Plantar-Fasciitis

Plantar fasciitis is a painful condition affecting the bottom of the foot.  It is a common cause of heel pain. The plantar fascia is a thick band of connective tissue.  It runs from the front of the heel bone to the ball of the foot.

As you can imagine, when the foot is on the ground a tremendous amount of force (the full weight of the body) is concentrated on the plantar fascia. This force stretches the plantar fascia as the arch of the foot tries to flatten from the weight of your body.  This leads to stress on the plantar fascia where it attaches to the heel bone. Small tears of the fascia can result.

The classical symptom is pain in the heel during the first steps out of bed in the morning.  The heel pain usually reduces once you have been walking for an hour or so, but can return with prolonged activity.

What causes it?

Most people cannot remember when it exactly started but often the symptoms are associated with:

  1. Increase in the volume of exercise
  2. Change of terrain (uphill walking or running)
  3. Increase of intensity of exercises
  4. Poor footwear not providing enough arch support, e.g.: flip flop sandals

How to resolve Plantar Fasciitis?

Physiotherapy of plantar fasciitis is successful in 90 per cent of all cases. When you begin therapy at Nose Creek Sport Physical Therapy, our physiotherapist will design exercises to improve flexibility in the calf muscles, Achilles’ tendon, and the plantar fascia.  We will show you how to increase the strength of your arch muscles. We will apply treatments to the painful area to help control pain and swelling. Examples include ultrasound, ice packs, and soft-tissue massage.  We may advise a change of your footwear for more supportive shoes. Another recommendations, is the orthotics, customized arch support designed to support the arch of your foot and to help cushion your heel. Your physiotherapist will also provide ideas for therapies that you can perform at home, such as doing your stretches and exercises for the calf muscles and the plantar fascia.  

Most of the time, the condition is self-limiting. This means it doesn’t last forever but does get better with a little time and attention.

If you experience heel pain that is not going away, give us a call, you will be glad you did.

Top 3 Stretches for Foot Pain

  • Heel Drops

    Heel drops are a set of exercises designed to strengthen the calf muscles and the tendon attaching the calf muscle to the heel bone (Achilles tendon). Nose Creek Physiotherapists believe by doing the exercises described below, the calf muscle is made to work while it is contracting and while it is being stretched. Physiotherapists refer to this unique form of exercise as eccentric loading and this is different from most strengthening programs. It more closely simulates the actual movements and loads during sport and exercise.

    Why Heel Drops?

    One of the main reasons that full recovery from injuries such as Achilles tendinosis is difficult is because the calf muscles often remain weak after injury. Strength does not return on its own, and inadequate strength is one of the causes of injury. Therefore, Physiotherapists know that correcting any weakness is a very important part of recovery from and prevention of injury.

    Even if the strength of the calf muscle/tendon unit is normal (meaning strong enough for normal daily activity), your Physiotherapist will caution that it may not be strong enough for exercise activities. The heel drop program has been designed to mimic the type of loads experienced during exercise, so it is known to be effective when used in a Physiotherapy program for someone returning to sports, which includes running.

    How do you do Heel Drops?

    Nose Creek Sport Physiotherapists point out that the important components of this program are your body position, the speed of the exercise and the progression.

    1) Position

    Stand with your feet shoulder width apart, with the balls of both feet over the edge of a step. You can use a handrail for balance, but not support. Next, ensure your toes are pointing straight ahead (don’t toe-in or toe-out). Rise up on your toes and lower your heels below the level of the step.

    2) Speed

    The program has two speeds which mimic the load that the legs experience during exercise. To begin with, you go down and up at a slow, comfortable speed. Later you begin to do fast drops, meaning you should do the drop very quickly. At the bottom of the drop your movement should stop suddenly, so that you feel a jerking or bouncing sensation. Then, raise slowly back up.

    Your Nose Creek Sport Physiotherapist knows that many people at first are a bit apprehensive about doing these quick drops. However, you will find that once you begin you will gain confidence quickly. This is the most important part of this Physiotherapy program, so press ahead!

