How To Fix Plantar Fasciitis Exercises

What is Plantar Fasciitis?

The name plantar fasciitis is somewhat of a misnomer. Typically, the suffix “itis” tells us that something is inflamed. Like tendonitis or tonsillitis. When it comes to the plantar fascia, though, that’s just not the case.

The root of this condition is a failure of the plantar fascia to tolerate load placed on the plantar fascia, leading to pain. This overload is often secondary to a misappropriation of forces due to limitations in mobility or strength at the foot, ankle or higher up the chain.

So the goals for treating it are to manage symptoms, increase tolerance to load and minimize excess load during activity.

In general, there are two subsets of people that tend to be more prone to developing this type of pain. The first are individuals dealing with obesity. This excess weight increases the stress and demand on the plantar fascia.

The other group would be active individuals who participate in activities that create repetitive foot impact such as distance running, dance or frequent jumping.

You might be asking, well I have pain in my heel but I’m not sure if it’s plantar fasciitis…

One of the hallmark signs of this condition is first step pain.

Picture this, you wake up in the morning, feeling rested, birds are chirping, coffee is brewing, and the sun is shining. You roll those sheets off of you, scoot to the edge of the bed, stretch your arms to the heavens, put your feet on the floor and then.. BOOM.. searing pain to the bottom of heel as soon as you stand up or take those first couple steps.

It may or may not be that dramatic and it can also occur after a period of prolonged sitting.

Sound familiar?

Morning Stretch

One thing you can do before you get out of bed to decrease the pain with those first steps is to apply a stretch to the plantar fascia. This tissue is so robust that you’re not looking for a change in length over time, rather, you’re priming it to accept load.

To do this you want to first lock your ankle in dorsiflexion and hold it there. Next you’ll want to extend your big toe towards the top of your foot. You’ll feel a pull in the bottom of the foot, maybe in the heel and maybe even higher up in the calf. The plantar fascia actually attaches to the achilles tendon, making them intimately related. This is one reason why tightness in the calf can be a factor in someone developing plantar fasciitis. So go ahead and do about 20-30 of these each morning. You can’t really overdo it so I wouldn’t worry about doing too many. This is also a good exercise to do after you’ve been sitting for an hour or so and that fascia has gotten a chance to tighten back up.

Once you’re done here and ready to get up, the next exercise will be a calf stretch. And this might be one of the few times you will ever… ever see us recommend a passive stretch for pain relief. But, if you have a tight achilles and tight calves, then to some degree, your body is placing extra load on the plantar fascia.

Calf Stretch

I like to do this one in 2 different ways. One passive and one more dynamic. We’re going to do this stretch in a lunge position. So head over to a wall or something sturdy. You’ll want the foot that you're stretching in the back and the other foot a few inches from the wall. Lunge forward as far as you can while keeping your back leg straight and also keeping your heel down. You should feel a strong pull in the back of the calf.

The variation to this is to take your front leg and move it across your body. This changes the position of the foot in the back. You should almost feel your weight shift to the outside and the stretch might change some. You can add in continuous leg movements to turn this static stretch into something a bit more dynamic and functional.

The third exercise is where you will find your long term benefits. The first two are excellent for short term pain modulation, getting you through the day, but then what? We mentioned one of the main causes of plantar fasciitis is the inability of the plantar fascia to tolerate load. So now we need to start building up that load tolerance.

Calf Raise

So, to start off you won’t need any equipment other than a towel but eventually you will need a stool or step.

For the base variation you’ll want to lay a rolled up towel on the floor. Place your toes on the towel. Then press up into a calf raise. The towel ensures that your big toe moves back into extension during the exercise, this allows for a better load to the plantar fascia.

It’s important to maximize time under tension, so I would recommend at least a 3 second count both while raising and lowering. Make sure you’re not pressing your toes into the ground, preventing that full extension from occurring. Shoot for about 20 repetitions here.

Eventually you’ll want to progress to single leg. You can start by simply raising up on both toes, removing a leg and then coming down on just one. And then repeat the process. Once you’re good with this, you can progress to raising and lowering on just one leg.

The next progression is to perform the same exercise but from an elevated surface. All of the previous rules apply. For this one you’ll want to ensure the towel is close to the edge of the box and when you lower, let your heel sink below the box. If you think about it, this places your foot in the same position as the morning stretch, with both the toes and ankles extended. You can progress this variation the same way, from double limb, to single limb.

The best way to prevent plantar fasciitis from returning is to keep loading your calves, maintain lower body mobility and strengthen your glutes in all 3 planes.

Sometimes, when conditions become too chronic, you need a little help getting over the first hump. If these three exercises don’t help to relieve your symptoms, shoot us a message. If you’re in the Phoenix metro area, give us a call, we would love to help you get back to your sport or activity.