Heel Pain and Plantar Fasciitis

Heel pain is usually related to the plantar fascia, a thick band of tissue that supports the arch of the foot. Plantar fasciitis is characterized by pain, inflammation, and even degeneration of this structure. The exact cause of plantar fasciitis is not completely understood. Possibilities include overuse, small tears, improper shoes, and stiffness of the plantar fascia itself and also the Achilles tendon.

The pain from plantar fasciitis begins gradually and is felt under the heel. It is usually worse in the morning or when first standing after sitting for a period of time.

Treatment starts with gentle stretching of the plantar fascia and the Achilles tendon to decrease the tension on these structures. Listed below are two stretching exercises that have been shown to help with plantar fascia pain.

In addition to stretching, there are other steps that may help. First, use a gel “heel cup” to cushion the plantar fascia. This inexpensive device can be purchased in most drug stores and is just as effective as custom orthotics–which are not covered by insurance and can be very expensive. Second, roll a frozen water bottle under your foot for a few minutes several times a day. This helps with inflammation and also loosens the plantar fascia. Finally, wear a “night splint” (we can prescribe this) to keep the Achilles tendon and plantar fascia stretched while you are sleeping.

Achilles Tendon Stretch
achilles-tendon-stretch
  1. Stand facing a wall. Press your palms on the wall and bend the unaffected leg until your knee is directly over your toes. The leg affected by the Achilles pain should remain straight.
  2. Slowly move the straight leg backward until you feel a stretch in your calf. Hold the stretch for 30 seconds.
  3. Repeat the exercise for the other leg if both sides are injured.

Number of stretches per set: 3 – 5 (30 seconds each)
Sets per day: 3 – 5

Plantar Fascia Stretch

plantar-fascia

  1. Sit on a chair and cross your leg such that the painful foot rests on the opposite knee.
  2. Then use your hand on the same side as the painful foot to gently pull back your big toe.
  3. With your other hand (while holding the stretch) gently massage the plantar fascia at the base of the heel where you feel the pain.
  4. Hold for 10 seconds and repeat.

Number of stretches per set: 10 (10 seconds each)
Sets per day: 3 – 5

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