Variations on a Theme: Plantar Stretch Redux

Thu, 27 Oct. 2011 - 4:19 p.m. MT
Credit: ARA Staff - American Running Association

In the Jun/Jul/Aug issue of FitNews, we discussed a study published last summer in The Journal of Bone and Joint Surgery that validates the efficacy of a stretch that works on the plantar fascia directly. 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.

Podiatrist and FitNews editorial board member Paul Langer, DPM, has a few additional recommendations to add:
 I had seen the study as well and have been recommending it to my patients for the last few months. The stretch makes sense since it is known that the plantar fascia becomes thicker and less elastic as the inflammation persists. The stretch is relatively easy to do, which always helps with patient compliance.
 
A variation of this stretch involves gently massaging the fascia while it is being stretched. As with any stretch, I always advise my patients not to stretch to the point of discomfort and to avoid stretching if it clearly makes their symptoms worse.

For my running patients with persistent plantar fasciitis, I also often recommend a boot-type splint for stretching the fascia. There are studies showing effectiveness of the night splint which stretches the plantar fascia when sleeping.

(J. Bone Joint Surg., 2006, Vol. 88, No. 8, pp. 1775-1781)

(RUNNING & FITNEWS® September / October 2007 • Volume 25, Number 5)



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