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If you’re experiencing pain from plantar fasciitis, there are exercises you can do to help alleviate the discomfort. Both seated and standing exercises can be effective in providing relief. Here’s what you need to know:

Understanding Plantar Fasciitis

The plantar fascia is a thin ligament that connects your heel to the front of your foot. When it becomes damaged or torn due to repetitive motion or increased pressure, it can lead to inflammation and heel pain. This condition, known as plantar fasciitis, is a common cause of heel pain, affecting more than 50 percent of people. It is often seen in runners and pregnant women due to the strain placed on the ligament.

Stretching Solutions

Stretching your feet and calves can help soothe and prevent plantar fasciitis pain. Consider incorporating the following stretches into your routine:

Stretching Your Calves:

1. Stand about an arm’s length away from a wall.
2. Position your right foot behind your left.
3. Slowly and gently bend your left leg forward.
4. Keep your right knee straight and your right heel on the ground.
5. Hold the stretch for 15 to 30 seconds, then release. Repeat three times.
6. Switch the position of your legs and repeat the stretch.

This stretch primarily targets the gastrocnemius muscle in your calf. As your plantar fascia heals and pain decreases, you can deepen the stretch by performing it with slightly bent legs. This variation focuses on loosening the soleus muscle in the lower calf. Remember not to hold the stretches for too long.

Seated Stretching Exercises for the Plantar Fascia:

1. Sit upright and roll your foot back and forth over a frozen water bottle, ice-cold can, or foam roller for about one minute. Repeat with the other foot.
2. Cross one leg over the other and gently pull your big toe toward you. Hold this stretch for 15 to 30 seconds, repeating three times. Switch legs and repeat.
3. Fold a towel lengthwise to create an exercise strap. Place the folded towel under the arches of both feet while sitting. Grab the ends of the towel with both hands and pull the tops of your feet toward you. Hold for 15 to 30 seconds, repeating three times.

Consistently practicing these stretches before your workout can help reduce heel pain and even prevent plantar fasciitis, according to personal trainer and triathlete Deborah Lynn Irmas.

Additional Tips and Precautions:

1. Rest: Give running a break until the inflammation in your plantar fascia subsides. Rest for approximately two weeks, while icing your foot and taking anti-inflammatory medication if necessary.
2. Gradual Return: After the pain has eased, gradually reintroduce running by starting with short distances at a slow pace. Incorporate calf stretches during your runs, stopping at markers along your route.
3. Supportive Footwear: Make sure you wear sturdy shoes that provide proper support and fit well. The American Academy of Orthopaedic Surgeons emphasizes the importance of adequate support to prevent heel pain and other running-related injuries. Replace your shoes as needed to maintain the necessary cushioning and support.

By following these exercises and precautions, you can help alleviate the discomfort of plantar fasciitis and reduce the likelihood of its recurrence.

Plantar fasciitis surgery is a procedure performed to address the symptoms of plantar fasciitis, a condition characterized by irritation and inflammation of the plantar fascia ligament that supports the arch of the foot.

There are two main types of surgical procedures for plantar fasciitis: plantar fasciotomy and plantar fasciectomy. The primary difference between the two lies in the extent of tissue removal. A fasciotomy involves detaching the fascia from the heel bone without removing any tissue, while a fasciectomy involves making an incision and excising scarred or inflamed tissue.

Plantar fasciitis surgery is typically reserved for cases where other conservative treatments have failed to provide relief. Non-invasive therapies such as orthotic arch supports, splints, taping, physical therapy exercises, icing, massage, medications, injections, and shockwave therapy are usually attempted first. It is estimated that about 90 percent of people respond positively to these conservative treatments within 12 months.

However, if chronic heel pain persists despite these efforts and significantly impacts daily activities, surgery may be considered. The goal of the surgery is to alleviate pain and improve foot mobility, allowing individuals to resume their regular routines.

Suitability for plantar fasciitis surgery depends on various factors, including the severity and duration of symptoms, the failure of non-surgical treatments, and the absence of alternative diagnoses. Candidates for surgery may have persistent severe pain for over six months, an inability to participate in physical activities, or interference with work due to heel pain. However, individuals with certain underlying health conditions like diabetes, peripheral neuropathy, or venous insufficiency may have a higher risk of complications and slower healing.

