Plantar Fascitis
The plantar Fascia is a band of tissue that travels from the base of the calcaneus (heel bone) and extends distal to the toes.
The Plantar Fascia’s purpose is to hold up the arch of your foot and assist with motion of the foot.
The Plantar Fascia can become damaged and irritated through direct trauma and/or, most often, chronic micro tears. This can lead to the condition known as plantar fascitis.
90% of plantar fascitis is treatable by conservative measures, and the majority of patients will not require surgery.
It is important to note that once plantar fascitis is treated, it is still important to adhere to stretching as plantar fascitis can recur, especially in those who have suffer from it before.
Treatment plan
- Rest: The key to treating any inflamed tissue is to rest the area and avoiding activities which can cause pain.
- Stretching: The gold standard in treating plantar fascitis is stretching. The plantar fascitis is connected dirrectly to the calf muscle, having equinus (tight calf muscles) is often the driving force in developing plantar fascitis.
- Splints/Strassburg Sock: DME that will assist in stretching the calf muscles while at rest.
- NSAIDs/Injections: Injections of low dose steroids coupled with NSAIDs, whether OTC or Rx, can assist in reducing inflammation.
- Physical Therapy: Once stretching and anti-inflammatories have failed, a proper physical therapy referral can aid in treatment.
- Surgery: Once all conservative treatment measures are exhausted, surgery is an option – the exact surgery will vary from patient to patient, but it will most often entail releases of the plantar fascia as well lengthening of the equinus (tight calf muscles)
Avoid:
- Barefoot/Minimally supportive shoes: Shoes like sandals, flip flops, and even some shoes that do not provide arch support can illicit increased pain to the plantar fascia
- Standing/Certain activities: Standing for long hours or high impact activities such as running or playing sports
Stretches
Foot dorsiflexion stretch with band/belt/towel
- Be in a comfortable position to allow your leg to stretch out
- Maintain knee extension (straight leg) position the entire time
- Take a workout band/belt/towel and wrap the tool around the metarsal heads (balls) of your foot
- Dorsiflex the foot (toes-to-nose) using only your hands, do not use your leg muscles to assist your foot dorsiflexing at any time (picture below)
- Return to a relaxed position and repeat
- Complete this stretch for 15-20 repetitions for 3 sets total. Perform exercise 3-5x per week during acute plantar fascitis pain.
Perform exercise 1x per week once pain is gone to maintain pain free plantar fascia.
Plantar Fascia Specific Stretch (Toe dorsiflexion)
- Cross pain side leg over the other side knee
- Using affected side’s arm, dorsiflex the toes (pull toes up towards shin) (picture below)
- Hold this stretch for 10 seconds and repeat 10 times. Perform exercise 3-5x per week during acute plantar fascitis pain. Perform exercise 1x per week once pain is gone to maintain pain free plantar fascia
