Plantar Fasciitis is a foot condition that some runners may experience. It’s not necessarily a “running” condition, though some runners may experience it.
If you have Plantar Fasciitis, you already know that the pain can be excruciating, especially in the morning. But did you know that a few simple exercises can help reduce pain, promote healing, and prevent future occurrences of this condition?
In addition to other easy, at-home treatments recommended for heel pain, exercises and stretching can contribute a lot to your comfort while you’re recuperating. With 10% of people in America experiencing the pain of Plantar Fasciitis at some point in their life, it’s information worth knowing ahead of time, too.
What Is Plantar Fasciitis?
The plantar fascia is a broad, firm, band of ligament-type tissue that is attached to the heel bone and stretches along the bottom of your foot to the base of your toes. You can feel it if you flex your foot and press along the inside of the arch. In fact, the plantar fascia is one big part of the assembly that makes up the arch of the foot.
Like any tendon or ligament, this tissue can become inflamed and sore. Tiny tears also occur, particularly at the heel bone attachment point. Walking or standing become painful as the full weight of your body stretches out the tender ligament. This medical condition is called Plantar Fasciitis (PLAN-tar Fash-ee-EYE-tis). The name means:
- Plantar indicates bottom of the foot
- Fascia is the type of connective tissue
- -itis is a suffix meaning inflammation
This inflammation of the plantar fascia causes pain at the heel attachment point, or anywhere along the ligament up to the base of your big toe. Some people have debilitating pain for part or all of a day; others just feel a troublesome twinge. Most commonly, sufferers experience a sharp pain first thing in the morning until their plantar fascia warms up through activity. The pain then subsides, but can return later in the day. In some rare cases, people have pain even when their foot is at rest, such as when they are trying to sleep.
How Did I Get Plantar Fasciitis?
It’s not hard to imagine why your foot is subject to injuries like Plantar Fasciitis. Your feet support you AND all the forces applied to you. A typical human can put as much as 1000 tons of force per day on their body, and all that force must ultimately be supported by the feet. That’s up to 7 times your body weight when you’re doing activities like playing sports or running up and down stairs. The feet “support” this weight by absorbing and distributing it among all the small bones, muscles and ligaments. The plantar fascia bears the brunt of this burden.
Picture a rubber band drawn tight to capture the force of the heel striking the ground; then it is let loose as you rise up onto the ball of the foot and toes to propel yourself up and forward. This is the function of the plantar fascia, and also just like a rubber band, with time or excessive hard use, small tears occur in the fibers of the band. These repeated stresses eventually cause painful swelling and irritation. Although a complete break of the ligament is rare, it does happen—but this event is obvious and immediately painful. In most cases, people won’t feel the pain of Plantar Fasciitis until a day or two after the incident, which can make it hard to pinpoint one single cause.
What Causes Plantar Fasciitis?
Although one single event is in some cases responsible for triggering a case of Plantar Fasciitis, it’s more accurate to say that people are at risk for the condition. Anyone can “get” it, but some people are more likely to, either because of lifestyle factors or activity choices. You will probably recognize yourself in at least one of the risk factors below, and possibly even in several
This is probably the greatest single risk factor leading to Plantar Fasciitis. In some rare cases (such as pregnancy), your weight gain cannot be avoided. But in general, overweight people—particularly women—are much more likely to have persistent pain from the condition. A rapid weight gain is more likely to cause the problem, because the foot does not have adequate time to adjust to the greater and different stresses placed upon it.
In addition to the obvious fact that more weight puts more force on the foot with every step, extra weight changes the way the foot has to work. When we walk, we’re essentially “tipping over” on the leading foot, and then catching ourselves with the swinging foot. The point of highest stress on the plantar fascia comes with the effort exerted to tip over—and tipping over a heavier person is harder.
Thus, the ligament needs to work harder with more weight in this situation. The reason women are most susceptible is because their center of balance is lower than a man’s, which already puts additional strain on the plantar fascia during the act of walking.
So if you have developed Plantar Fasciitis and are overweight, you will go a long way toward licking this condition by losing weight.