The surgical procedure can be performed using either an open or endoscopic approach. Open surgery typically takes place in a hospital setting under general anesthesia or regional block with sedation. A small incision is made to expose the plantar fascia, detach it from the heel bone, and address any associated nerve entrapment or bone spurs. Endoscopic surgery, on the other hand, can be performed with local anesthesia and mild sedation. It involves two small incisions under the ankle bone, through which an endoscope and a small knife are used to release the plantar fascia.

Following surgery, post-operative instructions will be provided, and discomfort or minor pain can be expected for several days. Recovery times vary depending on the type of surgery. After open surgery, patients may need a walking boot, cast, or special shoe for several weeks, and full recovery may take 6 to 10 weeks. With endoscopic surgery, limited weight-bearing is possible soon after the procedure, and patients may be able to wear regular shoes within 1 or 2 days. Recovery typically lasts 3 to 6 weeks for endoscopic surgery.

It is crucial to follow post-operative guidelines and attend follow-up visits as recommended by the healthcare provider. Wearing supportive shoes, particularly during physical activities, is advised to prevent future issues. While plantar fasciitis surgery can be successful in relieving chronic heel pain, there are potential risks and side effects such as adverse reactions to anesthesia, infection, slow wound healing, nerve injury, recurring heel pain, or a flattening of the foot’s arch. Any increasing pain or signs of infection should be reported to the doctor promptly.

If conservative treatments have been unsuccessful and plantar fasciitis significantly impairs daily life, consulting with a healthcare professional can help determine if surgery is a suitable option.

Plantar fasciitis is a condition that causes heel pain and can affect individuals of all ages and activity levels, although it is more commonly seen in runners and those who spend extended periods on their feet.

Research has shown that both strengthening and stretching exercises, including Achilles tendon stretches, can significantly reduce pain and improve walking ability in people with plantar fasciitis.

If you have been diagnosed with plantar fasciitis or are experiencing heel pain, a physical therapist can create a personalized treatment plan for you. This may include:

• Assessing your walking pattern and providing gait training.
• Instructing you on when to apply ice for pain and inflammation.
• Applying temporary taping to your foot for short-term relief.
• Recommending shoe inserts, supportive footwear, or a night splint.
• Teaching you specific stretching and strengthening exercises.

Physical therapists are experts in movement and can enhance your quality of life through hands-on care, patient education, and prescribed exercises. You can directly contact a physical therapist for an evaluation. To find a physical therapist in your area, visit Find a PT.

Here are six exercises recommended by physical therapists that you can try at home:

1. Plantar Fascia Massage

• Sit in a chair or stand with one foot resting on a small ball or frozen water bottle (ice can help reduce inflammation).
• Roll the ball or bottle gently forward and backward under your foot, starting just below the ball of your foot and ending just before the heel.
• Repeat the rolling motion slowly 10 times for each foot, performing two sets per foot.
• Do this exercise once daily.

2. Heel Raise

• Stand with the balls of your feet at the edge of a step.
• Allow your heels to hang off the edge and slowly lower them just below the step, feeling a stretch in your calf muscle.
• Rise up onto the balls of your feet and then lower again.
• Repeat this movement 10 times, resting between sets.
• Complete two sets of this exercise.
• Do this exercise once daily.

3. Floor Sitting Ankle Inversion With Resistance

• Sit upright on the floor with your legs straight out in front of you, ensuring no hip movement during the exercise.
• Cross your left leg over your right leg and secure an elastic exercise band around your upper left foot, looping it around the bottom of your lower right foot. Hold the end of the band in your hand.
• Rotate your left ankle inward, moving your upper foot away from the lower foot, and then return it slowly to the starting position.
• Repeat this movement 10 times for each foot, performing two sets per foot.
• Do this exercise once daily.

4. Seated Toe Towel Scrunches

• Sit upright in a chair with one foot resting on a towel, spreading your toes.
• Curl your toes to scrunch and draw the towel toward you.
• Repeat this scrunching motion 10 times, performing two sets per foot.
• Do this exercise once daily.

5. Seated Plantar Fascia Stretch

• Sit in a chair and cross one leg over the opposite knee, with the ankle on top.
• Hold your ankle with one hand and your toes with the other hand, gently pulling your toes backward until you feel a stretch in the bottom of your foot.
• Hold this position for 20 seconds and repeat three times for each foot.
• Do this exercise once daily.

