PLANTAR FASCIITIS PHYSICAL THERAPY TO REDUCE HEEL PAIN

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Published:  April 8, 2022
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Reviewed and contributions made by Diane Gordan, PT, DPT, OCS, CSCS

Imagine that there’s a rubber band stretched across the bottom of your foot from your heel to your toes. This rubber band is a ligament called the plantar fascia, and it supports the arch of your foot.

Now imagine a stabbing pain on the bottom of your foot or a strong ache in your heel. After some testing and diagnosing, a doctor may tell you that you have plantar fasciitis. Any kind of “-itis” may sound overwhelming, but in this case, “fasciitis” simply means that the rubber band is inflamed. It also means you may need treatment to help you feel good on your feet again.


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What are the Symptoms of Plantar Fasciitis?

Heel pain is the most common symptom of plantar fasciitis and it becomes evident in the following settings:

  • The pain starts in the morning and then progresses as the day goes on.
  • You experience pain after standing for long periods.
  • Your pain worsens when climbing stairs or standing on your toes.

While heel pain is the primary sign, it is still important to get a doctor’s opinion. A doctor will typically diagnose you after a short exam. If any imaging is necessary, like an X-ray, it’s usually to rule out other causes or abnormalities such as a fracture.

What Causes Plantar Fasciitis?

The plantar fascia supports the arch of your foot and, as a result, absorbs the impact of your steps when you walk. For many, this impact is normal. For some, this impact can become excessive, especially when paired with lots of standing, high-intensity activity like running, or pre-existing foot conditions like flat feet.

Plantar Fasciitis occurs when then the fascia is repeatedly stretched or torn and may be the result of:

  • Continually standing for long periods of time on the job or at home
  • Frequently wearing shoes without appropriate cushioning (e.g., flip flops, flats, high heels, etc.)
  • Overuse from too much exercise, particularly running, jumping, and/or walking
  • Aging
  • Obesity
  • Regularly walking barefoot on hard surfaces

Individuals can prevent developing plantar fasciitis by counteracting many of these risk factors.

For example, the solution can be as simple as wearing shoes with cushioned heels, maintaining your weight, or taking extra time to stretch before exercising. However, if you have already been diagnosed with plantar fasciitis know that there are several options to relieve pain.

How is Plantar Fasciitis Treated?

Plantar fasciitis is a condition that will generally heal all on its own given enough time. Unfortunately, the timeline varies greatly between individuals based on the severity of the issue, ranging between several weeks to several months.

Once diagnosed, doctors may prescribe over-the-counter pain relievers to assist with inflammation, icing, rest and avoiding activities that aggravate the area. Depending on the seriousness of the condition, they might also suggest using special devices like night splints, orthotics, or a walking boot to help relieve symptoms.

More than likely, they will encourage patients to seek physical therapy for plantar fasciitis to reduce pain and treat the root cause. Physical therapy for plantar fasciitis is one of the best ways to address the underlying issues that cause the condition in the first place.

Physical Therapy Exercises for Plantar Fasciitis?

When it comes to physical therapy for plantar fasciitis, they can be broken up into two primary categories: stretching and strengthening exercises. It’s important to consider a combination of both types to maximize their effectiveness and improve the mechanics of your foot.

Top 3 Physical Therapy Exercises for Plantar Fasciitis

Calf Stretch (aka Gastroc Stretch) 

The Calf Stretch is more formally known as the Gastrocnemius Stretch, or Gastroc Stretch for short. It is one of the best stretches you do for plantar fasciitis.

Instructions

  1. Stand with your hands placed against a wall. The foot affected by plantar fasciitis should be placed back with the other foot forward in a slight lunge position.
  2. Push towards the wall, keeping your back calf straight and your heel against the ground.
  3. Hold this position for thirty seconds and then release. Complete the stretch three times.
  4. Do this stretch two to three times per day.