Inflexible Calf Muscles
This probably ranks equal with weight as a risk factor, but overweight people tend to be inactive physically. And an inactive lifestyle is likely to contribute to calf muscles that are tight or too short. There are also some people who simply have short calves.
The consequence is that their feet are not allowed to work as efficiently as they were designed to, forcing the toes into the ground too soon and rarely allowing the plantar fascia to extend to its full capability.
There are various stretching exercises that will be very effective for limbering up your calves and ankles. If you have a biomechanical problem (such as short calf muscles that will not respond to simple at-home stretches), then other remedies can be suggested by a podiatrist. But for most of us, gently stretching the calves and ankles—every day, and always before any physical activity—will work wonders for preventing a recurrence of Plantar Fasciitis.
Sudden Change In Activity
This risk factor can apply both to inactive people and active people. If you’re inactive, your calf muscles and plantar fascia are probably not conditioned for the additional stretching that occurs when you suddenly begin to perform activities, even relatively mild ones like walking.
But it’s also true that people considered active can put sudden stresses on their feet that the plantar fascia is not prepared for. For instance, somebody who’s been walking several miles a day for years would not necessarily be prepared to play basketball or soccer without a very thorough and complete program of warm-up exercises.
This risk factor takes on more prominence as we age. When we’re young, we can spend weeks or months fairly inactive, and then suddenly “jump into” something more jarring without experiencing any pain at all.
But with age comes less ability to indulge in that kind of spontaneity without bad effects. It’s always a good idea to stretch well before playing any kind of running or jumping game; but when you’re over 25 years or so, it’s almost a requirement, if you don’t want to get hurt.
Sports and Hard Activity
Sports that require lunging, jumping, or repetitive hard steps are particularly hard on the plantar fascia, especially when they take place on hard surfaces. Tennis, basketball, running, step aerobics, and volleyball are all examples. There is a real possibility of tearing the fascia away from the heel in activities like this, especially in competitive situations.
But beyond the world of sports, some everyday “extreme” activities can cause problems as well. Pushing a heavy cart or rolling something uphill has a similar effect, except that it happens repeatedly.
There is really no amount of warming up that can prevent injury to the plantar fascia in these situations. Your best bet is to stay limber and eat well for bones, muscles and tendons that respond as well as possible in diverse situations. And never exert yourself beyond a point where it feels like something might “snap”.
People in some occupations are more likely to develop Plantar Fasciitis. Waitresses, nurses, mail carriers, and teachers are all people who spend too much time on their feet each day. Anybody who needs to stand or walk most of the day on hard surfaces should wear shoes with a lot of cushioning, and take time out to stretch. If possible, mats or carpeting should be used in areas where you stand for long periods.
What makes a “bad shoe”? One that is stiff, inflexible, and with too little arch support. Look for shoes where the toe bends back easily, and with plenty of cushioning inside. For you runners, this is especially true. Improperly fitted running shoes used over a long period of time (especially if you are of a heavier built) may cause plantar fasciitis. It’s essential that you wear the best running shoes for your feet to avoid any potential plantar fasciitis problems. There are running shoe brands (such as New Balance) that are quite popular with people who suffer from plantar fasciitis. These shoes offer extra arch support which enables the micro tears in the plantar ligaments to heal more easily.
High heels are not necessarily bad, but wearing them too much will get the calf muscles “used” to being foreshortened, and suddenly switching to flat shoes can create a painful shock for the plantar fascia.
Long-term use of flip-flops is particularly hard on the feet because they have zero arch support, and your toes are scrunched together trying to hold them on. This does not put the plantar fascia in the best position to handle stress.
Some people are subject to overpronation, where the ankle rolls inward slightly when walking or standing. This puts more weight on the insides of the feet, and may contribute to the development of Plantar Fasciitis. People with flat feet may experience overpronation more often.
The opposite is underpronation, and can also cause problems by rolling the feet outward. This occurs more often in people with high arches.
Having one leg shorter than the other is likely to cause foot problems, including Plantar Fasciitis.