6. Wall-Facing Calf Stretch

• Stand facing a wall, with your hands flat against the wall at arm’s length.
• Keep both feet flat on the floor and extend one leg straight backward, bending the front leg until you feel a stretch in the calf of the back leg.
• Hold this stretch for 20 seconds and repeat three times for each leg.
• Do this exercise once daily.

The rising popularity of plantar fasciitis socks as a cost-effective solution for the condition has caught the attention of many. Numerous websites promote these socks, claiming to cure plantar fasciitis. With a wide range of options available, from footless to knee-length, in different colors and with various features such as gel heels, ice pack pouches, splints, or support straps, the choices can be overwhelming and confusing. Moreover, the prices range from £10 to £50, adding to the complexity. Furthermore, the product descriptions often contain medical terminology, making it even more challenging for consumers to navigate the information.

However, the key question remains: Do plantar fasciitis socks actually work?

The straightforward answer to this frequently asked question about the effectiveness of plantar fasciitis socks is that we don’t have a definitive answer. While there are many anecdotal accounts on the internet from individuals who claim that these socks healed their condition, there is no published, peer-reviewed clinical evidence to support these claims.

As a sports podiatrist and healthcare professional, I prioritize medical facts. It is crucial that the treatments we employ are not only safe but also proven to be effective. At present, plantar fasciitis socks do not meet the criteria for established treatments. Interestingly, during the process of writing this article, we encountered a website asserting a connection between their product and a clinical trial. However, when we followed their link to examine the evidence, no such article could be found.

So what about the individuals who assert that plantar fasciitis socks have treated their condition? Making such claims is a significant and intricate matter. The reason is simple: in the realm of medical science, or any scientific field for that matter, claims of efficacy necessitate at least one, and usually several, reproducible trials. When conducting a trial, there are established rules that must be followed to ensure unbiased and valid results. In essence, these rules involve controlling variables accurately, enabling statistically rigorous analysis of results to draw meaningful conclusions that can be replicated consistently.

For instance, if a study were conducted to evaluate the efficacy of plantar fasciitis socks in treating the condition, researchers would need to consider and control variables such as the type of footwear worn by the patients, the number of steps taken, the level of physical activity engaged in, the initial severity of the plantar fasciitis injury, and factors like body weight, gender, and concurrent medical conditions, among others. Researchers would also need to address how to avoid biased reporting or the “placebo effect” in patients and how to tangibly measure the healing effect of plantar fasciitis socks.

So, how are people experiencing relief from plantar fasciitis socks? At first glance, these socks provide pain relief through compression. Sports podiatrists commonly acknowledge that compression is an effective method to reduce swelling and inflammation. However, this can be achieved through proper strapping techniques without the need for expensive plantar fasciitis socks. Additionally, it is highly unlikely that compression alone is sufficient to facilitate the healing of an injured plantar fascia. As mentioned earlier, other concurrent treatments or remedies utilized by patients could also influence the healing process and pain relief. Without this information, drawing definitive conclusions is challenging.

Now, what alternative treatments, proven to be effective, exist for plantar fasciitis apart from plantar fasciitis socks?

If you are suffering from plantar fasciitis, I would recommend consulting a sports podiatrist regarding clinically proven treatments. Examples of such treatments include custom-made orthotics that provide appropriate arch support, relieving pressure on the plantar fascia and aiding its healing, as well as shockwave therapy, which has been shown to stimulate blood flow, tissue regeneration, and provide almost immediate pain relief.

At our clinic, we do not currently stock plantar fasciitis socks, nor do we plan to do so in the foreseeable future. This decision is primarily due to the lack of credible scientific evidence supporting the efficacy of these products. However, this does not imply that plantar fasciitis socks have no value in providing relief for individuals with foot conditions; they may offer benefits for individuals with fatigued feet or other conditions. Nevertheless, the current lack of evidence regarding their effectiveness in treating plantar fasciitis should be taken into consideration.

Please note that the information provided in this article should not be regarded as general medical advice. It is intended for informational purposes only. If you are dealing with plantar fasciitis, it is important to consult a sports podiatrist for an accurate diagnosis and a personalized treatment plan. Prioritize the available evidence before considering the purchase of plantar fasciitis socks.

