If you’ve ever experienced plantar fasciitis, you know how painful and limiting it can be. From the moment you wake up and take your first step of the day, you can experience heel or foot pain.
Being on your feet all day can feel unbearable, and that persistent pain can severely limit your activity level.
Fortunately, there are exercises for plantar fasciitis that can be done to help decrease the pain.
This article will discuss what plantar fasciitis is and what can be done to help alleviate pain or possibly prevent it from occurring.
Which means, the exercises demonstrated/described in this article aren’t only for those who have plantar fasciitis, but also for those who have a history of it or who have never had it (that’s right, it’s an all-inclusive article!).
What is Plantar Fascia?
Have you ever had someone massage your feet, but you feel a sensation in your back? This isn’t because they’re performing some kind of magic trick, rather it’s due to fascia.
Our whole body is surrounded by a layer of tissue called fascia. This life-size (literally) network of tissue holds us all together.
Some areas of fascia are super thick, like the Iliotibial (IT) band on the side of each leg, or thoracolumbar fascia in the back. The plantar fascia is another example of a very thick band of tissue that is found on the bottom (AKA “plantar”) surface of the foot.
The plantar fascia attaches at the front of the heel and travels into the ball of the foot, and serves as a support in the arch of the foot.
What is Plantar Fasciitis?
Typically, the suffix “-itis” means inflammation. For example, someone that has arthritis has inflammation of their joints (arthro= joint, itis= inflammation).
In this case, that is a bit of a misnomer. While it may feel like your foot is inflamed because there’s pain, plantar fasciitis is actually caused by micro tears or strain in the tissue.
What Causes the Pain?
Since there’s not necessarily inflammation present, what exactly is causing the pain with walking?
Understanding the different foot movements with walking can help.
Plantar flexion is when the toes are pointed. For example, when you do a calf raise, you are plantar flexing the foot. Or the motion you do when you press the gas pedal down in the car.
Another way to think about this is your toes are moving downward, or towards the plantar surface of the foot.
Dorsiflexion is when your toes move upward (or towards the dorsal surface of the foot).
During walking, the foot moves from plantar flexion into a dorsiflexed position, which stretches the plantar fascia. When there are tears in the fascia, that stretched position causes pain.
If Plantar Fascia Supports the Arch, Why Does the Heel Hurt?
Many people with plantar fasciitis have heel pain, although pain in the arch can also occur.
The heel pain is due to the attachment of the plantar fascia. Its anchorpoint, is at the front of the heel. Oftentimes, the micro tears occur close to the attachment, which leads to heel pain.
Why Is It More Painful First Thing in the Morning?
A common complaint with plantar fasciitis is higher severity pain with the first few steps of the morning.
This is due to the position of our feet while we sleep. Most people’s feet fall into plantar flexion when we sleep, so the toes are pointed downward.
The tissues in the foot are then feeling even more stretch with the dorsiflexion that occurs upon taking that first step of the day.
Are Orthotics Required?
Short answer: not necessarily.
However, sometimes having orthotics in your shoes can be very helpful in decreasing pain in the short-term, which is extremely beneficial to those individuals who need to be on their feet for a significant portion of the day.
As a physical therapist, my goal is to get my clients’ feet stronger, so that the foot is more supported, and the plantar fascia is less likely to experience strain.
When this is achieved, my clients don’t have to avoid wearing sandals because their orthotics won’t work in them.
Even if you get orthotics to relieve pain initially, it’s highly beneficial to complete the exercises below in order to not have to rely on them forever.
What Can Be Done to Help Decrease Pain Right Now?
With plantar fasciitis, the pain can be really intense, so finding relief sooner rather than later is essential.
1. Freeze a Bottle of Water
Yup, that simple, just stick a water bottle (fill it 90% full) in the freezer.
Once it’s frozen
- Put socks on
- Take the frozen bottle out of the freezer
- Sit on the edge of your couch with your feet on the floor
- Place the bottle under your foot that has pain (you can do both sides if you want)
- Roll the bottle back in forth under your arch, moving from heel to the ball of the foot, putting some pressure into your foot so it’s getting the benefit of the ice and the massage from the bottle
Do this twice a day. This will help to relieve some of the sharp pain.
2. Buy (or Create) Night Splints
Night splints are designed to prevent your foot from falling into plantar flexion. You can purchase them online, or click here to buy them on Amazon.
Or, if you sleep on your back, you can roll a towel or take a pillow and place it against your heels so the toes can’t naturally fall downward.
3. Complete the Plantar Fasciitis Exercises Below
We have many muscles in our feet, and honestly, most of us don’t work them enough.
Strengthening the muscles that support the arch will help the plantar fascia not have to overwork, which can help prevent strain.
5 Exercises to Help with Plantar Fasciitis
Click HERE for video of Dr. Katie performing plantar fasciitis exercises.
