Plantar fasciitis is a pretty common condition that a lot of people deal with. It is characterized by pain on the plantar, or bottom, surface of the heel, and mainly at a point called the medial calcaneal tubercle. Now, although this point is the most common site of pain, the pain can also radiate up into the sole or the arch of the foot, and even up near the toes.
This condition is typically caused by one of two scenarios, either there is a very sudden and very acute overload of those soft tissues of the foot, or it’s the result of a lower intensity, but longer duration overload. This is all-in-all a kind of workload issue, or a case where you just stress those tissues too much for too long, they can’t handle it, and they get kind of angry and painful.
Now, we often call this issue plantar fasciitis. But for most people, that actually might be a little bit of a misnomer. Fasciitis has the ending of -itis, which indicates that there’s an active inflammatory process going on. What we actually know is that in most cases of plantar heel pain, there really isn’t much, if any, actual inflammation. So we actually now term this plantar fasciopathy, and it kind of behaves more like a tendon overload issue than a true inflammatory reaction.
So if you’re doing things like icing, foam rolling, and rolling the bottom your foot with a lacrosse ball, all that stuff might help. But, it’s not going to provide a long term solution, because those are good for decreasing inflammation. But since this isn’t really an inflammatory process, it’s not getting to the root cause of this issue.
So the three drills we’re going to cover will actually help you get to the root cause of the issue, and resolve that pain for good. There are two drills to help strengthen up the soft tissues of the bottom of your foot, and one to help stretch everything out and get it a little bit looser.
The first drill is a modified calf raise. We’re going to do one main modification to this to make it target that plantar fascia, and the tissues on the bottom the foot a little bit more. What you’re going to do is take a wedge or a rolled up towel, place it underneath the base of your toes, and then perform the calf raises from there.
The reason why we do this is because it activates something called the windlass mechanism, which means that when your toes are extended upwards, and then you go up into a calf raise, it targets those tissues on the bottom of your foot a little bit more specifically, and it can make this calf raise a little bit more effective in treating plantar fascia pain.
When we have most people do this, we usually start programming three sets of 10 to 15 reps. But, you should use a relatively slower tempo, going at a two to three second count on the way up, a slight pause at the top, and another two to three second count on the way down. This will just ensure that you’re not doing any really fast or really aggressive type motions, which can irritate these tissues in the very beginning.
The second drill is called the short foot drill. This is a drill that we like to use to help increase the strength of some of the intrinsic muscles of the bottom of the foot. These muscles are the small stabilizer muscles that help support the plantar fascia and the arches of the foot. This is going to take a while to get the hang of because it requires a lot of coordination. But, once you become good at it, it is an effective drill to help treat this sort of problem.
To do the short foot drill, you’re going to have your foot flat on the floor and you’re going to take your shoe off because it’s a little bit easier to do this while barefoot or just in socks. From here, you’re going to try to draw the base of your big toe and your heel together, like you’re trying to cramp up the base of your foot.
We typically have most people start with five second holds per rep, performing two to three sets of 10 reps. But as you get better at this, you can hold it for 10, 15, or even 20 seconds and just decrease the number of reps that you’re doing.
The last drill we’re going to do is a plantar fascia-specific stretch. We’re going to do this stretch because the research shows that using a combination of stretching and strengthening is probably the most effective way to manage this situation. To do the stretch, you’re going to take the affected foot, cross it up over onto the other knee, and then you’re going to take your hands, grab your big toe, pull your big toe up towards your shin and then hold that stretch.
We recommend that you hold the stretch for at least 30 seconds and do about three to five reps, two to three times a day to help loosen up some of those tissues on your foot and help calm things down.
If you need personal help resolving your plantar fasciitis/fasciopathy, or coming up with a plan to get you back into the gym after an injury, schedule a call with our expert physical therapists by clicking the button below!