Plantar fasciitis is typically diagnosed based on a medical history review and a physical examination. During the examination, a healthcare provider will assess areas of tenderness in the foot. The location of the pain can help determine the cause of the condition.

In most cases, imaging tests are not necessary for diagnosing plantar fasciitis. However, in some instances, an X-ray or MRI may be recommended to rule out other potential causes of the pain, such as a stress fracture.

Conservative treatments are usually effective in helping most people recover from plantar fasciitis within a few months. These treatments may include icing the affected area, performing stretching exercises, and modifying activities that worsen the pain. Shockwave therapy falls into this category and is usually the most effective.

Pain relievers like ibuprofen or naproxen sodium can be used to alleviate pain and inflammation associated with plantar fasciitis. Physical therapy and the use of specialized devices, such as night splints or orthotics, may also be recommended to relieve symptoms and promote healing.

If conservative measures fail to provide relief after several months, additional procedures may be considered. These can include injecting steroid medication into the tender area for temporary pain relief or using extracorporeal shock wave therapy to stimulate healing. In rare cases, surgery may be recommended to detach the plantar fascia from the heel bone, but this is typically only done when the pain is severe and other treatments have been unsuccessful.

Plantar fasciitis, a common foot condition characterized by heel pain, affects approximately one in ten people at some point in their lives. The pain is often most severe after periods of rest, such as upon waking up in the morning or after prolonged sitting.

Your doctor may provide comprehensive care for plantar fasciitis, including customized stretches and night splints. Night splints are medical devices worn on the feet while sleeping, and they can offer relief from plantar fasciitis pain.

Understanding why rest worsens plantar fasciitis pain

The plantar fascia is a thick band of tissue that runs along the bottom of the foot, connecting the heel to the toes. It provides support and absorbs shock during activities like standing, walking, and running.

Repetitive movements, overuse, and stress can lead to irritation and inflammation of the plantar fascia, resulting in plantar fasciitis. The pain is often more intense after periods of inactivity because rest causes the inflamed tissues to shorten. When you resume walking, the tissues stretch again, leading to increased pain.

How night splints alleviate plantar fasciitis pain

Rest is an essential component of the recovery plan for plantar fasciitis. However, it may seem counterintuitive since rest can exacerbate the pain. The key lies in balancing rest with gentle stretches, and Dr. Glover often prescribes customized stretches to relieve tension in the foot, heel, and ankle. Night splints complement these treatments by providing pain relief.

Night splints resemble boots or socks and are worn on the foot before going to sleep. The device elevates the toes and keeps the foot gently stretched throughout the night. Wearing a night splint should not be painful but rather provide a gentle stretch along the sole of the foot. Adjustable splints are available to ensure the best fit for individual needs.

The stretch offered by night splints helps maintain the length of the plantar fascia even during periods of inactivity. It also promotes blood flow, reducing inflammation and pain. Upon waking up, the splint is removed, and you can proceed with your day. By preventing the tightening of the plantar fascia during rest, you should experience less pain when taking the first steps in the morning.

Night splints and other plantar fasciitis treatments

Night splints are noninvasive and drug-free, making them highly effective conservative treatments for plantar fasciitis. Depending on the condition, your doctor may prescribe night splints alongside other treatments to facilitate the healing of the plantar fascia. These additional treatments may include daily stretches, custom orthotics, nonsteroidal anti-inflammatory drugs (NSAIDs), or corticosteroid injections.

You’ve tried conventional treatments for heel pain? You’re an expert in the ins and outs of taking rest? You’ve filled your freezer with ice packs? Your bathroom cabinet is bursting with pain relief and anti-flammatory meds? You’ve slipped on the support devices more often than you’d care to remember? You feel all physio’d out with all kinds of physical exercise? If this sounds like “my life with plantar fasciitis so far” and it’s all been to no avail, you might want to read on, ready to try something shocking!

You might have heard about Shockwave treatment for plantar fasciitis, referred to by NICE (National Institute for Health and Clinical Excellence) as Extracorporeal Shockwave Therapy For Refactory Plantar Fasciitis. Let’s break down its meaning;

Extracorporeal – outside the body

Refractory – (as above) it doesn’t respond to conventional treatments

Shockwave – high energy inaudible sound waves directed through the skin

What is Extracorporeal Shockwave Therapy For Refactory Plantar Fasciitis?

