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  • Writer's pictureLionel Pannunzio PT / SCS

Plantar Fasciitis and Heel Pain ( Part 2)


Introduction


We continue this week with exercises for Plantar Fasciitis, increasing the intensity and load.



Load Dominant Stage


We can move to the next phase once the Pain at 1st step in the morning improves and increases walking tolerance. Symptoms remain stable unless the fascia is overloaded ( runs or games) .


Interventions:

  • Increase Plantar Flexor capacity: progressing from Isotonics to Eccentric movements of the calf

  • Interval training to increase load capacity to develop calf endurance and Power : plyometrics.



Some exercises we like to use during this phase are shown below which are intended to create ankle Dorsiflexion and Great toe extension and at the same time mobility and strengthening of the plantar fascia and calf-ankle-foot- Toe complex muscles





Learning to roll over the big toe



In this video I show you a more advanced exercise to continue moving and loading the foot and the plantar fascia.


Same as with the previous drill , to keep the big toe relaxed, do not grip or put too much tension into this mobilization drill.


Recommended 3 sets of 5-8  reps to start and then when you feel the exercise is ok with you increase to 3 sets of 10 reps.




Toe Yoga



The following drill  will show you how to tap into the intrinsic muscle of the foot . These are a combination of baseline strength, coordination and mobility exercises necessary for everyday activities. 


❇️ Big toe raise, keep other toes down. Done slowly with control.

❇️ Lift the little toes and keep big toe down .

❇️ Alternation movement  from big toe to the other toes.

We are looking for quality of movement, without cramping. 



Plantar Fascia Load and Strengthening Exercise 1





The calf , plantar fascia and the big toe work synergically to propel the body forward. 

A good entry level exercise for loading the fascia  is the one shown in this video.

Learn how to push the big toe when you walk by doing this exercise.

Recommended 2 sets of 5, 8, 10 repetitions as tolerated. 





Plantar Fascia Load and Strengthening Exercise 2



he calf raise is done using this device ( you can use a towel as well ) to emphasize the position of the toe into extension and load the FHL and plantar fascia simultaneously. 

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Recommended 2 sets of 5,8,10 repetitions as tolerated. You’ll feel tension , burning in the inner part of the foot into the lower leg. Once you can control the exercises with your body weight you can add a backpack with weights for further loading.




Conclusion


  • Plantar Fasciopathy and heel pain affect a large population of soccer players

  • Conventional physical or chiropractic treatment usually fails to address all the possible causes of this condition

  • Improve and restore plantar fascia length and Plantar Flexion Capacity with emphasis on Great Toe strength are the main goals of the treatment.

  • Our comprehensive approach is backed-up by the most recent research. Once you resolve the root of the problem the Plantar Fascia becomes pain free

  • Education and load management are key factors for people with Plantar Fasciopathy


White Bay Sports Physical Therapy is a Sports-Injury clinic that specializes in Plantar Fasciitis treatment .

Lionel Pannunzio is a Physical Therapist Certified in Sports Injuries. With more than 20 years of experience helping athletes return to their sports after an injury. He is the Owner of White Bay Sports Physical Therapy and Fitness, conveniently located in the beautiful City of Weston, where he treats Soccer Players and Athletes of all ages



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