Plantar Fasciitis Treatment

The aim of Plantar fasciitis treatment is to reduce pain and inflammation and includes cold therapy, rest, taping, massage, and the use of a night splint or sock.

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Who is this program suitable for?

This program is suitable for anyone suffering from acute (recent) or chronic (long-term) heel pain from Plantar fasciitis.

Program structure

The Osgood Schlatter Disease treatment program consists of five phases. In order to progress to the next phase, you must reach specific exit criteria. So whatever type of injury you have, you begin at phase 1 and work through each phase.

The program is criteria based so you start at the beginning of phase 1 and only progress on to the next phase if you reach the specific exit criteria for that phase.

We recommend seeking professional advice if you are unsure before attempting any rehabilitation exercises.

Phil Pask

Phil is one of the World’s most experienced Sports Physiotherapists.

He has been England Senior Rugby Team Physiotherapist since 1997, continuing his role in recent years as Consultant Physio to the team.

Introduction to Plantar fasciitis treatment

Before you start it is important to determine your risk of exacerbating your symptoms and how much you should rest or ‘offload’ your foot in the early stages.

This will depend on how long you have experienced symptoms, how painful your foot is, and how long you experience early morning soreness or pain.

Plantar fasciitis treatment phase 1

Phase 1 is the acute phase where the aim is to protect your foot and reduce pain and inflammation. It comprises:

Cold therapy

Apply an ice pack for 15-20mins. Ice massage for 5-10 mins (you can freeze water in a small foam cup for this) Always protect the skin. Have an ice Bath (Toes out of water) for 10-15mins.

Rest

Acute injuries

Complete rest is required. No weight-bearing exercise at all. Offload your foot as much as possible until symptoms improve.

Subacute injuries

Active rest may be appropriate. Reduce training volume/intensity by 50%. If symptoms persist then reduce by half again.

Chronic injuries

Active rest is probably most appropriate. Move onto phase 2 of the program if you have a chronic injury.

Foot massage with MTP joint flexion

Alternatives are:

A tennis ball through the sole of the foot 5-10mins, or a frozen bottle of water and use as a roller for the sole of the foot for 5-10mins. This can be done 3-4 times per day.

Taping

Plantar fasciitis taping – a simple taping technique that provides excellent support to the arch of your foot. This is especially important if you cannot avoid standing or walking.

Night splint

A Plantar fasciitis night splint is worn overnight to keep help prevent tissues from tightening up overnight. It can be uncomfortable at first but try to gradually increase the time you wear it.

Often by the time, you can manage 4 hours or more your early morning pain will be significantly reduced. An alternative that works in a similar way is known as a ‘Strasburg sock’.

Exit Criteria

You are ready to move on to plantar fasciitis treatment phase 2 when:

  • Pain levels are 5/10 or less
  • You can walk normally including up and downstairs with 5 or less out of 10 pain?
  • Your foot is painful/stiff in the mornings for less than 30 mins

However, if your injury is acute then more time on phase 1 is required.

Access the full plantar fasciitis treatment program on our mobile app

Plantar fasciitis treatment phase 2

The aim of phase 2 is to significantly reduce pain and enable a normal gait pattern. with minimal discomfort. During this phase, we manage the load through your foot and try to get you back to doing some of your normal exercise routines.

Phase 2 comprises:

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

Exit criteria

In order to move on to plantar fasciitis treatment phase 3 you must:

  • In general, have 3 or less out of 10 on the pain scale?
  • Walk normally with 3/10 pain or less?
  • Less than 3 mins of stiffness first thing in the morning?
  • Do a single leg ‘heel-toe raise’ with 5 or less out of 10 pain?
  • Have equal flexibility in both legs?
  • Step up and down on a step pain-free?

Access the full plantar fasciitis treatment program on our mobile app

Plantar fasciitis treatment phase 3

The aim of phase 3 is to get you to a normal gait pattern with minimal discomfort and very little early morning stiffness. The idea is to progress from low to high loading of your foot, but keep it low impact with the ground.

Phase 3 comprises:

  • Cold therapy
  • Massage
  • Taping & splinting
  • 7 stretching & mobility exercises
  • 7 activation exercises
  • 4 specific strengthening exercises
  • 2 posterior chain strengthening exercises
  • 7 movement control exercises
  • 8 functional exercises

Exit criteria

To move on to plantar fasciitis treatment phase 4 you must:

  • Have minimal or no pain
  • Walk normally with no pain
  • Do a single-leg heel-toe raise with full power and minimal pain
  • Single leg heel raises 20+ in 30secs
  • Single hop test with less than 10% difference in legs
  • Accelerate and run at 75%+ maximum speed
  • Figure 8/10m Agility square/T Test at 75% pace?

Access the full plantar fasciitis treatment program on our mobile app

Plantar fasciitis treatment phase 4

By the end of phase 4, you should be pain-free, with a 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.

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

Exit criteria

To move onto phase 5 you should be pain-free

  • Normal gait pattern with no pain
  • No early morning stiffness
  • Single Hop Test (within 10% Right = Left)
  • 100% Linear speed and acceleration.
  • Complex Agility drills at 100% pace
  • Full power Grapevine/Carioca
  • At least 2 full training sessions (2 weeks for more serious injuries)

Plantar fasciitis treatment phase 5

Phase 5 is the maintenance or ‘injury mitigation’ phase. It is designed to help prevent your injury from returning.

Use massage before training/activity, or roll a Tennis ball through the sole of your foot for 5 to 10 mins. Select exercises from phases 3 and 4 to integrate as part of your normal training routine.

Access the full plantar fasciitis treatment program on our mobile app

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