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Deb Fuchek's Physio Column

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February, 2000

Plantar Fascitis

Plantar Fascitis or "heel pain" is a frequent complaint of both athletes and non-athletes. It is a strain or tearing of the long plantar ligament or aponeurosis on the bottom of the foot. Common symptoms are heel pain often described as a "heel bruise". Some people complain of "arch pain" while walking, especially doing stairs and going up on their toes. Morning pain and stiffness is also common. Signs include tenderness on the heel of the foot, pain with bending the toes up and stiff ankle movements due to tight calf muscles. A heel spur may be present on an x-ray which is the result of pulling of the plantar fascia from the bone as it is strained.

Plantar Fascitis can be due to training errors, a rapid increase in running mileage, or steep hill climbing. Inadequate footwear and biomechanical factors such as over=pronation (flat footed) are causative factors. Initial treatment includes rest, ice, and can include physiotherapy. The underlying causes must be addressed either through a change in training schedule, orthotics (shoe inserts), or appropriate footwear. As well, a stretching program for the calf muscles is important to maintain flexibility and support. Including these exercises in your warm-up schedule will assist in the prevention of plantar Fascitis and improve your overall health.

 

Stretches should be held for 15 to 20 seconds and done 3 to 5 times on each side before and after workouts and more frequently if plantar fascitis is present.

Gastrocnemius Stretch

Gastrocnemius Stretch

Purpose: To stretch the long calf muscle
Correct Position: Place the leg to be stretched behind the front leg. Keep the knee straight and heel on the ground. Toes should be pointed straight ahead on both feet. The front leg should be bent, hands against the wall and hips square to the wall. lean into the stretch which should be felt behind the back of the straight knee and upper calf.

Soleus Stretch

Soleus Stretch

Purpose: To stretch the shorter and deeper calf muscles.
Correct Position: Same as the first stretch but the back knee is bent slightly. The stretch should be felt lower down in the calf. Keep the back heel in contact with the floor.

Toe Raises

Toe Raises

Purpose: To strengthen the gastrocnemius, soleus and calf muscles which will help to support the arch of the foot.
Correct Position: Start with both feet on the ground. Raise up on your toes and won in a slow and steady manner. use a support in front to maintain your balance. Progressions: to increase the difficulty, do these standing on one leg, raising up and down on your toes. Progress to heel drops; stand on a step, drop down with your heels and then raise up on your toes. Prevention through stretching and strengthening exercise for the calf will ensure safer participation in sports and recreation.

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