• Luke Nelson

Plantar heel pain: to stretch or strengthen?

Suffering from plantar heel pain? Fortunately, there are various effective treatment options, two of which include strengthening & stretching. In this blog, we discuss which might be better suited to you!

A 2015 study by Rathleff et al compared the effects of shoe gel inserts PLUS stretching the plantar fascia to shoe gel inserts PLUS high load strength training, to explore which intervention was superior.


What did they find?

They followed both groups for 12 months and found that at 3 months the strength training group had superior results BUT at 6, 9 & 12 months both groups had similar improvements. These results were also replicated in a later study in 2019 by Thong-On.


How can we use these findings?

It's always nice to have options for treatment so below we discuss the pros, cons & which might be better suited for you:


OPTION 1: Stretching the foot

Sitting with your involved foot on your knee, simply pull the toe back as far as you can, feeling for the tension in your plantar fascia. Hold for 10seconds, repeat 10 times, 3 times per day.

  • PRO: ideal for those who are lacking in big toe or ankle mobility (see our previous blog on why this important, & how to test here)

  • PRO: requires no equipment

  • PRO: more suitable for non-active individuals

  • CON: can be time-consuming to perform 3 times per day

  • CON: doesn't do anything to address potential strength deficits in calf or foot strength which can often be lacking


OPTION 2: Strengthen the foot

This exercise involves performing a calf raise with a rolled-up towel (or using a Fasciitis fighter as seen in this video) to force the big toe into extension. The raises are performed at a slow pace of raising up for 3 seconds, pause at the top for 2 seconds, then lowering for 3 seconds. Starting with 3 x 12 reps for 2 weeks, then increase the load (either with weights or backpack with books in there) to 4 x 10 reps, then at 4 weeks, increase to 5 x 8 reps. Keep adding weight as you are able. Perform this 3 times per week.

  • PRO: builds strength in the calf and foot muscles, which are often lacking in those with plantar heel pain issues (see our previous blog for how to test here)

  • CON: does involve some equipment, but everyone should be able to find something heavy around the house (books, bucket of bricks etc)


So there you have it, 2 options to manage this condition, and you can even use both simultaneously!


For further assistance with your plantar heel pain, please don't hesitate to contact us at www.healthhp.com.au/plantar-heel-pain


#plantarheelpain #heelpain #plantarfascia #plantarfasciopathy #running #melbourneinstarunners #runninginjury #heelpainrelief #plantarfasciitis #plantarfasciitissucks #melbournerunners #healthhighperformance #sportschiro #physio

Reference

  • Rathleff MS, Mølgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2015 Jun;25(3):e292-300.

  • Thong-On S, Bovonsunthonchai S, Vachalathiti R, Intiravoranont W, Suwannarat S, Smith R. Effects of Strengthening and Stretching Exercises on the Temporospatial Gait Parameters in Patients With Plantar Fasciitis: A Randomized Controlled Trial. Ann Rehabil Med. 2019 Dec;43(6):662-676.

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