Plantar Fasciitis: 10 Tools for Successful Patient Pain Relief

Are your patients suffering from plantar fasciitis? Help them manage their pain with these exercises and tools. Use the exercises in your clinic, teaching your patients so they can continue to do the exercises at home!

What is plantar fasciitis?

Cause: The plantar fascia is a thick band of tissue that runs along the bottom of your foot that connects your heel bone to your toe bones. When the tissue is inflamed, it creates a condition called plantar fasciitis.

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Symptoms: Plantar fasciitis causes heel pain that is often described as “stabbing”. It tends to be worse during your first steps in the morning. As the day goes on and you continue to move, the pain normally decreases. But prolonged periods of standing or when standing after sitting for a long period of time can cause the pain to return.

Help your patients find relief from this painful condition using the exercises below!

10 Tools to Help Manage Plantar Fasciitis

Check out this video on plantar fasciitis exercises by John Hisamoto, PT, ATC!

1. Orthotics

If your patient has excess subtalar joint pronation, it can place a tractional force on the plantar fascia and cause inflammation. This may lead to the development of bone spurs, causing heel pain. If the foot can’t dorsiflex at the ankle due to tight calf muscles while walking, it can add to your client’s plantar fascial pain. Orthotics can help hold the subtalar joint in a neutral position, reducing this pain.

Depending on your patient’s needs, heel orthotics or full length orthotics may be the better solutions. Vasyli+McPoil Tissue Stress Relief Orthotics have a dual-density design and are ideal for active use, while Vasyli+Hoke Supination Control Orthotic have a three dimensional perspective and are ideal for everyday use. Fitting your patients with either of these products may help relieve their plantar heel pain.

2. TheraBand Foot Roller

Keep the foot roller in a freezer so it’s ready to provide soothing cold relief and then bring it out to teach your patient how to use one. Get started!

1. Have your patient sit down and place the roller under their foot
2. Have your patient roll gently on it for two minutes
3. Then ask your patient to push harder with their foot while rolling for another two minutes

This exercise helps ensure good mobility and can be done again at the end of all the other exercises. Encourage your patient to continue doing the exercise at home.

3. TheraBand Resistance Band

Next, move on to our top exercise for plantar fasciitis, the Foot Intrinsic Flat Exercise, using a TheraBand Resistance Band. Have your patient:

1. Sit down
2. Place their foot on the band (so the band runs from heel to toe)
3. Hold the ends of the band
4. Arch their foot
5. Pull up on the band to create tension
6. Slowly open up their foot for a six second lengthening against resistance
7. Hold the stretch for 15 seconds

Have your patient repeat the exercise ten times while in your clinic so they understand what to do when continuing the exercise at home. When 10 repetitions becomes easy, have them do 15, then 20, with the goal of reaching 25 repetitions by the time they return to see you again.

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Once your patient can complete 25 reps, they’re ready to learn the next exercise, the Foot Intrinsic Straight Exercise. This typically occurs on their second visit.

1. Have your patient sit down and place their foot on the band, (like in the previous exercise)
2. Arch their foot
3. Pull up on the band to create tension
4. Slowly open up their foot against the resistance while raising their leg out straight for six seconds

In addition to stretching out the foot, this exercise helps with gastrocnemius tightness. Once again, have your patient build off this exercise until they can easily complete 25 repetitions.

The next exercise focuses on the big toe. You can use a resistance band, CLX band, or stretch strap for this exercise.

1. While your patient is sitting wrap the band around your patient’s big toe
2. Have your patient hold the ends of the band
3. Have your patient hold their leg out straight and then extend their foot into dorsiflexion, which makes the plantar fascial ridge more visible
4. Have your patient hold the stretch for 15-20 seconds (stretching the big toe, gastrocnemius, plantar fascia, and peroneus brevis muscles)
5. This exercise position also lets you palpate the area to see which regions are causing your patient pain

4. TheraBand Roller Massager+

If your patient has issues with their calf, especially if they are an older runner or are really fibrotic, using a TheraBand Roller Massager+ can help. Have your patient lay on their back on a treatment table with their knees bent. Roll the massager up and down the calf muscle to help mobilize the gastrocnemius. You can also teach your patient how to mobilize their hip using the roller.

Then let your patient try using the roller. It’s a great tool for them to utilize at home too.

5. TheraBand CLX Resistance Band

The TheraBand CLX resistance band is another great tool for treating plantar fasciitis.

1. Have your patient sitting up on your treatment table
2. Place your patient’s foot inside one of the band’s loops
3. Attach the band to a secure anchor point (offer suggestions for anchor points they could use at home)
4. Have your patient go into anterior dorsiflexion, in concentric mode (flexing their foot toward their shin) for two seconds
5. And then to slow down, emphasizing the eccentric mode, for four seconds (pointing their foot away from their body)

Then teach your patients a CLX Eversion Exercise for targeting plantar fasciitis pain.

