Plantar Fasciitis / Fascitis, By: Brad Walker

Foot Pain and Plantar Fasciitis Treatment

One of the most common newsletter suggestions I receive is for information on plantar fasciitis. (Fascitis is sometimes spelt with only one i, but for the purpose of this newsletter we'll stick to fasciitis with two i's.) It seems that every third request lately is for an article about plantar fasciitis or foot pain. So here it is, a detailed account of how to treat and prevent plantar fasciitis and other foot pain problems.

I was going to write the article myself, but during my research I came across the following article and thought that it was very well written and addressed all the points that I think are important.

I asked the owner of the article if he minded me sharing it with my subscribers and he had no objection. What follows is the full article from a great site that I refer to often. That site is Peak Performance.

Peak Performance has a fantastic searchable library of over 750 sports articles. If you need specific sports information about anything from strength and stamina to motivation or endurance, Peak Performance is one of the first places you should look.

Enjoy this month's article. The full version of this article appeared on the Peak Performance website.

Some cases of plantar fasciitis can linger for months, with pain increasing and decreasing in an irregular pattern. Around five to ten per cent of all running injuries are inflammations of the fascia.

It's not surprising that plantar fasciitis occurs fairly frequently as the plantar fascia is not very receptive to stretching, and yet stretching occurs in the fascia nearly every time the foot hits the ground.

Why are some people troubled by plantar fasciitis, while others remain relatively plantar fasciitis-free?

Plantar fasciitis is often associated with a change in activity, using worn-out shoes, individuals with flat feet and also those with high arches. Obesity and weight gain are also linked to plantar fasciitis.

The traditional remedies for plantar fasciitis are quite weak. Stretching the calf muscles is often recommended, as are massage, decreasing training, losing weight, purchasing better-fitting shoes, using special insoles, relying on thick heel pads, icing the sore heel, and gulping down prescription-type doses of ibuprofen.

The trouble with most of these nostrums is that they don't really address what's going on. As is the case with any injury, you have to understand why plantar fasciitis cropped up before you can really rehab yourself.

You also need to increase the strength and resiliency of the plantar fascia and the other muscles and connective tissues of the foot - and stabilize and strengthen the entire leg - before you can expect to stay away from plantar fasciitis in the future. The exercises outlined below do just that.

Exercises to recover from and prevent plantar fasciitis
Our plantar fasciitis stretching routines are divided into two types - those that stress stretching and those that emphasize strengthening:

I. Stretching Routines

A. The Rotational Hamstring Stretch

• Stand with your weight on your left foot and place your right heel on a table or bench at or near waist height.

• Face straight forward with your upper body and keep both legs nearly straight.

• As you stand with your right heel on the table and your left foot on the ground, rotate your left foot outward (to the left) approximately 45 degrees, keeping your body weight on the full surface of your left foot (both heel and toes are in contact with the ground).

Now you are ready to begin the stretch.

• Lean forward with your navel and shoulders until you feel a steady tension (stretch) in the hamstring of your right leg.

• Don't increase the stretch to the point of pain or severe discomfort, but do maintain an extensive stretch in your right hamstring while simultaneously rotating your right knee in a clockwise - and then counter-clockwise - direction for 20 repetitions.

• As you move the right leg in the clockwise and counter-clockwise directions, stay relaxed and keep your movements slow and under control.

• After the 20 reps, remove your right leg from the table and rest for a moment. Then, lift your right leg up on to the table and repeat this clockwise and counter-clockwise stretch of the right hamstring, but this time keep the left (support) foot rotated inward (to the right) approximately 10 degrees as you carry out the appropriate movements. Perform 20 repetitions (clockwise and counter-clockwise) before resting.

Repeat this entire sequence of stretches, but with the right foot in support and the left foot on the table for the repetitions. Do 20 clockwise and counter-clockwise reps with the left foot on the table and the right (support) foot turned out 45 degrees, and 20 more reps with the right foot turned in).

B. The Tri-Plane Achilles Stretch

• Stand with your feet hip-width apart and your left foot in a somewhat forward position compared to your right foot (it should be about six to 10 inches ahead).

• Shift most of your weight forward onto your left leg and bend your left knee while keeping your left foot flat on the ground.

• Your right foot should make contact with the ground only with the toes.

Now you can start the stretch.

• Move your left knee to the left. Whilst doing this attempt to 'point' the knee in a fairly lateral direction.

• You should be able to feel this side-to-side and rotational action at the knee creating a rotational action in your left Achilles tendon.

• Bring the knee back to a straight-ahead position, and then move it toward the right.

• As you move the left knee to the right, again rotate the knee somewhat, this time to the right, creating more rotation at the Achilles tendon.

• When you bring the left knee back to the straight-ahead position, you have completed one rep (you should perform 20 total repetitions).

Make sure to keep most of your weight on your left leg while performing this exercise.

Repeat the entire action described above for 20 reps, but this time with your right leg bearing your body weight and doing the side-to-side and rotational movements.

C. The Rotational Plantar Fascia Stretch

• Stand barefoot, with your feet hip-width apart and with your left foot in a slightly forward position - two to three inches ahead of your right foot.

• The bottoms of the toes of your left foot should be in contact with a wall in front of you (the wall should be creating a forced dorsiflexion of the toes, so that the sole of the left foot is on the ground but the toes are on the wall), and your left knee should be bent slightly.

• Keep your weight evenly distributed between your right and left foot to start the exercise (see note below).

Now you are ready to begin the stretch.

• Slowly rotate your left foot to the inside (pronation) so that most of the weight is supported by the 'big-toe side' of the foot.

• Slowly rotate your left foot to the outside (supination), shifting the weight to the 'little-toe side' of your foot. Repeat this overall movement for a total of 15 repetitions.

Next, simply repeat the above sequence with your right foot.

As you become more comfortable and familiar with this exercise, gradually begin to shift more of your weight forward onto the forward, 'stretched' foot and ankle. This will enhance the intensity of the stretch.

II. Strengthening Exercises for the Plantar Fascia

A. Toe Walking with Opposite-Ankle Dorsiflexion

• Barefoot, stand as tall as you can on your toes.

• Balance for a moment and then begin walking forward with slow, small steps (take one step every one to two seconds, with each step being about 10 to 12 inches in length).

• As you do this, maintain a tall, balanced posture.

• Be sure to dorsiflex the ankle and toes of the free (moving-ahead) leg upward as high as you can with each step, while maintaining your balance on the toes and ball of the support foot. Walk a distance of 20 metres for a total of three sets, with a short break in between sets.

B. Toe Grasping

• Stand barefoot with your feet hip-width apart.

• In an alternating pattern, curl the toes of your right foot and then your left foot down and under, as though you are grasping something with the toes of each foot.

• Repeat this action a total 50 repetitions with each foot.

• Rest for a moment, and then complete two more sets.

Try pulling yourself across the floor (smooth surfaces work best) for a distance of three to six feet as you become more skilled at this exercise.

Always remember that icing, anti-inflammatories, reduced training, massage, etc. are temporary palliatives for plantar fasciitis. They do not cure the problem. The only true plantar-fasciitis elixir is an increase in the overall resiliency and strength of your legs and feet - so that plantar fasciitis just can't come back.