Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain, affecting millions of people each year. It occurs when the plantar fascia, a thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes, becomes inflamed or irritated.

Symptoms

The hallmark symptom of plantar fasciitis is sharp heel pain, especially:

• First thing in the morning when taking the first steps out of bed.
• After long periods of rest (like sitting or lying down).
• After exercise, though not usually during the activity itself.

The pain often decreases as the foot warms up but may return after prolonged standing or walking.

Causes and Risk Factors

Plantar fasciitis is often caused by:

• Overuse or increased activity
• Foot mechanics, such as flat feet, high arches, or an abnormal walking pattern
• Improper footwear
• Obesity, which puts extra strain on the foot

Treatment

Initial treatment can be remembered by the acronym, LUSKIN:

Frozen Water Bottle Roll
Roll your bare injured foot back and forth from your heel to your mid-arch over a frozen water bottle. Repeat for 3 to 5 minutes. This exercise is particularly helpful if done first thing in the morning.

Towel Stretch
Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around the ball of your foot, and pull the towel toward your body. Be sure to keep your knee straight. Hold this position for thirty seconds and repeat three times.

Standing Calf Stretch
Facing a wall, put your hands against the wall at about eye level. Keep the uninjured leg forward and your injured leg back about 12-18 inches behind your uninjured leg. Keep your injured leg straight and your heel on the floor and keep your toes pointed towards the wall. Next, do a slight lunge by bending the knee of the forward leg. Lean into the wall until you feel a stretch in your calf muscle. Hold this position for 30-60 seconds, and repeat 3 times.

Half Kneeling Ankle Mobility
Start by placing the knee of the uninvolved leg down on the floor and the involved leg out in front of your body so you are in a 90 degree lunge. Your knee should be stacked on top of your ankle. Keeping your foot/heel flat on the floor, slowly shift your hips forward so that your knee moves over your toes deepening your lunge. Hold for 5-10 seconds. Press your hips back to starting position. Repeat for 3 sets of 10 repetitions. Try to press your knee further out over your toes with each repetition.

Plantar Fascia Stretch
Stand with the ball of your injured foot on a stair. Reach for the bottom step with your heel until you feel a stretch in the arch of your foot. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. After you have stretched the bottom muscles of your foot, you can begin strengthening the top muscles of your foot.

Towel Pickup
While sitting in a chair with your heel on the ground, pick up a towel with your toes. Release. Repeat 10 to 20 times. When this gets easy, add more resistance by placing a book or small weight on the towel.

Towel Windshield Wipers
While sitting in a chair with your heel on the ground, pick up a towel with your toes and move foot out and in 10 times. Complete 3 sets of 10.

Arch Squeeze
Place a chair next to your non-injured leg and stand upright. The chair will provide you with balance if needed. Stand on your injured foot. Try to raise the arch of your foot while keeping your toes on the floor. Try to maintain this position and balance on your injured side for 30 seconds. This exercise can be made more difficult by doing it on a piece of foam or a pillow, or with your eyes closed.

Reaching Dynamic Balance
Start by standing on one leg. Engage your core and hinge forward at your hips while lifting your opposite leg straight behind you. Reach toward the table with the same side hand as your lifted leg. Coordinate the movement of your torso and lower body so that your chest lowers as your leg is lifting, like a teeter totter. Keeping your leg lifted and core tight, return to the starting position.

Resisted Dorsiflexion
Sitting with your leg out straight and your foot near a door, wrap the tubing around the ball of your foot. Anchor the other end of the tubing to the door by tying a knot in the tubing, slipping it between the door and the frame, and closing the door, or have a friend or family member hold the band for you. Pull your toes toward your face. Return slowly to the starting position. Repeat 10 times, and do 3 sets of 10.

Resisted Plantar Flexion
Sitting with your leg outstretched, loop the middle section of the tubing around the ball of your foot. Hold the ends of the tubing in both hands. Gently press the ball of your foot down, and point your toes, stretching the THERA-BAND. Return to the starting position. Repeat 10 times, and do 3 sets of 10.

Resisted Inversion
Sit with your legs straight out and cross your uninjured leg over your injured ankle. Wrap the tubing around the ball of your injured foot and then loop it around your uninjured foot so that the THERA-BAND is anchored at one end. Hold the other end of the THERA-BAND in your hand. Turn your injured foot inward and upward. This will stretch the tubing. Return to the starting position. Repeat 10 times, and do 3 sets of 10.

Resisted Eversion
Sitting with both legs outstretched and the tubing looped around both feet, slowly turn your injured foot upward and outward. Hold this position for 5 seconds. Repeat 10 times, and do 3 sets of 10.

Prevention

To prevent plantar fasciitis from returning:

• Maintain a healthy weight
• Wear supportive shoes
• Stretch your feet and calves regularly
• Avoid walking barefoot on hard surfaces

Plantar fasciitis can be painful, but with early recognition and proper treatment, most people recover fully. If heel pain persists despite home care, it’s important to consult a healthcare provider for further evaluation and management.