If you’re a runner/walker/flip flop wearing beach goer, the term plantar fasciitis is not new to you. I’m sure you’ve tried everything from orthotics, rehab, shockwave, new shoes and even injections.
There is no clear cut treatment that can 100% eliminate plantar fasciitis to date. Typically a combination of the treatments mentioned above with some footwear changes can eliminate most cases.
Plantar Fascitiis is not exclusive to runners. Individuals who travel a lot or have a desk job tend to suffer from this injury as well.
Research is suggesting that we should look at the Plantar fascia in a different way. A study published in The Foot and Ankle International Journal in 2011 suggests that contractures (very tight and fibrotic) calf & soleus muscles are present in 83% of cases of Plantar Fasciitis (Foot Ankle International 2011 Jan;32(1): 5-8).
Prolonged sitting (which is currently very common with COVID and at home work stations), exercising on very hard surfaces such as blacktop, and over-training (running, HIIT) are major causes of these contractures.
When viewing a chronic case, which is anyone who has had this for over 6 months, research is also noting a thickening of the flexor digitorum brevis muscle. This muscle is the muscle that is attached to the inside part of the heel, which is the most common site to feel pain, nad it extends to the base of your toes on the bottom of your foot.
So how is plantar fasciitis fixed or managed? Increasing the range of motion of your ankle is a must in all cases. This can be done via heel drop exercises:
Secondly, removing the contracture of your leg via motion based myofascial treatment therapies such as Active Release Technique can provide great results.
Plantar Fasciitis: The Value of Seeing a Qualified Physician
Nothing replaces treatment at a qualified facility, and a proper diagnosis should be reached by a medical provider prior to implementing these strategies. If you have already been properly diagnosed, these strategies are simple and easy. Below is a sequenced list of strategies that can be effective in helping resolve plantar fasciitis over time. As always, should symptoms increase with these exercises, please discontinue, and see a medical provider.
- Find a golf ball, lacrosse ball or tennis ball. A golf ball and lacrosse ball are going to be much harder; however, a tennis ball is good for very acute and painful cases. Make sure you are seated and have whichever ball you are using placed on carpet or a thick towel if you have hardwood floors. Start out gently rolling the ball in all directions. This strategy is attempting to loosen the tissue on the bottom of the foot. You only need to spend a few minutes doing this (2-5 minutes).
- Take a small hand towel and place it on a surface that will allow the towel to easily slide. Place your toes on the edge closest to you and begin curling your toes so that you are slowly scrunching the towel together. Repeat that process 5 times.
- You can use clothes pins, crayons, marbles, etc. With your feet, you should pick up these objects and move them from one side to the other. I have used my kids’ crayons and placed them on one side of a towel and picked each one up individually to move them to the other side of the towel.
- Using a towel, band or your hand, grab the bottom of your toes and pull them towards your knee\shins. This will be to stretch the plantar fascia and associated muscles. If this presents as very painful, please skip this step.
- Utilizing a foam roller, stick (grab a rolling pin if you do not have either) or massage gun to massage the back of your leg to loosen the calf muscles. Make sure you use more pressure in the upwards motion to move blood out of the area rather than pushing the blood down with more force.
- Lastly, revisit the eccentric calf stretches to help lengthen the calf and soleus muscles.
This routine should be done every other day. Once you become efficient, it should only take you 10-15 minutes. Steps 1-5 should be done in your bare feet while step 6 should always be done with your shoes.
I have included a video at the following link demonstrating each step mentioned above.
For those interested, here is a real view of the plantar fascia:
Dr. Derek Gearhart