Plantar fasciitis can significantly reduce your quality of life. Constant aching pain in the foot, the inability to fully step on the heel, discomfort even in a lying position - these are some symptoms that will only get worse every day.
If you do not start treatment on time, irreversible complications may occur. One of the best ways to get rid of plantar fasciitis is a set of simple exercises.
How long should you practice?
Exercises for plantar fasciitis do not work quickly, so you need to be patient. The key to success is the correct technique of performing exercises and regularity of exercises. Relief will occur in the first weeks, but for significant improvements and even complete recovery you will need about three months.
Despite the fact that all the exercises from our article are completely safe and can be used both to prevent disease and for general stretching of the legs, be sure to consult your doctor before starting training.
Additional research methods
The diagnosis of plantar fasciitis is usually made based on patient complaints and clinical examination. X-rays of the feet are not necessary to make a diagnosis. However, if an x-ray is nevertheless prescribed, a heel spur is visualized on the lateral projections.
It is important to understand that overload of the plantar fascia can cause excessive bone formation, in the form of heel spurs. However, the presence of a heel spur does not directly correlate with symptoms.
In many patients, a spur is visible on radiographs of the foot, but there are no symptoms, and vice versa - in patients suffering from plantar fasciitis, a heel spur is absent on radiographs.
Initially, patients are not prescribed MRI of the foot. However, if symptoms do not improve after treatment, an MRI may be ordered to rule out other causes of heel pain, such as a stress fracture of the calcaneus.
Exercise 1: fascia stretch with hands
This exercise will help you effectively work out the plantar fascia. Do it like this:
- Sit on a chair or high bench (the seat should be hard).
- Place the affected leg, bent at the knee, on the knee of the other leg.
- Use one hand to support your heel. Place your other hand on your toes and gently pull them towards your shin.
- Maintain tension for 10 seconds.
- Release for a couple of seconds and repeat the manipulation.
- Do 10 repetitions.
Plantar fasciitis
Conservative treatment is aimed at eliminating pain and returning to a full active life.
Conservative treatment should always be the first line of therapy. Its options include:
Activity modification
Abstain for a period of time from sports or the types of exercise that caused the development of symptoms. Elimination of high-intensity types of loads. Decreased time spent standing or walking on hard surfaces.
Shoes
Wearing shoes with shock-absorbing heels.
Orthotics
The use of soft heel pads that work as additional shock absorbers.
The use of orthopedic insoles to help redistribute the load over the entire area of the sole.
Splinting
Use of night splints to keep the plantar fascia and calf muscles in a state of tension.
Immobilization
In some cases, immobilization with a walking boot for 4 weeks may be indicated.
Nonsteroidal anti-inflammatory drugs
Taking non-steroidal anti-inflammatory drugs can reduce the severity of discomfort in the earliest stages of plantar fasciitis, when minimally expressed inflammation occurs. However, most patients do not experience any inflammation and therefore NSAIDs do not work for them.
Physiotherapy
Exercises aimed at stretching the calf muscle and plantar fascia can reduce overload on the fascia.
Exercises aimed at strengthening your own foot muscles, as well as general strengthening exercises for the lower extremities, also help reduce the severity of symptoms.
Time
Plantar fasciitis is a self-limiting condition in most patients. The duration of the disease may be 1 year or more.
Extracorporeal shock wave therapy (ESWT)
This is a relatively new technique and there is not yet enough evidence of its long-term effectiveness in certain cases. Its use is indicated for symptoms lasting more than 6 months. With a shorter duration of the disease, the use of the method may lead to aggravation of symptoms.
Shock waves lead to the formation of microtears in the plantar fascia, which in turn stimulate the development of an inflammatory (regenerative) response. 3 courses of ESWT are carried out at intervals of 1-2 weeks. Patients are not recommended to take NSAIDs during treatment. This procedure itself is quite painful. For most patients, these pain sensations are limited only by the duration of the session, which is about 5 minutes. We are talking about this here not to dissuade you, but to warn you.
Complications of the procedure may include bleeding, swelling, pain, numbness or pins and needles, and very rarely, tearing of the plantar fascia. The method does not guarantee relief from pain.
Exercise 2: rolling the sole.
For this exercise, you will need a large rolling pin, an aluminum can, a plastic water bottle, or a tennis ball. We recommend the jar: firstly, it fits perfectly to the size of the foot, and secondly, it can be placed in the refrigerator first, and then during the exercise you will additionally cool the damaged area.
Refrigerating does not mean freezing! During the exercise, you should experience pleasant sensations, and not tolerate too low a temperature.
Then proceed as follows:
- Sit on a hard chair with a backrest.
- Maintaining your posture, roll your object back and forth with your foot.
- Do 15-20 reps.
