What Is Plantar Fasciitis?
Plantar fasciitis is a painful condition when the plantar fascia becomes irritated and inflamed due to micro-tears in it. In our Therapy guide for plantar fasciitis we have demonstrated simple exercises that you can do at home to ease your pain. The plantar fascia is a large thick ligament that originates from your heel and fans out towards five toes. If the plantar fasciitis is left untreated progressive shortening of ligament results in the formation of scar tissue in your foot.
What muscles are affected in plantar fasciitis?
Plantar fasciitis occurs when the muscles in your calf and feet are tightened and stiff due to progressive shortening. There are three main key muscles that are affected by plantar fasciitis. The sharp shooting pain is usually felt in the heel where the fascia originates and the foot’s arch.
Soleus
The soleus muscle is an anti-gravity muscle that helps the body to maintain posture and prevent falling during standing. It is an eccentric muscle that de-accelerates pronation, internal rotation and dorsiflexion of the foot.
Gastrocnemius
The gastrocnemius, along with soleus muscle, is an anti-gravity muscle. The principal function of this muscle is to keep the ankle in a plantarflexed position. The pain in the gastrocnemius muscle runs from the medial aspect of the foot.
Quadratus plantae
The quadratus Plantae is the primary flexor of toes, and it resists toes from the extension.
What are the Signs of Plantar fasciitis?
The indicatory sign of plantar fasciitis is pain after rest. The reason for this is that when you rest or sleep at night, the micro-tears in the plantar fascia start to heal.They are only partially healed, and then you put your feet through strenuous activity, again causing injury in the foot.
Another reason is that the fascia becomes tight overnight because your feet are in a plantarflexed position.When you get out of bed in the morning, that quick stretch due to the body’s weight causes tears and a painful stabbing sensation.
Lifestyle modifications for plantar fasciitis
If your profession requires prolonged standing, walking or stair climbing, it puts a lot of stress on your feet that you aren’t used to in your daily routine. Then consider switching job positions, or either way, you can use a night splint to ease the pain in the day.
- Take short breaks, sit down for a while and stretch out your muscles.
- Wear shoes that do not put additional strain on your feet. Avoid wearing high heels or flat sandals as much as possible.
- Sitting on a desk working for long hours also puts a lot of stress on your feet. Taking a 10 min break and stretching or doing a quick myofascial release will help reduce the occurrence of pain.
- Night splints are a great option to consider when you are exposed to progressive loading injury.
Therapy guide for Plantar fasciitis
In therapy guide proven exercises are mentioned that treat the plantar fasciitis effectively.Following methods relieve the pain of plantar fasciitis;
- Stretches
- Exercises
- Myofascial Trigger Point Therapy
Myofascial trigger points therapy for plantar fasciitis:
The painful areas in the muscles are trigger points caused by the injury or overuse.
Any damage will lead to increased calcium ions release, and these calcium ions will cause sustained muscle fibres contractions.
These contractions may form a taut band that Trigger Point Therapy treats.
Myofascial trigger point therapy includes following
Deep stroking massage: massage is gently applied on the trigger points, back and forth rhythmically. It will lead to healing and inner repair.
Inhibition compression technique: The physiotherapist puts continued pressure on the trigger point to release it.
Diagnostic pattern of Plantar fasciitis:
● Taut band
● Referred pain
● Muscle stiffness
● Warmness on the affected area
Techniques for myofacial trigger point
● Identify the affected muscles.
● Find a comfortable position for the patient where his muscles are relaxed maximally
● Apply sustained pressure to the trigger point till that stress releases and softens. Do this with time, and increase the pressure as time goes on.
● After one session, change the application of pressure to get better results.
● Apply some moisturizing cream or oil at the end.
● Do this thrice per day.
Trigger point Therapy on specific muscles for plantar fasciitis:
Quadratus Plantae:
● First, examine the trigger point and look for the taut band.
● To avoid friction, provide some medium, i.e. gel/lotion.
● Place the patient prone with face downwards and bend the knees.
● Feel the taut band and put pressure on it for a few seconds with your thumb or elbows. You can also use some tools.
● Keep pressing until the pain goes away.
● Repeat 3 times a day.
Gastrocnemius: (self-treatment)
● Identify the trigger point.
● Lay down in a supine position with your legs on the chair or table
● Place the ball beneath the taut band that is present in the gastrocnemius muscle.
