Rehabilitation of Plantar Fasciitis 

The following guidelines are for information purposes only. We recommend seeking professional advice before attempting any rehabilitation.

Aims of rehabilitation:

• Decrease initial pain and inflammation.
• Identify biomechanical disfunction.
• Improve flexibility.
• Strengthen the plantar fascia.
• Return to full fitness.
• Injury prevention

Reducing pain and inflammation

• Rest from activities that cause pain. Stay off your feet as much as you can. Use crutches if necessary. Maintain fitness by swimming or cycling. Take the opportunity to work on upper body strength.
• If you cannot stay off your feet then the next best thing is to tape the foot. This taping gives excellent support while allowing the foot to heal. If taping is effective then it is likely that orthotics will also be effective in correcting foot biomechanics and helping to prevent the injury returning once normal training has resumed.
• Apply cold therapy. Ice massage for 10 minutes to the site of pain - every hour for the first day progressing to 3-5 times a day.
• NSAID's (Non steroidal anti-inflammatory drugs) e.g. ibuprofen may help in the early stages. Always check with a Doctor before taking any medication. Do not take Ibuprofen if you have asthma.

Biomechanical disfunction

• If your feet roll in or pronate excessively then this can contribute to the strain on the foot.
• If the foot rolls in then this tends to flatten the arch and so stretches the plantar fascia more than it is comfortable with.
• Repeated over-stretching will cause damage to the collagen fibres within the fascia.
• This can be corrected by orthotic inserts preferably fitted by a sports injury professional or podiatrist.
• The inserts should be worn at all times. Not just when training. During rehabilitation, you should wear orthotics from the moment you get out of bed until you get back in again.
• You can get an idea of whether you over pronate by looking at your footwear. If you tend to wear out the inside front of your sole then this is a strong indication that something is not quite right.

Improving flexibility

• Gentle stretching should be started as soon as pain will allow - the first day of treatment if possible.
• Stretching the plantar fascia is essential but in addition all the muscles of the lower leg should be stretched - including the calf muscles and the tibialis anterior at the front of the leg.
• Continue stretching daily throughout the rehabilitation phase and long after the injury has healed.

Sports massage techniques

• Sports massage should be applied as soon as pain will allow - gently at first and gradually becoming deeper.
• Massage can be performed every other day. A days recovery is required between sessions, especially if the massage has been deep.
• Massage should be applied to the fascia itself, but also to the calf muscles to help loosen them and so increase the range of motion at the ankle.

Return to full fitness

• When you have gone at least a week with no pain then you can begin to slowly start to increase the stress on the foot.
• Start off by walking and increasing the distance and speed you walk until you can walk at a fast pace for at least 30 minutes with no pain.
• This should be a gradual process. If you feel pain at any time then go back a step.
• Apply tape to the foot to support it for the first few times, especially if you do not have orthotics.
• Gradually introduce running by following the program below.
• Ensure you have the correct shoes for your running style or sport.
• After every training session apply ice to the foot for about ten minutes.
• Ensure you stretch properly before each training session and after. Hold stretches for about 30 seconds and repeat 3-5 times.

Below is an example of a gradual return to running programme. Begin each training session with a 5 minute walk followed by a stretch.

Continue this programme until you are confident enough to return to full training.

Prevention of Plantar Fasciitis

• Increase training gradually.
• Get a full biomechanical analysis to ensure your feet are functioning properly. You don't build a house without getting the foundations right first.
• Ensure you have the correct footwear and that it is not too old. A pair of running shoes will have lost most of their cushioning after 400 miles. If you run few miles but your shoes are over 6 months old then they still may need replacing.
• Continue to stretch properly - especially the plantar fascia and muscles at the back of the lower leg.
• Get a regular sports massage. This will help keep the muscles of the foot and lower leg in good condition.
• Apply ice to the foot after training, particularly when returning to fitness. This may help keep inflammation down before it gets bad.

Stretching >>

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