It is important to regulate the pressure. You should not be in unbearable pain, you should feel the same sensations as during a regular massage.
Exercise 3: lift the napkin
To perform the exercise, you will need a thin towel or cloth napkin.
- Sit on a hard chair with your feet on the floor.
- Straighten your back (you can lean on the back of a chair).
- Place a napkin under the sore foot.
- Without lifting your feet off the floor, first gather and then squeeze and lift the tissue with your TOES. Do not drag the napkin with the rest of your foot, bend over, or otherwise assist.
- If this comes easy to you, put something heavy (for example, a weight) on the napkin. Do the same, trying to pull the napkin out from under the weight.
- Repeat 10-12 times.
Exercise 4: Lying Foot Stretch
This wonderful exercise will help you not only get rid of plantar fasciitis. It is a great stretch for the entire back of the leg, helps improve hip mobility, and is also part of a preparatory workout if you want to do the splits.
To perform this exercise, you will need an elastic band or yoga strap.
- Lie down on the floor.
- Bend your healthy leg at the knee and place your foot on the floor.
- Place a band/strap on the front of your sore foot.
- Lift your sore leg up, point your heel at the ceiling, toe toward you, knee straight, foot parallel to the floor.
- Gently pull the band/strap, trying to lower your leg towards your body. You should feel a pleasant stretch both in your foot and along the back of your leg.
- Stay in this position for 10-15 seconds, release the tension. Repeat 3-4 times.
Exercise 5: Wall Leg Stretch.
One of the causes of plantar fasciitis may be pathology of the soleus muscle and Achilles tendon. This exercise is aimed at working out this zone.
- Stand facing a wall at arm's length.
- Place your palms against the wall.
- With your healthy leg, step forward a little, bending it at the knee.
- The affected leg should be completely straight, the foot pressed to the floor, the heel slightly pressing into the floor.
- Bend your elbows, moving your body towards the wall (the movement resembles a push-up against a wall).
- Hold the wall for 10 seconds, feeling the stretch in the back of your leg.
- Repeat 4-5 times.
- For prevention, do the same with the other leg.
Preventive measures
The development of plantar fasciitis can be prevented.
To do this, use the following measures:
- You should always choose only comfortable shoes, preferably orthopedic;
- use orthopedic insoles;
- You need to wear shoes for no more than 2 seasons, especially sports shoes;
- monitor your weight;
- do not run on asphalt, this means daily jogging;
- Stretch your ankle ligaments regularly.
Prevention of stress and inflammation
Chronic fasciitis can be treated, but it becomes more difficult to do so as you age. Periods of exacerbation will occur more and more often. To do this, you will need to use several methods in combination, so it is easier and more useful to prevent any diseases, especially fasciitis.
Exercise 6: Plantar Fascia Stair Stretch
If you do not have a ladder at your disposal, you can use any stable object that replaces the step.
- Stand with both feet on the step. A healthy foot should stand on it completely, a sick one - only the front part. For stability, you can hold on to the handrails of the stairs, a wall, etc.
- Slowly pull your heel down so that your toes do not point away from the step.
- The leg with plantar fasciitis should be straight, while the healthy leg can be slightly bent at the knee.
- Hold the stretch for 30 seconds.
- Repeat 4-5 times.
This exercise can be done up to 7-10 times a day, for example every time you walk up the stairs.
Clinical picture
Patients with heel spurs complain of pain when taking their first steps in the morning, after sitting at a desk or driving for a long time - the so-called “starting pain”. The pain is felt in the heel and can be quite severe (Fig. 1).
Often improvement occurs after the first steps or stretching the muscles of the lower leg and fascia of the foot. However, the pain usually returns during the day, especially if the patient walks or stands a lot. Burning pain is not typical for plantar fasciitis and may occur due to nerve irritation (eg, Baxter's neuritis).
The main reasons for the development of plantar fasciitis:
- age
- recent increase in physical activity level (eg, a new running program)
- work that requires standing for long periods of time
- weight gain
- tight (rigid) calf muscles
On clinical examination, pain is most often localized along the inner surface of the heel from the plantar surface of the foot. Pain also occurs with direct pressure (palpation) on the specified area.
Stiffness in the lower leg muscles is also a common symptom. Symptoms may be aggravated by pulling the toes toward you, thereby stretching the plantar fascia (see Figure 3). There is a connection between flat feet and the development of plantar fasciitis, but this disease can develop in any type of foot.
Plantar fasciitis is the most common cause of heel pain, but there are other less common causes:
- pain associated with heel overload
- atrophy of the soft tissues of the foot
- entrapment of the first branch of the lateral plantar nerve (Baxter's nerve)
- tarsal tunnel syndrome
- calcaneal stress fracture
- inflammation of the periosteum
- inflammation caused by seronegative arthritis