The foot is an engineering wonder that supports body weight and acts as a lever to propel. It’s both strong enough to push off with each stride, supple enough to absorb the impact of every step, and facile enough to negotiate uneven surfaces. Its activity relies on a network of bones, muscles, tissues, and nerves that all must work together. And when something isn’t quite right, you will typically feel pain….oh boy, will you feel it!
Now foot pain can come in lots of different severities and locations. But probably the most common foot pain that I have treated in my 10 years as a Doctor of Physical Therapy is plantar fasciitis. It is estimated that approximately 1 million patient visits to medical professionals per year are due to plantar fasciitis. In fact, plantar fasciitis accounts for about 10% of runner-related injuries and 11-15% of all foot symptoms requiring professional care. It is thought to occur in 10% of the general population as well.
So what IS plantar fasciitis? And how do I know if I'm suffering from it? And most importantly, what can I do to alleviate the pain? Don’t worry, good ol’ Dr. Rob is here to help answer all your burning questions.
First Things First…What IS Plantar Fasciitis?
The plantar fascia runs along the bottom of your foot and supports the arch. When people perform repetitive weight-bearing/impact activities over days, months, or years (especially when they overdue it), this causes microtears and chronic inflammation of the thick band of tissue that runs across the bottom of the heel bone to the ball of your foot.
And because plantar fasciitis is often caused by repetitive motion or anything that puts a lot pressure on the arch of your foot, activities like running, jogging and walking, or consistent long periods of standing or being on your feet can often lead to plantar fasciitis.
How Do I Know If My Foot Pain is Due to Plantar Fasciitis?
Everyone experiences plantar fasciitis a little differently. But plantar fasciitis pain is often described as a dull to sharp, stabbing pain in your heel. Many people say that they feel pain and stiffness, especially when they take their first steps after getting out of bed in the morning, or if they have been sitting or lying down for a while. It’s also known to be a pain that may become more intense as the day goes on, particularly if you’ve been standing or walking a lot.
In my practice, runners and other athletes who perform high-impact activities that put pressure on the foot are most at risk for developing plantar fasciitis. Other risk factors for plantar fasciitis include:
Being between the ages of 40 to 60 years old.
Changing the surface of where you exercise – for example, running on the road instead of a track, or working on concrete floors for a long period of time.
Standing on your feet for long periods of time, or if you do a lot of walking, running, standing, etc.
Being overweight (as this will put extra strain on your heel).
Wearing shoes that lack appropriate support, do not fit well, or are worn.
Should I see a Physical Therapist if I think I have Plantar Fasciitis?
In a word – Absolutely! A well-trained Physical Therapist will know how to correctly check for tenderness in your foot and the exact location of the pain. This is to make sure that the pain isn’t the result of a different foot problem.
During the evaluation, I may ask you to flex your foot while you push on the plantar fascia to see if the pain gets worse as you flex and better as you point your toe. It’s also important for me to see if you have mild redness or swelling.
I may also need to evaluate the strength of your muscles and the health of your nerves by checking your reflexes, muscle tone, coordination, and balance.
When clients, old or new, comes into my North Massapequa practice, they are given the utmost attention and care. We will work with you to worry less about more pain meds, "getting older", bothering the doctor, and more getting to enjoy the things you love to do most without having pain or injury, in this case plantar fasciitis, hold you back.
What Exercises Can I Try at Home to Help Alleviate my Plantar Fasciitis Pain?
Try performing these 8 exercises to help loosen up the tightness and strengthen all the surrounding, supportive muscles at once. You can also perform these moves as a preventative measure, so you don’t get plantar fasciitis or to avoid getting it again.
Note: For each exercise, I have provided a link to my YouTube channel with a video of yours truly demonstrating each exercise. Feel free to click on the links to get a better idea of how to complete the exercise.
1. Heel Raise -- https://youtu.be/yiAFt1XhjQs
Stand with the balls of your feet at the edge of a bottom step.
With your heels hanging off the edge, slowly and gently lower your heels just below the edge of the step. You may feel a stretch in your calf muscle.
Slowly rise onto the balls of your feet. Repeat this 10 times, then rest. Complete two sets of this exercise.
Dr. Rob’s helpful hint: This exercise should be done slowly and with controlled movements. Make sure to maintain your balance and hold on to a railing or other support if needed.
2. Plantar Fascia Massage -- https://youtube.com/shorts/8nvW-a51ecw?feature=share
Sit in a chair or stand with one foot resting on a small ball or frozen water bottle (i.e., the frozen water bottle is useful as the ice helps reduce inflammation).
