A blog by runners. For runners.

Stretches to Help Plantar Fasciitis

Early last week, Dr. Nace gave us an overview of plantar fasciitis and explained what it is. Now that we know what plantar fasciitis is, we wanted to know a few exercises to help prevent it, as well as treat it. Meredith Franczyk, MPT, shares some great tips and stretches. She will continue to blog for us about injury treatment from a physical therapist's perspective. She works with runners to help them get back to running after struggling with these common injuries.


Plantar Fasciitis Overview

Plantar Fasciitis plagues many people and is common among runners. The plantar fascia, which is the strong band of tissue that attaches from the heel to the toes becomes tight during the propulsive phase of running or known as pre push off. Anatomical risk factors include leg length discrepancy, excessive pronation, flat feet or high arches. Biomechanical risk factors include poor footwear, hamstring/soleus or gastroc tightness and obesity. It?s typically diagnosed when there is pain with the first few steps out of bed or after prolonged sitting. The pain typically improves with activity, but then increases after activity. The pain could also be inflammation of the infracalcaneal fat pad, nerve entrapment or a stress fracture.

Treatment

Rest, I know that that is a difficulty word for a lot of runners to understand, but if the plantar fascia continues to tighten it can cause excessive bone growth to the heel also known as a heel spur. Research has shown stretching to be the most effective way to prevent and treat plantar fasciitis. The research states that you are less likely to injure yourself with a consistent (daily) stretching program rather that just stretching pre and post runs. The recommended stretch time is 20 seconds, 4 times of each stretch per leg. Some other treatment ideas include stretching the fascia by grabbing the toes and pulling up and self-massage to the plantar fascia for about 3-5 minutes. Also, rolling the a frozen water bottle, foam roll or golf ball under the foot has been helpful for instant pain relief. It is also important to strengthen the toe flexors and dorsiflexors. They also sell night splints or sock splints, which keep your feet in a stretched position during the night. You can also see a podiatrist, orthotist or physical therapist for orthotics. A physical therapist can also tape your foot for temporary relief.

Stretches

Gastroc Stretch (Runners Stretch)

Hold 20 seconds, 4 times on each side

Running Injuries

Soleus Stretch

Perform the runners stretch except slightly bend your back knee keeping your heel on the ground.
Hold 20 seconds, 4 times on each side

Running Injuries

Plantar Fascia Stretch

Put both feet on a step and slide one foot about half way off the step and hold for 20 seconds, 4 times each foot.

Running Injuries

Dorsiflexion Strengthening

Stand against a wall and slowly raise your toes up and down. You should feel it in the front of your ankle. 3 sets of 10.

Running Injuries

Prevention

Again, stretching daily rather than just before or after a run is the best way to prevent this from happening. It is also important to not only strengthen the dorsiflexors of your feet, but to also strengthen the hips especially the glutes. Wear proper footwear according to your foot type, remember there is no “breaking in” a running shoe, they should feel comfortable the moment you put them on. If there is an anatomical problem you will probably need to look into custom orthotics for your shoes. It may also be beneficial to have your running form looked at by a professional to see if there is any risk for injury.

If you'd like to get more information about research on plantar fasciitis, please check out these sources:

Amako, M, Oda T, Masuoka, K, Yokoi H, Campisi P. Effect of static stretching on the prevention of injuries for military recruits. Mil Med. June 2003; 168 (6): 442-446.

Shrier I. Does stretching improve performance?: a systematic and critical review fo the literature. Clinical Journal Sports Medicine. Sept 2004;14 (5): 267-273.

Shrier I. Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. Clinical journal sports medicine. Oct 1999 9(4): 221-227.

Thacker SB, Gilchrist J, Stroup DF, Kimsey CD, Jr. The impact of stdretching on sports injury risk: a systematic review of the literature. Med Sci sports exercises. March 2004;36(3):371-378.

Yeung EW, Yeung SS. Interventions for preventing lower limb soft-tissue injuries in runners. Cochrane Database System Review. 2001(3): CD001256.

Running Injuries

Meredith Franczyk, PT, MPT

Meredith has over ten years of experience and is currently working in outpatient orthopaedics at lakeshore physical therapy. Over this time, she has developed specialities in general orthopaedics, manual therapy, and sports rehabilitation. Meredith has specific interests in sports related injuries. She takes a keen interest in new methods and advancements in physical therapy practice and has taken multiple continuing education courses to improve her skills and enhance her knowledge. If you have any questions or are looking for physical therapy please contact her at Lakeshore Physical Therapy.