For Relief, Stretch the Plantar Fascia Directly

Wed, 12 Oct. 2011 - 9:31 p.m. MT
Credit: ARA Staff - American Running Association

Plantar fasciitis: the nagging plague of the road runner. You awake in the morning and put your feet on the floor. Instantly, a sharp pain erupts in your heel. As the day wears on, the pain eases. Then following your afternoon run, there it is again: the swelling, the inside-heel tenderness - you thought you had it licked because the run went smoothly enough. In the evening, you sit at your desk for an hour or two checking email and paying bills. You stand up and there it is again.

Occurring when the fibrous band of connective tissue under your foot becomes inflamed, plantar fasciitis effects millions of runners annually, and, though not particularly dangerous, curtails training and can cause foot, knee, hip and back pain, as well as gait irregularity and altered stride, the sure paths to other injury.

The plantar fascia connects your heel to your toe bones. While most people suffering from plantar fasciitis use pain relievers, orthotic shoe inserts, Achilles tendon stretches and occasionally shockwave therapies and corticosteroid injections, new research suggests that stretches that target the plantar fascia itself—a notoriously difficult area to target - are a very effective treatment and consistently outperform Achilles stretches in helping patients recover in the long term.

A study published last summer in The Journal of Bone and Joint Surgery gave a group of chronic sufferers a three-week supply of the anti-inflammatory drug celecoxib along with orthotics and instructions for an Achilles tendon stretch. A second group received the NSAID and the orthotics but along with instructions for a plantar fascia stretch instead. 

After eight weeks, the plantar fascia stretch group felt less pain and could perform more activities than the Achilles stretch group. Even more significantly, when the study ended all 82 study participants were taught the plantar fascia stretch. Two years later, 66 of these original patients were re-examined, and 94 percent reported feeling either less pain than they had before the study, or no pain at all, with only 30 percent having even undergone further treatment with a physician or physical therapist.

The stretch is performed as follows:

1. From a sitting position, cross the foot to be stretched over your other leg so that your foot rests on top of your knee.

2. Holding the base of the toes in your hand, pull the toes back toward the shin. (To clarify, this would mean pulling the toes up away from the ground if you were standing.)

3. As you feel a stretch in the bottom of your foot, touch it with your other hand to check that the plantar fascia is tense under the skin.

4. To perform this stretch as in the study, do it 10 times, three times daily.

(J. Bone Joint Surg., 2006, Vol. 88, No. 8, pp. 1775-1781; Health After 50, 2007, Vol. 19, No. 3, p. 7)

(RUNNING & FITNEWS® June / July / August 2007 • Volume 25, Number 4)



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