    3) Progression

    There are two parts to the progression; the build up and the maintenance.

    Build Up

    Start by 3 sets of 20 repetitions of the slow drops. This means that you do 20 drops, wait a minute or two, then do 20 more, recover, and then do the 3rd set of 20. Continue doing this every day. After 14 days, you can move to the next stage. When doing the single leg exercises be sure to exercise both left and right sides.

    By using your own body weight on one or both feet, and by varying the speed, there is enough change in resistance over the program that you don’t need to use weights. This entire Physiotherapy program is easy to do because it doesn’t require any equipment!

    Build Up Exercises

    3 sets of 20 repetitions daily
    Both legs slow14 days
    Both legs quick drop, slow up14 days
    Single leg slow14 days
    Single leg quick drop, slow up14 days
      56 Days Total

    Maintenance

    Once you have reached the single leg quick drop level for 14 days, switch over to the maintenance program. Physiotherapy requires you to perform the last stage every other day. Then, continue with the maintenance program as part of your regular exercise routine. To maintain strength, decrease the single leg quick drops to every other day. You should also stretch before and after doing the heel drops, and ice the area if painful.

    Start position

    HeelDrop1

    Then drop down until stretch felt and repeat 3 sets of 20 reps. First 2 weeks drop slowly until no symptoms felt in tendon then, progress to fast drops for 2 weeks.

    HeelDrop2

    Then progress to one leg once 2 legs fast drop is symptom free. Start with one leg slow then again progress to one leg fast drops.

    HeelDrop3

    This is best done on a stairwell on the last step, where you can hang onto a railing.

    HeelDrop4

  • Gastrocnemius Stretch

    Superficial muscles stretched with back leg straight. Toe in slightly to increase stretch on inside of calf.

    Gastrocnemius

  • Soleus Stretch

    Deeper muscles stretched with leg bent. Toe in slightly.

    Soleus1

    Arch muscles stretched with toes on wall then lean your knee towards the wall.

    Soleus2

  • Ankle Tubing

    Start in a neutral position, then pull the ankle straight up, within your pain free range of motion.  Then return to the neutral starting position, repeat 3 sets of 10 repetitions the first week, then add another 1 set of 10 repetitions per week until your reach 10 sets of 10 repetitions over the next 7 weeks.

    TowelExercises3TowelExercises4

    Start in a neutral position, then pull the ankle up and out to the side within your pain free range of motion.  Then return to the neutral starting position, repeat 3 sets of 10 repetitions the first week, then add another 1 set of 10 repetitions per week until your reach 10 sets of 10 repetitions over the next 7 weeks.

    AnkleUpOut1AnkleUpOut2

    Start in a neutral position, then pull the ankle up and in, within your pain free range of motion.  Then return to the neutral starting position, repeat 3 sets of 10 repetitions the first week, then add another 1 set of 10 repetitions per week until your reach 10 sets of 10 repetitions over the next 7 weeks.

    AnkleUpOut3AnkleUpOut4

  • Towel Exercise

    Pulling towel by contracting arch muscles and slightly curling your toes until you have made large bunching of towel under your feet, then lift up and make another pile of scrunched up towel under your feet and repeat until you reach the end of the towel.

    Then pushing towel by extending toes, and work your way all the back to the end of the towel.
    Go to the end of the towel and back and repeat 3 times or when you reach fatigue.

    TowelExercises1

    TowelExercises2

  • Standing One Leg Balance

    Eyes Open:

    Once static balance is easy and you can hold for 1 minute then challenge yourself with:
    a.) Arm movements in a circular pattern
    b.) Swimming motion with arms
    c.) drawing alphabet with non weight bearing foot.

    StandingOneLegBalance2

    Eyes Closed:

    Once advanced open eyes exercises are easy, then progress to eyes closed static then the same exercises as above.

    StandingOneLegBalance1