Plantar Fasciopathy rehab programme

Plantar Fasciitis, or now more accurately described as Plantar Fasciopathy, is characterized by pain on the underside and towards the back of the foot, where the plantar fascia attaches to the heel bone.

Patients report pain first thing in the morning as they take their first few steps, pain on getting up after a period of rest and initially when walking or running. The onset is usually gradual and maybe related to changes in activity levels.

The length of time it takes to settle varies from person to person, from 3 months up to a year, but it is good to know that in most people it is a self-limiting condition.

Plantar Fasciopathy has been divided into 2 phases:

Pain Dominant Phase:

• Acute phase

• Patient unable to tolerate any load, eg walking or running

• Pain levels influenced by level of tissue irritation and patients own expectations or beliefs

• Time on feet needs to be reduced

• Wear most comfortable footwear, with cushioned arch support

• Avoid firm arch support orthotics

• Consider adjuncts to care such as taping, massage, stretching and gel heel cups

Load Dominant Phase:

• Reduction in pain levels

• Can tolerate increasing amount of activity

• Able to tolerate moving from double leg calf raises to single leg

• Cross-train to maintain cardio fitness, eg swimming, cycling, rowing machine

• Use Osteopathy to address underlying causes. Reduced ankle mobility and muscular strength have been identified as predisposing factors.

Exercise program

This is just an example of a basic program, and each person will need a variation of this. Combine your rehab with finding the right level of walking or running which causes minimal pain and doesn’t aggravate the symptoms.

1. Single leg squat. 

Focus on control. Balance on one leg and bend your knee over your toes. 10-15 reps on each leg. Progress by increasing depth of squat.

2. Plantar fascia stretch

In sitting with the right foot resting over the left knee. Bend the ankle and big toe up, hold for 10 seconds, repeat 10 times. Repeat on other foot.

3. Modified calf raise

Barefoot with a rolled up towel under your toes. Slowly push up into a calf raise, hold at the top then lower. 3 seconds up, 2 second hold, 3 seconds down. Do 3 sets of 12 reps on each leg.
If too painful or too hard, start on 2 legs, with minimal movement. If too easy on 1 leg, add weight to make 12 reps challenging.

4. Ankle strengthening

Turn the ankle out against the band for 8-12 reps. Then turn the ankle in against the band for 8-12 reps on each leg. Repeat 2 or 3 times.

5. Toe flexion

Push the big toe down as hard as is comfortable against resistance (wedge or hand) hold for 3 seconds, relax for 3 seconds. Repeat 5-10 times on each foot.

Aim to perform this exercise programme 3 or 4 times a week with a rest day in between.

Please note that any exercise programme needs to be tailored to suit the individual and it may not be suitable for those with more irritable symptoms. So do get in touch for a comprehensive assessment, treatment and exercise plan.