● Put pressure on the ball with your leg and make a circular motion, first clockwise and then anticlockwise.
● Always change the direction of pressure application after one repetition.
● In the end, apply some oil or cream.
stretchings for Plantar fasciitis:
Gastrocnemius muscle stretch for Plantar fasciitis:
● Stand straight on a step (of stairs or something similar) with half of the foot on that stand
● Keep the heels low over the edge of the step.
● Go on lowering the heels. This will increase the stretch of the gastrocnemius muscle.
● Keep the knees straight for gastrocnemius stretch, and for soleus muscle, you have to bend the knees.
● Maintain this position for 30-50 seconds thrice every 2-3 hours.
Hamstrings stretch:
● Put one leg on the ground surface and the other on a step with one step forward while adopting a standing position
● Bend your trunk forward
● Do this for 30 seconds, and then go for the other leg.
● Repeat the process thrice two times a day.
Gluteus medius stretch: (buttocks area)
● Position of side-lying on the edge of the bed.
● Drop the upper leg over the body, letting it hang from the bed.
● Place the upper arm behind the neck like you are holding your neck and rotate the pelvis.
● Adapt this position for 30 seconds three times, twice a day.
Soleus stretch:
● Standing position with hands leaning against the wall
● Place the affected leg with bent knees behind the other leg.
● You will sense a stretch at the back of the leg.
Adapt the position for 30-40 seconds with repetition of 3 times a day.
Plantar Fascia stretch
- Sit on a chair
- Put affected leg on unaffected leg
- Hold your heel with one hand
- Place your fingers beneath the toes
- Give a gentle stretch up towards the shin
On wall calf stretch
- Stand in front of a wall
- Support the wall with your hands
- Put the toes on the wall of affected leg
- Do a heel raise on your unaffected foot and lean forward towards the wall
- You’ll feel stretch on the arch of your foot and at the back of your leg on calf muscle
Exercises for Plantar fasciitis
The goal of physical therapy and rehabilitation exercises is to strengthen the weak muscles in the calf and foot.
Straight leg raise exercises
SLR aids in strengthening and developing endurance in the lower leg muscles.
- Straighten out your leg, lying flat on the bed
- Lift the leg above the bed and hold it for sometime
- Gradually increase resistance and weight for 10-15 minutes.
Lifting towel using your toes:
- Place a blanket and spread it flat on the ground surface.
- Try to lift it using your feet while standing.
- Now reverse the process and flatten the towel with your toes.
- Repeat 10 times.
Ankle inversion with resistance Band:
- Take a pew in a long-sitting position
- Grasp a resistance band, wrap it around your affected foot and tie it with the knot outside.
- Then cross the unaffected leg over the affected leg and wrap the band around your other foot
- Turn the affected foot in an eversion and inversion position.
- The resistance is provided by a band that is wrapped around the foot.
Heel raise
- Also called as Plantar fascia heel raise
- Perform single leg heel raise on a towel under toes
- Keep the unaffected leg in swing position
- This exercise allows maximum dorsiflexion on affected foot
Heel and toe raise
- Sit on a chair at 90 degree angle
- Raise your heels with toes touching the ground
- Then raise raise your toes with heels being in contact with the ground
- Repeat alternatively
- Do it in standing position if you’ve moderate pain
Toe scrunch and splay
- Adapt a long sitting position
- Toes are in neutral position
- Flex and extend the toes in the direction towards the shin and away from the shin
Ankle pump
- Adapt a long sitting position
- Keep the toes still
- Extend and flex the ankle
Roll up Technique
- Sit on a chair at 90 degree angle
- Take a tennis ball or freeze a water bottle overnight if you have inflammation in your plantar fasciitis
- Roll the tennis ball with the arch of your foot
- Apply minimum to moderate pressure in sitting position
- Apply moderate to high pressure in standing position
Calf raises with big toe extension
- Go over to a wall
- Place a rolled towel under your toes of affected leg
- Move the unaffected leg forward with wall
- Lean on the wall in forward direction
- You’ll feel stretch on the arch of foot and calf muscle
- You can also add variation in this exercise by keeping your unaffected leg in swinging position.
Takeaway
In context plantar fasciitis means inflammation and irritation of plantar fascia. However that’s not the case, basically plantar fascia is unable to sustain increased load placed on it over time.
Plantar fasciitis is treatable. With few mobility exercises included in your daily routine, you can get rid of plantar fasciitis within a couple of days.