Plantar Fasciitis Phase 4

Phase 4 comprises:

Cold therapy
Massage
Taping & splinting
7 stretching & mobility exercises
5 activation exercises
4 specific strengthening exercises
3 posterior chain strengthening exercises
9 movement control exercises
1 functional exercise

By the end of phase 4, you should be pain-free, with normal gait and no early morning stiffness. During this phase, we get you back to running at 100% maximum speed and performing sports-specific drills.

Treatment

As required.

Hot & cold therapy

Ice after training or performing rehab exercises by any of the following methods:

Ice pack – 15-20 mins
Ice massage – Freeze water in a small foam cup and massage over the area for 5-10 mins
Ice bath – submerge your foot in an ice bath (but keep your toes out of the water) for 10-15 mins

Massage

Apply gentle massage techniques first thing in the morning and before training or rehab exercises until your foot is pain-free.

Use any of the following methods:

Roll your foot over a Tennis ball through the sole of your foot for 5-10 mins
Foam roller through the sole of your foot for 5-10 mins

Taping

Apply Plantar fasciitis taping only for training or activities.

Night Splint

Wear a night sock or splint if you still have early morning stiffness.

Mobility & stretching

Before training sessions.

Massage foot and mobilise big toe (only if stiff)

Massage foot and mobilise big toe (only if stiff).

Toe on heel of foot (if Plantar fascia feels tight)

Teaching point:

Put one foot in front of the other
Gently press your toe into the heel of the front foot
Bring the stretch onto that joint of the back foot
This will stretch your plantar fascia as your big toe is stretched
4 sets for 30 seconds

Calf stretch straight leg

Teaching Points:

Calf stretches should be done with your leg straight to stretch the larger gastrocnemius muscle and bent to target the deeper soleus muscle
4 sets each for 30 seconds
3 – 5 x per day

Calf stretch bent knee

Teaching Points:

Calf stretches should be done with your leg straight to stretch the larger gastrocnemius muscle and bent to target the deeper soleus muscle
4 sets each for 30 seconds
3 – 5 x per day

Band assisted ankle dorsiflexion (only if stiff)

Teaching point:

Place the band around the front of the foot
Bend the knee slightly over the foot, with the band gently distracting the joint
4 sets and hold for 30 seconds

Lateral stepovers dynamic

Teaching Points:

Step over a hurdle or similar sideways to mobilize your hips
Begin to perform these up on your toes with a little more energy than in the earlier phases
3 sets of 8 each leg

Front stepovers dynamic

Teaching point:

Stand tall, keeping your head and chest up and core engaged
Alternate which leg leads, keeping a good range of motion through both hips
3 sets of 8 reps (each leg)

Strengthening (specific)

2 to 3 times a week.

Tiptoe walking

You can use a dumbbell to make this exercise harder.

Toe walks heel in:

With your heels inward, walk up on your toes keeping the heels slightly up, (you should just fit a credit card under)
4 sets of 5 metres

Toe walks heel out:

With your heels pointing outwards, walk up on your toes keeping the heels slightly up, (you should just fit a credit card under)
4 sets of 5 metres

Note: When you are confident you can perform these exercises comfortably, progress to the other specific foot-strengthening exercises.

Pogos

Teaching points:

Quickly bounce up and down on the balls of your feet
4 to 5 metres forward and then 4 to 5 metres backwards
1 set

Windlass heel raise

Teaching point:

Towel under toe, single leg (continue with this one for the next 3 months!)

60 degree bent knee heel raise

Teaching Points:

Lean into a wall and slightly bend your knees
Take the load on one leg, keeping the knee bent
Perform your heel raise from the ankle
4 sets of 8 to 12 reps

Strengthening (posterior chain)

2 times a week.

Heel raise in lunge: foot on plate/step

Teaching Points:

In a lunge position place your front foot on a step and perform a heel raise from the ankle
3 sets of 8 reps on each leg

Bulgarian squat

Teaching points:

Place your foot behind on a chair, step or block
Keep your knee over the foot
Keep your belly and chest over the knee
3 sets of 8 reps

Side lunge with kettlebell

Teaching point:

Holding a kettlebell take a wide step to the side and lower down into a squat, keeping your planted foot leg straight
Push through the heel to return back to the starting position and repeat, stepping to the other side
3 sets for 8 reps

Activation

Twice a week or as part of a warm-up.

G Band “Monster walks”

Teaching Points:

Ice skater exercises using a band at the knees are performed more dynamically on your toes
3 sets of (12 steps each way)

Single leg bridge on bench

Teaching Points:

Single leg bridge is performed on a bench
Place one foot on the bench or chair and push your hips up keeping your core muscles firm.
Use a resistance band around the knees to activate your hip muscles more
2 to 4 sets for 15 to 30 seconds

Ankling drills: toe taps linear

Teaching points:

Slightly up on your tiptoes, weight on the ball of your feet, heels off the floor, perform a stiff-legged run/shuffle
Keep tall, head and chest up, keeping the abdominal muscles engaged
Keep legs stiff, hitting the floor with each movement to propel yourself along
4 sets of 10 metres

Ankling drills: toe taps lateral

Teaching points:

Slightly up on your tiptoes, weight on the ball of your feet, heels off the floor, perform a stiff-legged run from side to side
Keep tall, head and chest up, keeping the abdominal muscles engaged
Keep legs stiff, hitting the floor with each movement to propel yourself along
4 sets of 10 metres

Standing paloff press+ leg sweep

Teaching point:

This exercise works the trunk.

Stand on one leg holding the resistance band out in front
Keeping the weight on your supporting leg, sweep the other one round in a semicircle
Keep your core strong to maintain balance
10 reps for 3 seconds each

Movement control

2 times a week.

Forward T

Try this exercise on a balance board or Bosu if you want to make it harder, If not, stick to the floor.

Teaching point:

Perform in a slow and controlled way
Stand on one leg with your knee slightly bent
Lean forwards, open up your arms pulling the non-supporting leg backwards to make the shape of a ‘T’
Maintain balance for 4 or 5 seconds and repeat
3 sets of 6 reps for each leg