The Soleus Stretch

The Soleus Stretch is like the Calf Stretch with one distinct change – a slight bend in the back knee. The slight bend in the knee allows the stretch to be felt closer to the Achilles tendon. When paired with the Calf Stretch, the calf becomes more flexible and overall mechanics are improved.

Instructions

  1. Stand with your hands placed against a wall. The foot affected by plantar fasciitis should be placed back and the other foot is forward in a slightly bent position.
  2. Push towards the wall, now with a slight bend in the back knee and your heel against the ground.
  3. Hold this position for thirty seconds and then release. Complete the stretch three times.
  4. Do this stretch two to three times per day.

Plantar Fascia Stretch

One of the most common physical therapy exercises for plantar fasciitis is simply called the Plantar Fascia Stretch.

Instructions

  1. To do this stretch, position your foot on the edge of an elevated surface like a stair or a yoga block.
  2. Let the ball of your foot bear all your weight and drop your heel to the floor. You should feel the stretch from the bottom of your foot up into the middle of your calf.
  3. Hold the stretch for thirty seconds and repeat three times.
  4. Do this stretch two to three times per day.
Top 3 Strengthening Exercises for Plantar Fasciitis

Single-Leg Toe Curl

For this exercise, you will need a towel.

Instructions

  1. Spread the towel out on the floor and stand with your affected foot on it.
  2. Begin curling your toes and slowly bunch the towel up.
  3. Repeat these exercises three to five times, twice a day.

Marble Pickups 

This exercise requires marbles (or something small of comparable size) and a cup.

Instructions 

  1. Spread the marbles out on the floor near the cup.
  2. Use your toes to pick up the marbles and put them in the cup.

Side Lying Hip Abduction

The Side Lying Hip Abduction is a great way to strengthen your gluteus medius. This muscle group helps stabilize your pelvis, which keeps the knee from moving inward and the foot from overpronating. As a result, the gluteus medius can help absorb impact and reduce stress on your legs and feet.

Instructions

  1. Lie on your side with your hips stacked upon each other. Your top leg should be straight and your bottom leg and arm bent for support underneath.
  2. Lift your top leg to just beyond hip level (about eight inches) and hold for five seconds before lowering the leg.
  3. Complete this exercise two sets with ten repetitions on each leg.

NOTE: When performing this exercise, be careful of allowing your hips to rotate forward or backward so that your body remains in alignment.

As mentioned above, rest is oftentimes prescribed to treat plantar fasciitis in combination with plantar fasciitis physical therapy. This “relative rest” replaces activities that might aggravate the plantar fascia for ones that align with your treatment plan. These activities may include plantar fasciitis physical therapy treatments and low-impact workouts.

Low-Impact Exercise for Heel Pain

Stretching and strengthening may not be enough for you, especially if you’re an athlete that’s used to more rigorous or intense movement and activity. It is possible to exercise with plantar fasciitis, if you are focusing on low-impact options like swimming, cycling, yoga, Pilates and weight training.

While it may be difficult to take a break from your regular workout routine, these options can help keep you moving while your body is recovering. Plus, they offer a wide range of health benefits. Swimming and cycling are great ways to improve your endurance; yoga and Pilates can help increase your flexibility; and weight training can help you continually build strength.

Whatever option you choose, it is important to remember to stretch your calves and feet before exercising. The stretches and exercises for heel pain described above are a great way to ensure the muscles are loose and ready to work. Plus, the combination of  plantar fasciitis physical therapy treatment and low-impact exercise can not only improve your plantar fasciitis but also your overall health.

Seeking Plantar Fasciitis Physical Therapy

Rest and stretching are proven treatments for plantar fasciitis. In fact, physical therapy for plantar fasciitis has been proven effective at reducing pain and alleviating symptoms. Not only that, but these exercises for heel pain are not just treatments after you’ve been diagnosed. They’re also great preventative measures to ensure your feet are as healthy as possible.

Let us be a part of your health journey! Visit our website to learn more about ATI’s PT for plantar fasciitis and to find a physical therapist near you.