My last blog introduced the topic of Plantar Fasciitis. As discussed previously, the symptoms of Plantar Fasciitis usually appear as a result of excessive stress on your fascia. This stress can be caused either by overuse or by faulty biomechanics.  The image I left you with illustrated the fiber-by-fiber tearing process that occurs when your fascia begins to weaken and break.  In this next entry I want to give you the lowdown on how to deal with your Plantar Fasciitis using stretching.

At this point, those with inquisitive minds may have begun to wonder: “If my injury originated because the fascia was being pulled on, why would I want to stretch it further?  Wouldn’t that just add to the damage that the fibers are feeling?” Good question.  There is a difference between slow, gentle, well-executed stretches and the excessive tension that occurs during the stress of everyday life.

In order to grasp this concept, watch this old commercial about silly putty:

Ignore the strange old guy in the captain’s uniform. What I wanted you to see was how Silly Putty behaves under stress. If you stretch it slowly and smoothly, it will lengthen seamlessly into a thin ribbon of putty. But if you place a sudden, snapping tension on the putty, it will break and tear.  This is a good illustration of what happens to your fascia. We want to slowly lengthen the fibers so that they will become less susceptible to sudden forces which could cause them to snap.

For the purposes of this entry, I want you to imagine that all the muscles on the back of your leg are like the fibers of one giant elastic band. The band starts just underneath your butt, extends all the way down your leg, wraps around the bottom of your heel and attaches to your foot just before your toes. (For you muscle buffs out there this includes the following muscle groups: Hamstrings, Gastrocnemius, Soleus, Plantaris, Flexor D. Longus, Flexor H. Longus.) In order to effectively stretch your plantar fascia, you have to work on lengthening this entire band.

Caution: Sometimes it is best not to stretch. If your Plantar Fasciitis is really flaring up right now, or if this is a brand-new injury, it is often best to give it a few days of rest. If in doubt, don’t do it – ask an expert.

These stretches will be most helpful to people who have Chronic Plantar Fasciitis (meaning that their symptoms have been around for at least a month).  They should be performed slowly and smoothly. You should be able to feel the stretch, but you should not feel any pain. In order for stretches to be effective, you have to do them consistently at least once or twice a day. Never stretch only one leg – You don’t want to neglect the other side, even if it doesn’t hurt right now.  

1.       Standing Hamstring stretch:

(These instructions are for stretching your Right leg, do the exact opposite in order to stretch your Left) Place your Right foot up on a table or bench. (The top of the stretching surface should be taller than your knee, but shorter than hip height). Make sure your Right knee is straightened and your Right toes are pointing straight up. You may be able to feel the stretch already – but if you don’t, you can intensify the stretch by leaning your upper body forward and tightening the muscles on the front of your Right thigh.  You should feel the stretch all along the back of your upper Right leg.  Hold for at least 30 seconds before switching to the Left leg.

2.       Slant board / Wall stretch

In order to accomplish this stretch, you will need one of two things; either a slanted surface that you can stand on or the vertical surface of a solid wall. (You can buy commercially produced slant boards, or you can make one yourself pretty easily) The purpose of both variations of this stretch is to position your heel lower than your toes. This places tension on the muscles in the back of your calf. When performing this stretch, keep your body upright and your legs straight. Be sure that your heels do not leave the floor. In order to intensify the stretch, hinge forward at the waist to lean more of your bodyweight toward your toes. Hold this position for at least 30 seconds. Now (without moving your feet) bend your knees and repeat the stretch. This position targets the lower calf muscles more directly. Hold for at least 30 seconds.

3.       Towel stretch

I talked about this stretch in my post about exercises that reduce pronation. Read the whole post here

While sitting down with your legs out in front of you, use a towel to make a “U” around the ball of your foot. (Sort of like reins on a horse) Hold one end of the towel with each hand. Gently pull back on the towel, bringing your toes closer to you. You should feel the stretch on the back of your lower leg. You can change the exact location of the stretch by pointing your toes inward or outward. Experiment with your foot positioning until you find the tightest spot, then hold for at least 30 seconds.

Bonus: Water Bottle Ice Massage

Follow up your stretching sessions with a nice ice massage. This is the ideal way to speed up your recovery because it kills two birds with one stone: Icing helps your body to eliminate any swelling in the area (you might not see swelling, but trust me – it’s there) and the massage helps to relax and lengthen the fibers of your fascia.

The best way to make your own water bottle ice massager is to recycle a disposable plastic water bottle. Fill it 3/4 of the way full of water (you know, because water expands when it freezes) make sure the lid is on tight and to be doubly sure, seal it off with duct tape. Put it in your freezer STANDING UPRIGHT (otherwise it won’t roll evenly). Lay a towel down on hard floor to absorb the condensation and roll the frozen water bottle firmly along the length of your arch. Do this for about 5 minutes for each foot, then put the bottle back into the freezer for next time. You might think that it would be a better idea to use a more resilient container (such as a Nalgene) instead of a disposable bottle…but you would be wrong… the thin plastic sides of the disposable bottle ensure that you can really feel the cold.

A Word to the wise:

Sometimes even the most faithful adherence to a stretching and icing routine won’t solve your Plantar Fasciitis blues. You know the usual disclaimer; if your pain suddenly seems to be getting worse, be sure that you talk to your doctor. If you think things are under control, then try out these stretches while you wait for my next blog installment which will talk about what shoes/orthotics you need to be wearing to support your aching fascia. In the meantime, walk well.

Picture and Video Sources:

http://www.youtube.com/watch?v=GxdfoJoWNE4&feature=related

http://www.topendsports.com/medicine/images/hamstring-standing.gif

http://www.sonoguide.com/Images/Nerve%20Block%20Content/Popliteal%20folder/Popliteal_nerve_block_illustration1(sm).png

http://www.northcoastfootcareblog.com/wp-content/uploads/2007/12/stretch-arch-color.jpg

http://www.sports-injury-info.com/image-files/angle-board.jpg

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