Here are five strategies to increase mobility, decrease pain, and help the symptoms of plantar fasciitis. Updated with transcripts 10/25/2021.
So you have foot pain, what next?
As a Physical Therapist, I become increasingly frustrated that there are people in TONS of pain out there, that can HELP their situation while they wait for their doctor appointment or see if they can decrease their pain on their own, IF ONLY they knew a few strategies.
That’s why I started recording videos to teach others how to DIY their HEALTH. Simple, easy to follow videos that can help you feel better & more empowered about taking charge of your body.
Today, we’re going to chat about five things you can do right now to help address plantar fasciitis & foot pain.
in these five videos, you’ll learn:
Video #1: What plantar fasciitis is & how your foot moves
Transcription from the video:
today we're going to talk about heel pain and foot pain and is there anything you can do about it?
Once you're experiencing heel pain, foot pain, or toe pain there have been certain things along the line that have gone wrong but your brain has just ignored them.
Let’s talk a little bit more about your ankle joint and your foot joint.
In order for your foot to move biomechanically in the appropriate manner your leg bone has to be able to go over your ankle. So your ankle joint comes up this way and also points this way (demo in video).
A lot of times people will get tightness or junk in here and the front of your ankle and that will limit your ability to go up (dorsiflexion). A lot of times heel pain is gonna be right on the this bottom part here or in the middle part and it's gonna happen a lot of times in the morning right as you step — getting out of bed.
why it hurts getting out of bed
The reason why that happens is because all night you kind of have a relaxing position, right if you just let your ankle relax its gonna kind of be an a pointed position (plantar flexion) and then you go to step out into your bed and all of a sudden you go oh and you go to step on the ground right and you’re immediately putting your foot in a dorsiflexed position, lengthening the foot (which is the opposite of how it healed over night).
And what happens overnight is that you have damage to this area and then it's shortened because here it's long here (dorsiflexion) it gets shorter during plantar flexion (toes pointed) and it shortens because your ankle is pointed well then right in the morning it's like having a scab right there. And you basically rip the scab open every time you go to step on it right in the morning because you go from a shortened to lengthened position on the bottom of your foot.
things you can do to improve the pain and help your foot heal
So one of the things you can do is buy a ankle brace or kind of night splint and it will hold your foot into this position (dorsiflexion) so that when that scab heals it heals in a lengthened position and then when you go to step on it and the morning it's not kind of ripping that scab off that area that is one option.
Another option is to really work on the flexibility of this area. Now your ankle needs to move up down (dorsiflexion/plantar flexion) the it moves in it moves out (inversion/eversion) and your fore foot twists this way and it twisted that way and so these bones in the forefoot can get really sticky as well (meaning they don’t move as well due to joint capsule and surrounding muscular tightness)
joint mobility in the ankle and forefoot/midfoot
Now this is a little advanced for this video but if you feel like you kind of are wiggling on your foot and this one foot, the foot you have pain in seems a lot stiffer than your other foot when you do the same kind of twisting motions I would consult with a physical therapist (they are able to assess joint mobility, motion, and muscle tightness and be able to tell you if you would benefit from joint mobilizations and/or stretching to improve your foot and ankle mobility to decrease the stress/strain on the area and decrease overall pain).
How your plantar fascia tightens and how it needs big toe mobility to work
If you bring the big toe back it actually stretches all this tissue out and it makes this forefoot, mid-foot more sturdy. This is needed so when you hit the ground, the force from the ground goes up through your heel and this foot needs to be study so it doesn’t just wiggle all around.
So when you hit the ground, this (plantar fascia) is all nice and tight and it makes a sturdy foot, it brings the arch of your foot open and it makes a nice sturdy base for you to push off of and walk on and then what happens though is if you’re lacking mobility and this big toe doesn't go backwards this tissue down here is not able to stretch the way that it should and so that is going to compromise the integrity of the stability of this middle part of your foot so every time you hit the ground more force is going to go through into this tissue because this isn't as stable and that is going to create increased stress and strain on the remaining tissues in your foot.
You want to do is make sure that this toe is getting stretched out so one really good exercise for that is (see next video!)
