Heel pain

If the first few steps of each day feel you’re like walking on broken glass, then it’s possible you have a condition called plantar faciitis (a.k.a plantar fasciopathy).

This stubborn condition comes on gradually, causing acute heel pain after resting and without treatment these symptoms can linger on for for a long time and periodically recur.

What is plantar fasciitis?

The plantar fascia is a thick band of tissue connecting your heel and the base of your toes, which supports the arch of your foot when you move around. Accumulative strain in the plantar fascia can cause pain over time, either in your heel or in your instep (or both). The clinical term for this is plantarfaciitis.

As with most overuse injuries, there are usually several underlying factors which all have the potential to contribute to this issue such as:

  1. Low arches in your feet
  2. Stiff ankle joints or tight calf muscles
  3. Weakness of the deep muscles in the soles of your feet
  4. Poor strength around your hips

What are the best exercises for plantar fasciitis?

A physiotherapist will be able to examine you for all the underlying factors and provide you with an effective treatment programme targeting the problems which are specific to you.

In the short-term you will need to avoid or decrease any activities that flare up your heel pain. A gel insert to support your heel can also be helpful, particularly if you are wearing work shoes.

Warm up your feet using a spiked ball:

Heel pain exercise

 Strength training

Before you start, roll up a towel and lift up onto tip toes. At the top of the movement your toes should be pressed back as far as they can be, if not adjust the thickness of the towel:

Strength training to reduce heel pain

This exercise must be completed slowly, three seconds going up, two seconds pause at the top and three seconds coming down.

You need to establish the heaviest weight you can lift onto tip toes – for one repetition – giving it your maximum effort. This is your one-repetition maxmimum (1RM).

This might simply be your body weight with both feet on the ground or on one leg, as you get stronger you can use a backpack and add books to the pack to increase the load.

Start with 12RM for three sets, every other day. After two weeks increase the load as recommended above but reduce the number of repetitions to 10 RM for four sets. At four weeks, increase the load again and complete 8RM for 5 sets. Continue the exercises adding more load as you get stronger until you reach three months, even if your heel pain resolves in the meantime (you don’t want it to come back again).

It’s nothing to worry about you experience some pain during this exercise but it shouldn’t persist afterwards or cause a flare up in your symptoms later.

Calf stretchesCalf stretch 1

Cake stretch 2

Stretch out your calf muscles, hold each stretch for 30 seconds, rest for 10 seconds and repeat three times:

Nerve glidingNerve gliding exercise

Lie on your back with your knee bent and bend your ankle. Turn the sole of your foot outwards and holding this position bend and straight your knee. Repeat up to 30 times within a comfort zone.

Plantar Fascia stretch Stretch for the plantar fascia 

Take hold of your toes and bend them backwards until you feel a stretch in the arch of your foot. Hold for 10 seconds, repeat 10 times, up to three times per day.

 

The take home message is that plantar faciitis responds well to treatment but you have to be diligent with your exercises or they won’t be effective.

Plantarfaciits also responds well to shockwave therapy but this is also more effective if you have a strong rehab programme in place.

Don’t hesitate to get in touch if you have any questions,

The Physiofit Team!