Gently roll the ball or water bottle forward and backward under your foot. Start at just below the ball of your foot and end just before your heel.
Roll the ball or bottle back and forth slowly 10 times for each foot. Do two sets per foot.
Dr. Rob’s helpful hint: Apply enough pressure to feel a gentle stretch, but not pain. You should not experience pain during this exercise.
3. Seated Ankle Inversion with Resistance Band -- https://youtu.be/muUnZn7cqds
Sit up with your legs straight out in front of you.
Loop a resistance band around your foot to be exercised, holding the ends in each hand.
Place your other foot inside the loop and cross if over the front of your other shin.
Press this foot into the resistance band, creating some tension in the band between both feet.
Keeping your upper foot still, turn your lower foot inwards against the resistance of the band. Repeat 10 times and complete two sets per foot.
Dr. Rob’s helpful hint: Ensure your leg stays straight with your knee pointing directly up towards the ceiling.
4. Seated Toe Towel Scrunches -- https://youtube.com/shorts/nNFB-3oEyiM?feature=share
Sit upright in a chair with one foot resting on a towel and spread your toes. Ankle and knee should be bent to 90 degrees)
Keep the heel of your foot down and slowly scrunch the toes while dripping the pulling the towel. Hold this for 2-3 seconds and release.
Curl your toes to scrunch and draw the towel toward you 10 times. Do two sets per foot.
Dr. Rob’s helpful hint: It’s important to keep your heel still and firmly on the ground. If your heel is up or moving along with your toes, you will miss out on the many foot strengthening benefits toe curls have to offer.
5. Seated Plantar Fascia Stretch -- https://youtu.be/xksHoLSQnyY
Cross your legs over by placing the affected foot on your other knee.
Use the hand on the affected side to pull the toes up as far as they will go toward the shin Feel the tight band (like a guitar string) on the sole of the foot with your other hand.
Hold the stretch for 10 seconds. Perform 10 times. Repeat 3 times a day.
Dr. Rob’s helpful hint: The first set should be performed before the first step in the morning. Also try to perform before standing after seated for long periods.
6. Wall-Facing Calf Stretch -- https://youtu.be/lffw0w8Te1c
Stand facing a wall, about 12 inches away from it.
Extend your arms in front of your shoulders to place your hands flat on the wall, keeping the elbows bent.
Lift your left foot and flex at the ankle to "pop" your toes up toward the ceiling. Place the sole of your left foot onto the wall and your heel on the floor.
Gently lean forward into the wall to enhance the stretch that you feel in the calf of the front leg. Breathe deeply and hold for 10-30 seconds. Switch sides.
Dr. Rob’s helpful hint: The more you flex at the ankle and lean into the wall, the deeper you will feel this stretch.
7. Unilateral Balance Challenge -- https://youtu.be/jThBzvEjEe8
Using the injured foot, step onto a foam pad, bosu ball, pillow, or any uneven surface that will require you to use your foot muscles for stabilization.
Hold for 30 seconds, then rest. Repeat on each side three times, once or twice a day.
Stand next to a stable surface to check your balance so you need it and so you don’t fall.
Dr. Rob’s helpful hint: Pin your big toe into the floor and soften/unlock your knee so that you can have better control and base of support to maintain balance throughout the activity.
8. Walk Outs with Resistance Band -- https://youtu.be/iEG_BcgzUWI
Place a loop band around your ankles and stand with your back straight.
Begin exercise by stepping in one direction while facing forward for about 20 feet (or as much room as you have).
Legs should be relatively straight with a slight knee bend and slight forward lean of the torso with your abdominals tight. Simply pick one foot up off the ground and step to the side and then follow with the other foot.
Reverse movement and step in the other direction for 20 feet.
Dr. Rob’s helpful hint: Don't drag your feet on the ground and don’t sway from side to side. Keep your torso as steady as possible.
Can I Just Ignore the Pain?
Well, you can but I don’t recommend it! Complications can arise if you leave plantar fasciitis untreated. You can develop chronic heel pain that stops you from going about your regular activities. Also, you may change the way you walk to compensate for the heel pain, which can lead to knee, foot, back, or hip problems.
So there you have it folks. If you have questions about plantar fasciitis, please let us know! We would love to assist in any way to make sure you stay active and healthy. To learn more or speak with a Doctor of Physical Therapy, please give us a call at 516-387-0053. You can always email me as well at firstname.lastname@example.org. And if you would like to follow us along as we present more information about different topics related to endurance athletics, please give us a follow on Instagram.