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Treating plantar fasciitis

Three exercises to address plantar fasciitis symptoms include gastrocnemius stretching, soleus stretching, and eccentric calf lowering.

WHAT IS PLANTAR FASCIITIS?

Plantar fasciitis is a condition in which the plantar fascia, otherwise known as the thick band of tissue that runs across the bottom of each foot and connects the heel bones to the toes, becomes inflamed. Common signs and symptoms that one has plantar fasciitis is sharp stabbing pain the heel of the foot that usually occurs when one takes their first few steps of the day, with prolonged standing or walking, and when one first stands up after sitting for a while. While the causes of plantar fasciitis are poorly understood, the condition is more common among runners and overweight individuals.

WHAT TYPE OF STRETCHING HELPS WITH PLANTAR FASCIITIS?

Just behind the attachment of the plantar fascia on the heel is where the Achilles tendon is located. The Achilles tendon is what connects the calf muscles to the heel. When the muscles in the calf become tight, they can in turn pull upon the plantar fascia further exacerbating heel pain. These two calf muscles that attach to the Achilles tendon include the gastrocnemius and the soleus. The difference between these two muscles is that the gastrocnemius is a two joint muscle, meaning it crosses two joints (the knee and the ankle), where as the soleus is a one joint muscle, meaning it only crosses one joint (the ankle). Both muscles work to plantarflex the foot or push the foot down towards the ground. Methods of stretching these muscles are listed further down in the blog.

WHAT TYPE OF STRENGTHENING IS HELPFUL FOR PLATAR FASCIITIS?

When exercises muscles, there are three types of contractions that can occur. I personally like to use the biceps as a good example. The first type of a contraction which plays a prominent role in building up the muscle is called a concentric contraction. This is where the muscle is shortening to lift an external load. In terms of a biceps curl, this would be the going up phase. The second type of contraction which plays a prominent role in building strength of the muscle tendon is an eccentric contraction. During an eccentric contraction, the muscle is lengthening in a slow and control manner. In terms of a bicep curl, this would be the down phase. If one had no eccentric control, the arm would simply fall down rather than being able to slowly descend. The last type of exercise is an isometric contraction. During isometric contractions, the muscle is not changing in length, but is being activated. If one were to add some pressure at the wrist and try to perform a bicep curl without the arm moving, this would be an example of an isometric contraction. When it comes to strengthening exercises for the plantar fascia, being that eccentric exercises better load the tendons of muscles, these types of exercises have been found to be helpful in reducing heel pain.

STRETCHING AND STRENGTHENING FOR HEEL PAIN FROM PLANTAR FASCIITIS

Some helpful tips for addressing heel pain from plantar fasciitis include gastrocnemius stretching, soleus stretching, and eccentric calf lowering.

  1. Gastrocnemius stretching
    1. Stand at the base of a step or against a wall with your foot pointed up to towards the ceiling.
    2. With your knee straight, lean forward until you feel a stretch along the calf muscle
    3. Hold this position for 30 – 90 seconds 3 times per day
  2. Soleus stretching
    1. The set up for the soleus stretch is very similar to the gastrocnemius stretch, but as stated above, the soleus is a one joint muscle.
    2. To place the gastrocnemius on slack so the soleus muscle can be targeted through stretching, one would repeat the above instructions but have the knee of the bent.
    3. Hold this position for 30 – 90 seconds 3 times per day.
  3. Eccentric Calf Lowering
    1. Perform a calf raise on both legs by pressing your toes down towards the ground and lifting your heels from the floor.
    2. Once in a position where both heels are both lifted off the ground, lift one foot off of the ground so you are only standing on the toes of one foot.
    3. Slowly and in a controlled fashion, lower your heel back towards the floor.
    4. Repeat for 3 sets of 10 repetitions once a day.

Rose Physical Therapy is here in Washington, DC to help!

If you are struggling with the exercises above or you have had unresolved heel pain for more than 2 weeks it’s probably time to give us a call to setup an appointment, or schedule through our website. Either our office in downtown Washington, DC between Dupont Circle and Farragut Square, or at our office in Navy Yard and Capitol Riverfront, just a few blocks from Capitol Hill DC has the best area physical therapists who are capable of getting you on the track to recovery. One-on-one appointments at Rose are about one-hour with a physical therapist, never a technician. And Rose Physical Therapy in Washington, DC accepts most private health insurance so that the best physical therapy is also affordable for you based on your insurance plan.