Plantar fasciitis is a common condition of the foot causing pain, stiffness, and changes in gait. The term “plantar fasciitis” refers to an inflammation in the fascia found along the bottom, or plantar surface, of the foot. Symptoms are often markedly worse with the first few steps of the day and tend to somewhat diminish as the foot loosens through the day. Sometimes, foot discomfort starts gradually and works itself out, but in many cases, symptoms become progressively worse until it impacts activities of daily living –walking, standing, driving, and sports to name a few.
There are several causative factors including a change in activity, improper footwear, muscular tightness, or even just a biomechanical predisposition to the syndrome. No matter the cause, there are effective interventions that can help treat and prevent plantar fasciitis-related foot pain.
In this article, we will discuss physical therapy for plantar fasciitis. By becoming familiar with different exercises and stretches, perhaps you can avoid this uncomfortable condition that affects thousands of people every day.
What Does Plantar Fasciitis Feel Like?
Pain from plantar fasciitis tends to present in the bottom of the heel or in the arch of the foot and can range from dull and achy, to sharp and stabbing. Often the pain is worse in the morning, or after a period of inactivity, and tends to gradually lessen with walking around. It’s a fine balance, however, because as activity continues to increase, pain can return.
What Causes Plantar Fasciitis?
There is not one single cause for plantar fasciitis. Anything that causes excessive stress to the fascia can contribute to the development of symptoms. Excessive running, walking, or even standing can add stress to the plantar structures in the foot, and lead to plantar fasciitis. People with high arches, or flat feet may also be more prone to plantar fasciitis symptoms. A common cause is having tight calf muscles. Tight calves impact ankle range of motion resulting in added strain to the plantar fascia when a person walks. In some cases, a change in activity may contribute to plantar fasciitis. For instance, if you recently just started running again after a long break, the sudden increase in activity may add excess stress to the structures in your foot and lead to plantar fasciitis. Pregnant women are also more at risk for plantar fasciitis, both from changes in their ligamentous structures and from the added weight that can increase stress forces through the foot. In fact, weight gain in general increases the likelihood of developing foot and heel pain commonly felt in plantar fasciitis. Although there are many causes to this condition, the treatment tends to include several benchmark exercises and stretches that aim to improve foot flexibility and strength.
What is Physical Therapy for Plantar Fasciitis?
There are several stretches and exercises Physical Therapists often prescribe that are effective in helping to treat plantar fasciitis. These movements are all geared towards keeping the foot and lower leg stretched and strong, so regular performance may help keep foot pain to a minimum.
Here are some stretches and exercises to try:
A calf stretch is a routine aspect of any plantar fasciitis treatment plan. For good measure, perform this on both sides.
- Find a sturdy wall and stand an arm’s length away from it.
- Place hands on the wall and separate feet in a lunge style position.
- Make sure that the toes are pointing forward & bend the front knee while keeping the back foot/heel flat on the floor.
- Making sure the back knee is straight, lean forward until you feel a stretch in the back of the calf. Hold for 30 seconds, no bouncing, and repeat 2-3 times alternating on each side.
Towel Pick Up
To strengthen the small, integral muscles of the foot, an exercise called the “towel pick up” can improve your exercise regimen. For this exercise, you will need a chair and a small size towel or large washcloth.
- Sit with your knees bent to 90 degrees and your feet flat on the floor.
- Place a small towel under one or both of your feet.
- By making a curling motion with your toes, grab the towel with your toes to scrunch up the towel, even holding on enough to pick it up if you can.
- Repeat this towel pick up routine 5-10 times on each foot.
Don’t be surprised if the small foot muscles feel a little tired. This may seem easy, but really puts your foot to work!
Seated Plantar Fascia Stretch
This stretch is great to help relieve tightness along the plantar fascia. You may want to perform this after the towel pick-up when your muscles feel fatigued.
- Sit with one ankle crossed over the opposite knee so that you have access to your foot and toes.
- With your right hand on your right foot (or left on left) gently bend the ankle so that the toes move backward, paying special attention to the big toe.
- Apply extra pressure at the big toe to flex it back as far as it can, creating a focused stretch right along the arch of the foot.
- Hold this for 20-30 seconds, and repeat 3 times, then again on the opposite foot.
Standing Heel Raises
Not only do you want to make sure your calf is flexible, but also strong. This will help to reduce unnecessary strain along the plantar fascia when you participate in activities such as walking, running, and jumping. For this exercise, you will need a step or staircase.
- Stand on the bottom step, holding on to walls or railings for stability.
- Move feet towards the edge of the step until the heels drop off the edge.
- Keeping the knees straight, reach heels towards the floor
- Perform 10 heel raises, contracting the calf muscles so that you are moving your body up and down on the ball of your foot.
Finally, foot rolling can help to loosen up the foot muscles and bring some relief. For this exercise, you need a chair, and something to roll your foot over (ie. foam roller, lacrosse ball, or tennis ball).
- In sitting, place the arch of the foot over the ball (or foam roller), and roll your foot back and forth repetitively over the tender fascia areas.
- You may also use a frozen water bottle, or an iced cold can as the “roller” component of this exercise to create a cooling sensation to the foot that can help with pain and inflammation.
- Repeat this as needed for pain relief.
Staying on the Right Foot
If you or someone you know is experiencing plantar fasciitis symptoms consider the above exercises as a way to provide relief. If pain is persisting or worsening, it is recommended that you contact your local Physical Therapist for a more in-depth evaluation and treatment plan. If you’re looking for Physical Therapy in Brooklyn, NY, give us a call or reach out to us using the form below.