Video #2: how to use the toddler squat and why it’s effective for ankle mobility
transcript:
so today we are going to talk about the toddler squat I'm going to first demonstrate the toddler squat (see video thumbnail or video).
Just so you guys understand, the toddler squat is my number one exercise for pretty much everything so heel pain ankle pain, hip pain anything like that I want you to always see if you can do the toddler squat and if you cannot is a great way to help you increase your flexibility and strength.
what's important with the toddler spot and why I want you to do it is so that you have a sign. You know this activity is difficult for you to do then when you do an intervention you can try this activity to see if it is better and see if you're making any changes.
So here is the toddler squat and how to do it:
you can see that my hips are below my knees
my toes are facing forward
my heels are on the ground and
my butt is kind of sinking back (close to my heels)
Now when you’re really good you can lift your chest up without falling backwards and if you want to do this toddler squat as an exercise you essentially hold this position for one to two minutes and you will feel a stretch of burn and it strengthens and lengthens your whole body.
If you're having heel pain likely the Achilles tendon which attaches from your heel to the back of your gastroc soleus complex or your calf muscles that is going to be tight.
What you might see is your toes pointing pointing out and your heels off the ground.
If your toes or your heels are off the ground and you go to try to bring them down you may fall backwards and lose your balance.
If that is the case what you want to do to do this as an exercise is to progress toward having your heels on the ground so you can stretch out the this calf muscle and the knee and also increase the dorsiflexion of your ankle which this exercise is going to do.
How to modify the toddler squat
If you are having difficulty maintaining the toddler squat position it is super important for you to find something really sturdy hold on to.
Something that is not going to fall on top of you if you pull back on it, for me that is my bed it's really sturdy it’s not going to move if I kind of pull back on it so if you're having trouble dropping your heels, hold onto something and try to drop that butt backwards.
You can kind of lean further backwards and that is going to help stretch this area which will then increase that dorsiflexion angle so that you can have more of an angle like this instead of an angle like this (see video for example).
You want these knees to be able to make a pretty hard angle here between your leg bone and your ankle bone if that ankle is tight that is gonna throw off the mechanics on the bottom of your foot and that can be tight because this tissue in the back is not lengthening it can also be tight because the bones and the front of your ankle actually aren't moving the way they are supposed to.
If you keep doing this and it's not improving likely it is the joints of your ankle that are potentially causing the problem in which case you absolutely want to look up a physical therapist come on who is skilled in doing joint mobilizations to that ankle so that you can get movement back there and then instead of being back here you're able to bring your knees over that ankle and that foot can get stretched properly.
Good so so far we have covered into doing the toddler squat we have a couple more so stay tuned (see video #3).
Video #3: Stretches that address foot pain & plantar fasciitis
transcript:
so one exercise to do for this big toe is to keep this leg straight and you are going to pull on this big toe nice and gently.
You may feel a stretch in the bottom part of your foot or you may not. You may have to grab all of those toes and kind of pull them back and this will stretch the bottom muscles of your foot. This is just a generalized stretch, a more specific stretch I will show you is a toe lumbrical stretch next.
Lumbrical toe stretch
What you're gonna do is you're gonna grab your hand like this and you're gonna grab the inside part of your of your foot and you're gonna stabilize these bones right below your toes (see video for instructions).
Then you're gonna spread your toes apart and you can do this with four fingers at a time so I'll do all of them but my big toe and then I'll do my big toe.
You really want to squeeze these bones on the middle part of your foot and you're gonna pull these toes back. Now I feel way more of a stretch here than I did in the other the other more generalized stretch and you're gonna hold this here for thirty seconds.
This is stretching the muscles right in between the toes that can get really tight. Then I'm gonna grab kind of my big toe I'm gonna stabilize here and I'm going to stretch these guys back.
So far we have covered toe stretching and doing the toddler spot we have a couple more so stay tuned (see video #4).
Video #4: Self Massages you can do on your foot to improve flexibility
what I want you guys to know is that you should never feel afraid to massage your own muscles.
How to self massage your foot muscles
What you're gonna do is you're really going to want to get some lotion but you're gonna focus on these muscles right in the middle of your foot and you want to kind of loosen all of these tissues up and it's gonna kind of be a little sore even if you don't have heel pain.