All the above can be corrected with orthotics (shoe inserts), whether mass-produced or custom made. However, be careful to break in any rigid orthotics as directed, since they can actually make the problem worse if they don’t fit perfectly. If you experience more pain with any orthotic device, stop using it immediately and switch to another or get a doctor’s advice.
Some medications have a side effect or risk of weakening ligamentous tissue. Whether or not these medications actually cause Plantar Fasciitis is not proven, but there is some support for the possibility that quinolone antibiotics are a contributing factor. If your medicine chest includes antibiotics with names ending in “oxacin”, consult your doctor for further information.
This is a risk factor that obviously can’t be controlled, but if you simply can’t think of how you might have injured your foot, realize that older tendons and tissues are more susceptible to rips and tears. It might not take much to do damage if you’re over 50. In addition, the padding of the foot thins as we age, providing less protection from the shock of all the forces we subject the feet to each day.
Whatever led to your getting Plantar Fasciitis, it is very important to start introducing remedies and preventive techniques as soon as you notice this type of pain, because allowing further damage can quickly escalate the condition to a very painful, long-term problem. One of the best ways to stop the pain and start healing is by performing Plantar Fasciitis exercises.
Plantar Fasciitis Exercises
Since most people suffer their worst pain from Plantar Fasciitis first thing in the morning when they step out of bed, it makes sense to address that first. The reason this happens is because the plantar fascia contracts during the night while you’re sleeping and your foot is relaxed.
There are several products made especially to prevent this from happening, or to at least reduce the severity of the pain. Night splints and plantar fasciitis socks attempt to keep the tendon slightly extended all night and not allow it to contract.
But before investing in these products, see if a simple exercise helps you. Before you get out of bed, simply extend your leg and very gently flex your foot. Your goal is to get your foot to 90 degrees or beyond, but any amount of stretch is helpful. Try to do this about 10 times before standing on your foot.
Another way to accomplish this is the Towel Stretch: Sitting on the floor with your legs outstretched, place a rolled towel under the ball of your foot and hold one end in each hand. Gently pull the towel toward you, keeping your knee straight. Hold for 15-30 seconds, and repeat 2 or 4 times.
You can also simply massage the bottom of your foot gently before trying to walk. Most people will do this instinctively, anticipating the pain of stepping on their heel, but they may not be doing a complete enough job to be effective. Try to make it a ritual that lasts at least a couple of minutes and touches the entire bottom of your foot, not just the heel where you feel most of the pain.
More stretching exercises include:
For the muscles of the calf and Achilles tendon. Keeping your lower leg limber and pliable can help a lot in reducing the pain of Plantar Fasciitis and preventing it in the first place. All it involves is:
- Place your hands against a wall at about eye level
- Put the leg you want to stretch about a step behind your standing leg
- Keep your back heel on the floor and bend your front knee until you feel a gentle pull in the back leg.
- Hold for about 30 seconds and repeat a few times
Plantar Fascia and Calf Stretch
This one is easy to do at home or work, several times a day:
- In a stairway or doorway, stand on a step and hold onto the handrail.
- Slowly back up until your heels are over empty air.
- Let your heels down slowly over the edge and relax your calf muscles. You’re looking for a gentle pull across the bottoms of your feet and up the backs of your legs.
- Hold for 15 to 30 seconds, then tighten your calf to bring your heel back up to level
- Repeat 2 to 4 times.
As your lower legs become more flexible with this exercise, you can let more and more of your foot hang over the step until you’re just using the balls of your feet to contact the surface. But don’t do this until your feet and legs feel strong and you have no pain when performing the stretch.
In addition to the stretching exercises above, here are a couple of easy activities meant to strengthen the muscles in your feet and legs:
- Towel Curl: While seated, use your toes to scrunch up a towel spread out on the floor under your foot. Then smooth it out again, still using your toes. If that’s not challenging enough, add some weight to the towel with a can of soup or other small item.
- Marble Game: put some marbles and a cup on the floor. Again while seated, pick the marbles up one at a time with your toes and drop them into the cup.ity