3 Exercises for Plantar Fasciitis Pain

3 exercises for plantar fasciitis

As one of the most common sources of heel and foot pain that we encounter in physical therapy, plantar fasciitis can often show up without warning, becoming a constant source of pain and disability. If you’re experiencing any symptoms of plantar fasciitis—pain with the first step in the morning, discomfort in the heel or arch while walking after prolonged sitting, or a sensation of a lump or rock in the shoe—early treatment is key to avoiding long-term problems and more aggressive treatments like injections or surgery. If you have heel or foot pain, try these three exercises to strengthen key muscle groups and reduce the amount of force that is placed on your plantar fascia during weight-bearing activities.

Leg Wave

The leg wave strengthens the hip abductor musculature to keep too much stress from falling on the arch of your foot and irritating the plantar fascia.

1. Lying on your side, lift your leg and turn it slightly inward.

2. Bring the entire leg forward and then backward, trying to draw a perfectly level line.

Calf Stretch with Arch Support

This exercise stretches the musculature that ultimately becomes the plantar fascia.

1. Get into standing position with one foot about two feet in front of the other, front leg slightly bent.
2. Place a towel under the arch of the affected foot in order to keep a neutral position and to isolate the stretch and the correct tissue. Feel the stretch in your calf.

3. Move the foot forward and perform the same stretch with a slight bend in the back knee.

Great Toe Extension

Decrease pain of the first steps in the morning with this stretch that can be performed before you even get out of bed.

1. Sitting up, cross your leg over the unaffected leg.
2. Grab your first toe and pull it back.

3. Using the knuckle from your other thumb, move your thumb up from the heel to the toe as you use the other hand to pull the toe back.

4. Repeat 20-30 times before placing weight on the foot.

Peyton Manning’s Plantar Fascia Tear…Is this the End?

Fantasy Football Injury of the Week:  Peyton Manning and his Plantar Fascia

Yesterday we learned that Peyton Manning has a tear in his plantar fascia and will miss at least this week’s game against Chicago.  The fantasy implications of Manning missing time might be minimal (Manning is ranked 30th in my leagues this year for QBs), but as a Denver resident and Broncos fan, this is some serious news.

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This week I want to focus on what exactly is a tear of the plantar fascia, what can be done to treat it, and will Manning play again this season or ever again?

What is the plantar fascia and why is a tear career threatening?

The plantar fascia is a thick band of connective tissue that supports the arch of the foot. In the physical therapy clinic, we most commonly see an acute inflammation or micro-tearing of the fascia near the heel bone, known as plantar fasciitis.  We also see very chronic cases in which there is a buildup of scar tissue at the same location from repetitive micro-tearing followed by healing.  Plantar fascia injuries are one of the more common diagnoses that we see in PT but also one of the hardest to treat, especially the chronic cases.  Even though this band is thick and tough, it’s job is to maintain your arch while supporting all of your body weight.  When the plantar fascia becomes irritated, inflamed or weakened by chronic injury, every step can be painfully perpetuating the injury.

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Manning’s situation is much more severe than the common plantar fasciitis diagnosis we see at Therapydia.  In his case, he has sustained a partial rupture or larger tearing of the plantar fascia.  For any of you who have experienced the pain of plantar fasciitis yourself, that pain is magnified significantly with a partial rupture.  Imagine having a cut on the knuckle of your finger.  Every time you use or bend that finger, the cut painfully reopens and the healing has to start over.  The finger is easy to keep from moving, just buddy tape it or use a splint from the drugstore to keep it from bending.  The foot on the other hand is very difficult to immobilize so the time it takes to heal can be painfully long…..and therein lies the major problem with Peyton Manning’s foot issue.  Will there be enough time for him to return and be effective this year or will this be the end of Manning’s illustrious career?

When will Manning be back and is there anything that can be done to speed up his return?  

Unfortunately, I am not privy to all the details about Manning’s injury.  I can only speculate on what I’ve read or seen on Sportscenter.  The typical time frame for a non-operative recovery of a partial tear of most soft tissue injuries is 12 weeks or more.  This is when we often consider the injured tissue to be back to or near full strength.  However, at 4-6 weeks, the injury could be 80% healed which may be sufficient enough to allow an athlete to return to their sport.  Returning too early though can increase the likelihood of reinjury or lead to another serious problem.  See Arian Foster.

Manning has a few options that may get him back on the field quickly.  Platelet rich plasma (PRP) injections are being used more often these days to speed up the healing process.  Injecting the injured tissue with PRP provides an instant proliferation of growth factors that can quickly stimulate healing.  Tenex is a minimally invasive procedure that removes the damaged or injured tissue, allowing the healthy tissue to regenerate and thrive.  Finally, Manning and his doctors may decide to do a plantar fascia release or surgical cutting of the the partially torn fascia.  By fully releasing the partially torn section of the plantar fascia, tension is released and inflamed nerve endings are no longer sending painful signals to the brain.  However, the long term risk factors of this procedure are much greater than other options including nerve damage, instability in the joint of the feet, loss of normal biomechanics of foot and ankle.  The expected recovery from these procedures is 3-6 weeks versus the 8-12 weeks or more of conservative treatment.

Again, I have very limited information on the severity of Manning’s plantar fascia injury.  He is also dealing with injuries to his throwing shoulder and ribs.  As the Denver Post points out, there are also a number of scenarios that could occur in the next several weeks that impact Manning’s return.  Nonetheless, we are here to predict when or if Manning returns from his plantar fascia tear, so here it is….

Prediction: Peyton Manning misses 4 games.  The tear is either mild enough to return in four weeks or he undergoes a minimally invasive treatment that allows him to return for an important Week 15 matchup against the Pittsburgh Steelers.