Shockwaves are passed through the skin to the affected area using a special device where ultrasound guidance might be used in a clinical setting to get to the place in need of treatment. Here the soft tissues and tendons are stimulated into healing and regeneration in one or more sessions that reduce the pain at the time and afterwards.
The process is like a non-surgical version of standard operative procedures for tennis elbow, where tiny holes are burned into the site of pain and strain to cause blood to flood the injury zone and start the body’s own process of healing. The advent of shockwave therapy has replicated this process using vibration instead of surgical tools so all the inconvenience, expense and risk of surgery are eliminated.

Does it work?

In one study cited in the NICE guidelines 25 more patients than those receiving the placebo treatment reported less pain after 3 months and didn’t need medication.

In a further study 56 more patients receiving the shockwave therapy reported a reduction in pain relief 3 months into their treatment than those receiving a placebo.

What’s more, the NICE procedure guidance leaflet details a study of 149 patients with 69% of patients who had the procedure reporting “an excellent result” (no heel pain) whereas those who had received conventional treatments – you know the ice, the rest, the exercise, the meds – reported some pain after an average of 64 months.

Overall therefore it seems that assessment on Extracorporeal Shockwave Therapy appears positive. NICE’s own go-to expert advisors say the main success is the relief of symptoms. For long term sufferers that offers hope and a way forward.

Will my GP prescribe it?

Realistically what are the chances of your doctor offering you ESWT on the NHS? As we’ve discussed in previous articles, this is pretty unlikely due to budget constraints. This kind of treatment is often only available privately costing upwards of £300 per session as it must be delivered in a hospital setting with all associated costs.

As a result, plantar fasciitis sufferers are now seeking low cost alternative shockwave treatments that they can try themselves at home or work.

Next week: Going under the knife – when is it time to think about surgery?

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“Walking is the best possible exercise” if you’ve heard that phrase as a plantar fasciitis sufferer it probably makes you wince. But exercising your way out of pain might be worth looking into. What top 3 exercises do experts consider to be the best way to ease away the pain of chronic heel discomfort?

Early on in the diagnosis of plantar fasciitis it’s vital to get the balance right between light exercise to stretch and strengthen your inflamed plantar fascia ligament and rest which will allow the tears and strains to heal. So, with that in mind, start your exercise regime lightly and be gentle on yourself and your inflamed feet.

We tend to think of exercise as vigorous activity, but that may be what has caused the condition in the first place, if you’ve done too much running, power walking, jogging or ball court sports. Instead opt for our top 3 basic stretch and flex exercises that avoid weight bearing altogether and can be carried out in a seated or supported position in the comfort and privacy of your own home.

Exercise 1

Sit comfortably on a chair and place your foot on a tennis ball or rolling pin, some find a chilled bottle of wine does the job for arch rolling! You want something curved that will support the shape of the arch of your foot as you gently move it back and forward to ease the pain. Repeat as necessary. If you are able to progress to standing then do so – but gently. It’s probably best to use a tennis ball for this.

Exercise 2

You may want to follow this exercise with a gentle toe stretch. Simply place each heel in turn on the floor, reach forward and pull your big toe up and towards you holding for approximately 20 seconds. Aim for 4 reps on each foot, several times a day.

Exercise 3

Another great seated activity is the towel stretch. You can do this by sitting on the floor with your legs outstretch in front of you. Place a lightweight flexible towel under the ball of your foot. Pull the towel gently towards you without bending your knee to allow the foot to gently flex for approximately 30 seconds. Aim for 4 reps on each foot. Try to do this daily and feel the give in your calf and foot.

Any more activities?

If you’re keen to keep your entire body active as part of general health and wellbeing but can’t stand the pain of walking or running, consider swimming or gentle cycling. Both forms of exercise, if undertaken gently, will allow you to flex and stretch your feet without having to bear the weight of your body. This should help you feel lifted.

If for whatever reason you’re unable to undertake exercise, maybe through injury or disability, you might consider a device for shockwave therapy to the injured area.

Next week: Shockwave therapy for heel pain – does it work?

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