increases stress at the foot. So, we need to travel up the chain to address strength that contributes to how you move. There are a million great hip strength exercises, but here's a good one to start with!
Heavy Lifting for Plantar Fasciitis
Ok, you first asked me to do hip strength for foot pain, now you want me to lift heavy?!? Yes, that is correct. No, I am not crazy. Lifting heavy under the correct parameters is what causes the tissue to remodel. Under the proper direction of a physical therapist, you should be doing various calf strength exercises holding heavy weight. This will cause the tendon to remodel and get stronger to rebuild its ability to tolerate activity. This is truly the key to fixing and closing the door on your plantar fasciitis!
Plyometrics for Plantar Fasciitis
Lifting heavy...now you want me to jump?!? Yes, I do. Often one of the driving causes of plantar fasciitis is decreased tolerance to jumping/pounding activities. So, after you have worked hard to re-build your strength, you need to help your body apply it to those jumping/pounding needs before you do them on your own. Something as simple as short bouts of hopping (like pogos) is a great starting point to progress your foot's tolerance for jumping/pounding activities. This is just a common starting point. But it's important to bring the whole picture back together before you hit the ground, quite literally, running!
What About Footwear For Plantar Fasciitis?
We are a clinic that is largely rooted in exercise. However, there are certain times in which orthotics could be indicated to help manage plantar fasciitis, but you should consult your physical therapist first. Along those lines, having the proper footwear is a must. Shoes influence how your feet move, absorb and produce force. Having the right shoe for you is incredibly important. We suggest consulting with your physical therapist for what type of shoe you might need, as well as going to your local running store to be properly fit for the correct shoe.
Soft Tissue Care for Plantar Fasciitis
There are a plethora of different balls, rollers, etc. out there to "roll out your plantar fascia." These tools do not really change your tissue, but it does help desensitize the area. Ultimately, if it helps you feel better, then it's a tool for you. However, I always caution that if you have an acute irritation and inflammation response, sometimes digging harder in that area might garner more of the same response. A physical therapist might have manual techniques between massage, dry needling, mobilizations, etc. to help decrease your pain and positively effect your foot and ankle based on their findings.
Take Control of Your Plantar Fasciitis Today
Like I said above, treating plantar fasciitis is much more complex than just rolling out and stretching your foot. However, if you stay the course and implement our strategies and exercises discussed here, 90% of patients get better in 6-12 months! So hang in there. It is a process, but when done correctly, it can be very successful!
If you are not having success on your own, we find that the best results are experienced when you are assessed and treated for your specific needs by a Doctor of Physical Therapy.
If you are in pain and need support, we are here to help you understand what is causing your pain, get you out of pain and get back to the things you love pain-free. If you would like to learn more, call us to book an injury consultation call or a visit with one of our Doctors of Physical Therapy today!