1. Begin with your patient sitting on the treatment table with both legs stretched out before them
2. Place the CLX loop around one foot and then wrap the band around the bottom of the other foot
3. Allow your patient to hold the band ends
4. Instruct your patient to bring the foot that is in the loop up and out for two seconds
5. Then bring the foot slowly back into starting position over four seconds, while utilizing the perineal muscles

This third exercise is great for patients who have tenderness when you palpate the posterior tibial.

1. Have your patient sit on the treatment table with both legs extended in front of them
2. Place one foot inside the CLX loop
3. Ask your patient to cross their legs, keeping them extended (with the foot in the loop on the bottom)
4. Wrap the band around the bottom of the foot that is stacked on top and hand the ends of the band to your patient
5. Have your patient bring their bottom foot up and in for two seconds
6. Then return to the starting position over a four count

Have your patient work at home on achieving 25 easy repetitions on each of the above exercises.

6. TheraBand Professional Resistance Tubing Loop with Padded Cuffs

If your patient is displaying weakness in the hip, these TheraBand cuff exercises can help!

1. Have your patient lay down on their back on your treatment table
2. Place the cuff over your patient’s feet and move it up to their thighs, just above their knees
3. Have them bend their knees and place their feet flat on top of the table
4. Ask your patient to go into a 45 degree hip abduction, bringing their knees apart and then bringing them back together twice as slowly

Next, have your patient complete a clamshell exercise.

1. Have your patient lay down on their side on the treatment table, with the cuff just above their knees
2. Tell your patient to raise their top knee up and back, going into abduction
3. Then return to their starting position and repeat

This exercise works your patient’s hip abduction and external rotation to balance out the hip.

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As you know, a variety of muscles can have an impact on your patient’s plantar fasciitis. Be sure to explain how each of these exercises ties back to helping treat their condition.

7. TheraBand Stability Trainer

Have your patient stand on one leg, to observe them in a single leg stance. To maintain that position, you may see excessive pronation in the foot that is still on the ground. This exercise can be used without any equipment and be made more challenging by using a stability trainer. You can choose the trainer’s resistance depending on your patient’s existing balance skills.

1. Have your patient stand on one leg.
2. With the foot that is currently still on the ground, have your patient dorsiflex their big toe, bringing them into a neutral position.

• As your patient gets better at this exercise, make it more challenging by following the steps below

Place the Stability Trainer on the ground, with the textured side up Have your patient stand on one leg on the Stability Trainer and work on balancing Have your patient dorsiflex the foot that’s on top of the Stability Trainer

This exercise brings the hip into play as well as balance and is a great all-around exercise to use with your patients.

8. HawkGrips Dual-Edge Tongue Depressor Instrument

By the third visit and during subsequent visits, you may be ready to begin instrument assisted soft tissue mobilization (IASTM). HawkGrip instruments offer a variety of tools to help you break up fibrotic tissue and relieve your patient’s plantar fasciitis.

1. Have your patient sit on the treatment table and extend one leg
2. Work on each of the components of the foot that your patient is having trouble with including the heel and the peroneus brevis
3. Then have your patient lay on their stomach and work on using IASTM on their achilles and gastrocnemius

9. TheraBand Kinesiology Tape

If your patient is in a lot of pain, applying TheraBand Kinesiology Tape can help.

1. Cut two pieces of longer tape and two pieces of shorter tape and round the edges of all four
2. Stick one end of the tape at the base of your patient’s heel
3. Bring the tape around the heel, with a little tension
4. Next bring it across the bottom of the foot, securing the other end at the top of the foot, in the middle
5. Repeat starting on the opposite side of the heel
6. Take a small piece of tape and place it on inner side of the heel, applying compression as you bring it directly across the heel and secure it on the outer side of the heel
7. Repeat this step with the smaller piece of tape, just above and slightly overlapping the first piece

Your patients can continue to do their exercises, even while the kinesiology tape is applied.

See another taping option in the video below!

10. Biofreeze Professional

If your patient needs fast, temporary pain relief, suggest that they use Biofreeze in addition to the exercises above. The gallon jug is perfect for your busy clinic while smaller bottles and sprays can be used by your patients at home. The cooling relief is a perfect complement to all of the exercises your patients perform while in the clinic.

Plantar fasciitis is a chronic issue that doesn’t go away quickly. By using a variety of tools, you’re doing everything you can to get your patients back to their daily activities without pain!

References

1. https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846
2. https://www.vasylimedical.com/research/conditions/plantar-fasciitis

Medical Disclaimer: The information provided on this site, including text, graphics, images and other material, are for informational purposes only and are not intended to substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other healthcare professional with any questions or concerns you may have regarding your condition.

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