Effective treatment requires treating the cause and not just the symptoms of heel pain.
Things to know about Heel Pain
Plantar fasciitis is a painful condition characterized by a gradual onset of pain on the bottom of the heel near the inside of the foot. The pain is usually worst in the morning when talking the first steps or after periods of inactivity.
The plantar fascia is a thick band on the bottom of the foot, running from the toes to the heel. Deep to the fascia there are muscles that also run along the length of the foot and insert on the heel in the same area as the plantar fascia. Together, these structures provide support to the foot and aid in shock absorption.
Possible contributing factors to the development of plantar fasciitis:
Compression on the heel leading to increased load and reduced circulation
Footwear that alters the normal function of the foot
Weakness of the foot muscles that transfers load to the plantar fascia
Abnormal stress on the arch from decreased ankle flexibility, pronation, or a high BMI
Goals of Plantar Fasciitis Treatment
To have an effective treatment of the plantar fasciitis the abnormal stress on the foot needs to be replaced with healthy stress, that will promote tissue regeneration. This means:
Increasing Foot Strength
What to do as treatment
Changing standing posture and habits to take pressure off your heel
Increase barefoot activity
Increase ankle flexibility
Wearing less supportive shoes
Strengthening the muscles in the foot and leg
Stretching and massage for the legs and feet
Ways to increase Ankle Flexibility
A lack of ankle flexibility is one of the most reliable risk factors for developing plantar fasciitis. Decreased ankle dorsiflexion range of motion alters the mechanics of the foot and can cause abnormal forces under the heel.
Calf stretching exercises:
Simply walking up hill
Runner’s Stretch- Lean against a wall with the leg to be stretched in back. Keep the heel down and the back knee straight, lean forward until a stretch is felt in the calf (first pic).
Soleus Stretch- A similar position to the runner’s stretch, except this time the leg in front will be the one getting stretched. Keeping the heel of the leg in front flat, lean into the wall while bending the front knee until a stretch is felt in the back of that leg (second pic).
Foot Strengthening Exercises
Short Foot Exercise: Try to form and hold an arch in the foot. Hold for 5 seconds, relax, and repeat
Foot Gymnastics: This can include any activity that requires foot agility. For example grabbing a pen with the toes, passing a pen back and for between your feet, picking up marbles, or stacking plastic cups. Imagination is the limit!
Towel Curl: Spread a towel out on the floor and try to bunch it up by pulling it in with the toes but without moving the rest of your foot
Imaginary Beach: pretend you are gripping sand with your toes, picking it up, and then dropping it.
Working with elastic bands: ankle inversion, eversion, dorsiflexion, plantarflexion.
General Leg Strengthening
Calf Raises: Raise up high on the toes and then lower down slowly. Focus on pushing through the big toe on the way up
Toe Walking: Stand on the toes and walk 10-15 steps at a time keeping the heels off the ground
Squats: are a great way to build leg strength and increase ankle flexibility
Single Leg Balancing: Practice balancing on one leg to increase ankle and lower leg strength
Hip Strengthening: the stronger the muscles are around the hip the more they can improve the mechanics of the foot
There is some evidence that tight hamstrings like tight calves, play a role in causing plantar fasciitis.
Consult your therapist for stretches best suited for you
Stretching the foot is important for promoting flexibility and circulation, as well as adding stress to the tissue to encourage healing. Heres a few examples.
Plantar Fascia stretch:
Toe Extensor Stretch:
Massaging the calves and underside of the foot can promote tissue health.
Rolling a tennis or golf ball under the foot
Using a foam roller to massage the calves
Shockwave therapy induces microtrauma to the affected tissue and this initiates a healing process. More bloodsupply and nutrients are delivered to the area which stimulates the repairing progress and relieve the symptoms of pain.
Consult your therapist to get the right diagnosis and then the right treatment plan customized just for you. There might be different reasons to why you are having this problem, so it’s important to approach the issue you are dealing with properly. There are many different ways to strengthen and to stretch the muscles, this article is just meant to give you an idea.
Have a great day!