You're gonna get in here (see video example) and you’re gonna loosen all of these tissues up.
Self massage arch with lacrosse ball
The next one we are gonna do is with a lacrosse ball, you can also use a golf ball or a tennis ball depending on what you have in your house.
First stand up and you're gonna put it underneath the meaty part of your foot and you're just gonna step on it and roll it out when you feel a particularly tender spot we're just gonna kind of sit on it.
Roll this out (your arch muscles). I would do this for two to five minutes and I would do both feet because if one foot doesn't have pain it does not mean that it's functioning and working properly.
Frozen water bottle massage
If you guys are really struggling with pain one great way is to freeze in a regular water bottle and use it to help you roll out the bottom of your foot, it is pretty much the same as a little lacrosse ball.
You’re gonna put on the floor oh man this one is chilly. If it's too much you can always put a pillowcase over it and you can also do this after you've done your lacrosse ball.
You’re essentially just gonna kind of roll this out you can roll out either till your foot is numb or around three to five minutes depending on which one comes first. If you get a little bit of redness to the area that's gonna be totally normal.
So far we have covered toe stretching and massaging the muscles on the of your the bottom of your foot and doing the toddler squat.
We have a couple more so stay tuned (watch video #5).
Video #5: Rolling out your foot muscles to increase flexibility & decrease pain
transcript:
next thing I want you guys to really concentrate on is the joint above the ankle so you may feel like bottom of your foot is the one that is in pain but I want you to always remember that the entire body is connected.
So just because you're at the bottom of your foot is in pain does not mean that the problem isn’t originating from above that area like your calves, the back of your knee, or further down like your big toe.
I also want you to throw out any notion that there’s only one specific thing that is the cause, most of the time when I see patients in physical therapy, especially if it's an orthopedic injury like a sore foot it is four to five things that we have to address until the whole system is moving properly.
Think of your body like a machine: if one piece of the machine isn't working properly the machine is still going to go but if ten things aren't working properly all of a sudden you have a significant issue and that is like the emergency light which your brain interprets as pain.
Tiger Tail Massage Stick Tutorial for the lower leg
We’re going to use my favorite tool called the Tiger tail (massage stick). One thing you really want to get taken care of is you really want to roll out these muscles.
You want to go all the way down to the bottom so you do the outside, Center, inside of your Achilles (see video for example). You’re going to go all the way up and you also want to do the front of your leg: this is the tibialis anterior region and this is when people have shin splints.
All the muscles that are on the front part of your ankle go down and a lot of them come right over that top part of the ankle and they can get really stuck together. So sometimes I'll even come in here to these tendons these little rope like structures and I will just wiggle them back and forth.
A lot of times that will open up that dorsiflexion which can then take some of the stress off the bottom of the foot.
I’ll get more behind my knee and support it you want to do it in different weight-bearing statuses and so I can really get in here and loosen up this muscle and I can tell you, it doesn't feel super great it's kind of hard to do in video I can even have somebody else do this while I'm laying on my stomach.
So if you don't have a tiger tail what you can also use is a foam roller.
Foam Roller for lower leg muscles
What you’re gonna do with a foam roller is you’re gonna lay it on the floor and then you can foam roll kind of your whole body with it if you have heel pain it is a really really fantastic idea for you to roll out all of your lower extremity muscle groups.
Because tight hips could be changing the way you're walking which could be putting more pressure through the bottom of your foot and irritating it.
To do it on your calf you are going to hold your body up so it’s kind of a nice little workout and you can roll both of them out at one time. The most intense is going to be when you cross your leg over and I want you again to go to the inside.
So I'm kind of turning my hips to the right, the center, and keeping my hips up. I’m going the whole length too so I want to do all the way down by my ankle, the middle, and then also go all the way up behind my knee and then I’m going to turn my hips to left.
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That is the end of the video playlist for helping to decrease heel pain at home. Please always share any symptoms or concerns with your Physician and call up a local physical therapy clinic to see if they provide free screens to get answers fast.
For all the videos, here is the playlist:
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