1. Short Foot Exercises
Flexor Hallucis Longus and Flexor Digitorum Longus are muscles that run along the arch of the foot and help support it. These muscles also flex (bend) the first toe and toes 2-5, respectively. We don’t often take the time to strengthen these muscles, which leads to less support in the arch, and additional stress on the plantar fascia.
Since this exercise is something we should do more often, please do on both injured and non-injured side.
- Stand with feet under hips.
- Take a step forward with your right foot (make sure you feel balanced, you don’t need your feet directly in-line with one another)
- Feel your foot in contact with the floor at the ball of the big toe, ball of the little toe, and the center of the heel. This is called the “tripod” and it’s important when you’re standing to feel yourself standing with the tripod in contact with the floor.
- Exhale as your press the tips of the toes down into the floor.1
- **A common mistake here is that people curl their toes too far under and then the foot cramps because of the excessive muscle contraction. All you need to do is gently press the tips of the toes into the ground.**
- Repeat 10x on right side.
- Repeat on left side.
- Complete 3 sets on each foot.
2. Calf Stretch
The gastrocnemius (AKA “calf” muscle) is responsible for plantar flexion of the foot. Tightness in this muscle may cause greater degree of plantar flexion in the foot, causing more stress on the plantar fascia when it is forced into dorsiflexion during standing and walking.
- Stand facing a wall with feet under hips.
- Take a long step backwards with the right foot, making sure the right heel can stay on the ground.
- Bend the left knee towards the wall, keep the right knee straight.
- You should feel a stretch (but no pain) in the right calf.
- Hold for 1 minute.
- Repeat on left side.
- Complete 2 sets on each side.
3. Plantar Fascia “Stretch”
Because the plantar fascia is so thick, we really can’t stretch it. This stretch allows for the muscles that attach to the plantar fascia and that surround it to loosen. This stretch is recreating the position of stretch it’s placed in during standing to help relieve the tension when it is in that position while weightbearing.
- Sit in a chair or on a couch with feet on the floor.
- Bring your right ankle over your left knee.
- Hold your right ankle with your left hand.
- With your right hand, gently push your toes towards your shin, until you feel a stretch in the bottom of your foot.
- Hold for 30 seconds.
- Repeat on the left side.
- Repeat 3 sets on each side.
4. Calf Raises
While it may seem counterintuitive to strengthen the plantar flexors, strengthening can actually allow for proper pull by the muscles on the tendons. This means that the legs are stronger and not as tight, which provides support to the arch of the foot. Additionally, the downward motion (or eccentric component) of this exercise provides some stretch to the arch of the foot as well.2
This can be done using a step or threshold or can just be done on the floor. Using an elevated surface will help to provide the additional stretch to the arch.
With Step:
- Stand with feet under hips, with heels hanging off the edge of the step, hold on to banister/rail/doorway.
- Putting the weight in the ball of the first and second toe, lift your heels up (Think about pressing your head towards the ceiling).
- Lower heels back down with control.
- Focus on moving straight up and down, not rocking forwards and backwards.
- Repeat 10x.
- Take a 1 minute rest.
- Complete 3 sets total.
Without Step:
- Stand with feet under hips, with heels on the floor, hold on to stable surface for balance.
- Putting the weight in the ball of the first and second toe, lift your heels up (Think about pressing your head towards the ceiling).
- Lower heels back down with control.
- Focus on moving straight up and down, not rocking forwards and backwards.
- Repeat 10x.
- Take a 1 minute rest.
- Complete 3 sets total.
5. Windshield Wipers
This exercise helps to strengthen the muscles that move the foot inwards/outwards. A number muscles attach to bones on the bottom of the foot. Once again, strengthening the muscles that surround the foot and ankle help with proper muscular balance and alignment, decreasing stress on the plantar fascia.
- Grab a kitchen towel/hand towel
- Sit in a chair with feet flat on the floor.
- Place the hand towel horizontally on the floor under your right foot, so that the arch and toes are on the towel and 90% of the towel is to the left of the right foot.
- Keeping your heel in contact with the floor, use the right foot to move the towel all the way to the right side (moving your foot outward).
- **Make sure your foot stays flat- don’t use the side of your foot**
- Once the towel is on the right side, straighten the towel out and repeat with the right foot, this time pulling to towel inwards.
- Complete 3 sets on each leg.
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Sources:
- Are you doing short foot correctly? | Clearing the confusion. (2022). Retrieved 22 March 2022, from https://barefootstrongblog.com/2019/02/22/are-you-doing-short-foot-correctly-clearing-the-confusion/
- Kidd, J., & Starks, J. (2022). Calf and Foot Strengthening Exercises | Heel That Pain. Retrieved 22 March 2022, from https://heelthatpain.com/heel-pain/calf-foot-exercises/#:~:text=Wall%20and%20Book%20Calf%20Raise,mores%20support%20for%20your%20arch!
- Photos created on Canva.com
- Plantar fascia photo taken from https://www.flickr.com/photos/sportex/8271788761
