Advice and Exercises for the Treatment of Plantar Fasciitis

Patient Information
Provided by:
Physiotherapy
Worcestershire PCT
Produced by the physiotherapy department, February 2011.
Due for review February 2013.
Advice and Exercises for the
Treatment of Plantar Fasciitis
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What is plantar fasciitis?
What are the symptoms of plantar fasciitis?
Plantar fasciitis means inflammation of the plantar fascia. The plantar
fascia is a strong band of tissue (like a ligament) that stretches from
the heel to the toes. It supports the arch of the foot and also acts as
a shock absorber in the foot. Repetitive small injuries to the fascia
with or without inflammation are thought to be the cause of plantar
fasciitis. The injury site is usually near to where the plantar fascia
attaches to the heel bone.
Pain is the main symptom. This can be anywhere on the underside of
the heel. Commonly, one spot is found as the main source of pain. This
pain is often under the heel bone, and may be tender to touch.
The pain usually eases on resting the foot, but is often worst when
first used in the morning or after long periods where no weight is
placed on the foot. Gentle exercise may ease things a little as the day
goes by, but a long walk often makes the pain worse.
Who gets plantar fasciitis?
Plantar fasciitis is quite common. It mainly affects people over 40 and
seems to be more common in women. However, it can occur at any
age. It is also common in athletes. Situations where it is more likely
include the following:
• If you do lots of walking, running, standing, etc, when you are not
used to it. Conversely, people with a sedentary lifestyle are also more
prone to plantar fasciitis.
• If you have recently started exercising on a different surface.
Fibrous band
Plantar Fascia
• Wearing shoes with poor cushioning or poor arch support.
• Sudden gains in weight or being overweight will put extra strain on
the heel.
Heel bone
(Calcaneus)
Area of pain
from Plantar
Fascitis
• Overuse or sudden stretching of the sole.
• Tightness of the Achilles tendon (at the bottom of the calf muscles
above the heel) causing reduced ability to flex the ankle.
Plantar fasciitis causes pain under the heel. It usually goes in time.
Treatment may speed up recovery. Treatment includes good footwear
and exercises. A steroid injection or other treatments may be used in
more severe cases.
Often there is no apparent cause, particularly in older people. A common misconception is that the pain is due to a bony growth or ‘spur’
coming from the heel bone (calcaneus). Many people have a bony spur
of the heel bone but not everyone with this gets plantar fasciitis.
These are the stretches you can do to help
Stand about 40cm away from a wall
and put both hands on the wall
at shoulder height, feet slightly
apart, with one foot in front of
the other. Bend the front knee but
keep the back knee straight and
lean in towards the wall to stretch.
You should feel the calf muscle
tighten. Keep this position for 10 –
15 seconds then relax. Do this about
3 times, then switch to the other
leg. Now repeat the same exercise
for both legs but this time bring the
back foot forward slightly so that
the back knee is also slightly bent,
Lean against the wall as before,
keep the position, relax and then
repeat 3 times before switching to
the other leg. Repeat this routine
twice a day.
Sit on the bed with your legs out
in front of you. Loop a towel
around the ball of one of your
feet. With your knee straight,
pull your toes up towards you.
Hold the position for 10 - 15
seconds and repeat three times.
Repeat the same exercises for
the other foot. Try to do this
morning and night.
Heel bone
(Calcaneus)
Stand on the bottom step of some stairs
with your legs slightly apart and with your
heels just off the end of the step. Hold
the stair rails for support. Lower your
heels, keeping your knees straight. Again
you should feel the stretch in your calves.
Keep the position for approximately 20
seconds then relax. Repeat six times. Try to
do this exercise twice a day.
You may find it helpful to
massage the bottom of your
Fibrous band foot. Sit down on a chair
Plantar Fasciaand cross your leg (as the
diagram shows). Hold your
toes and gently stretch them
back towards you using small
Area of pain circular movements, massage
from Plantar
along the foot, from the heel
Fascitis
to the toes.
For this exercise you need an
object such as a rolling pin or
a drinks can. Whilst sitting in a
chair put the object under the
arch of your foot. Roll the arch
of your foot over the object in
different directions. Perform
this exercise for a few minutes
for each foot at least twice a
day.
Home ice treatment
1. Prepare the ice pack using a pack of frozen peas wrapped in a damp
tea towel.
2. Place a plastic bag or dry towel under the area to be treated. Ensure
limb is well supported and comfortable, preferably elevated.
3. Smooth a small amount of oil e.g. Baby oil or cooking oil all
around the area to be treated. DO NOT PLACE ICE PACK ONTO
UNPROTECTED SKIN.
4. Place ice pack firmly over the area and wrap a dry tea towel around
the limb and ice pack.
5. Leave ice pack in place for 5 - 15 minutes then remove.
THIS TREATMENT CAN BE REPEATED UP TO 3 TIMES A DAY.
Frozen peas must be clearly marked and should not be eaten after use.