To recap on our first blog, the plantar fascia functions to maintain the shape of the arch through the different phases of the gait cycle. Plantar fasciitis is generally believed to be caused by excessive strain within the fascia due to repetitive loading that causes micro tears and an acute inflammatory response. Inflammation is our bodies natural response to injury and is an important part of the healing process.

So, what is happening? The problem happens when the body isn’t able to go through the full healing process before the next micro-tear occurs. At this point, you are stuck in a continuous cycle where tears continue to happen, not healing properly, leading to a buildup of scar tissue, a weakening of the plantar fascia, and poor blood flow to the area. All this makes treating the plantar fascia a tricky and length process at times. 

Risk factors that may contribute to plantar heel pain but not limited to: 

• Loss of ankle dorsiflexion  

• Flat feet or high-arched feet 

• Excessive foot pronation 

• Impact/weight bearing activities such as prolonged standing, running, etc. 

• Improper shoe fit 

Treatment Recommendations:  

• Apply heat to promote increased blood flow to the area 

• Self-massage to break up scar tissue buildup 

• Mobility drills if lacking ankle/foot range of motion 

• Strengthening exercises

Below is my go-to exercise when rehabbing someone dealing with plantar fasciitis and it’s based off an evidence-based rehab protocol by Rathleff et.al (2014).

How to perform:

• Roll up a towel and place it on a step

• Place your toes on the towel to maximally extend the toes (find that sweet spot, even if it’s a small towel roll at first)

• Perform a single leg heel raise. We want to increase time under load…so go slow! Take 3 seconds to rise, hold 2 seconds, 3 seconds to lower.

• If it’s too painful to start on one leg, start on two and progress

• Perform every 48 hours

It’s okay to feel some slight pain while performing the exercise, as long as symptoms return to baseline in 24 hours!

Progressions:

• Week 1-2: Perform 3x12

• Week 3-4: Perform 4x10 (add external load such as a weighted vest or backpack with canned goods)

• Week 5-12: Perform 5x8 (progress load)

If you’re dealing with plantar fasciitis and don’t know what to do next, I’d love to help. Schedule a complimentary call and start your journey back to running! Thanks for taking the time to read!

References:

Rathleff, M. S., Mølgaard, C. M., Fredberg, U., Kaalund, S., Andersen, K. B., Jensen, T. T., … Olesen, J. L. (2014). High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scandinavian Journal of Medicine & Science in Sports, 25(3). doi: 10.1111/sms.12313

Plantar Fasciitis https://www.physio-pedia.com/Plantar_Fasciitis