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Johns Hopkins Health Alert

Stretching Away Plantar Fasciitis

A recent study of plantar fasciitis patients reveals that stretching the plantar fascia may reduce pain more than stretching your Achilles tendon.

Rising in the morning, you put your feet on the floor and immediately feel a sharp pain in the inside of your heel … or after exercising your heel aches and swells … or your heel hurts anytime you stand up after sitting for a while.

These pains are typical of plantar fasciitis, a common foot condition. Although it's not dangerous, plantar fasciitis can curtail your activities and alter your gait, which can cause foot, knee, hip, and back pain. Plantar fasciitis occurs when the plantar fascia, a fibrous band of connective tissue that attaches your heel to your toe bones, becomes irritated. Plantar fasciitis becomes more common with age.

Most people with plantar fasciitis use pain relievers, splints, and orthotic shoe inserts that redistribute pressure on the affected foot. In severe cases of plantar fasciitis, corticosteroid injections can help with plantar fasciitis pain. A less common option to relieve the pain of plantar fasciitis is extracorporeal shockwave treatment. During treatment, an ultrasound device aims sound waves at the plantar fascia. Shockwave therapy may stimulate healing, but thus far, studies show conflicting results. About 5% of people with plantar fasciitis go on to have a surgical procedure, such as detaching the plantar fascia.

Stretching your Achilles tendon is often recommended for additional pain relief of plantar fasciitis; however, directly targeting the plantar fascia may have better results. A study published in The Journal of Bone and Joint Surgery evaluated 82 chronic plantar fasciitis patients who were given a three-week supply of Celebrex (celecoxib), orthotics, and instructions for an Achilles tendon stretch or a plantar fascia stretch. After eight weeks, participants who stretched their plantar fascia felt less pain and could perform more activities than patients who stretched their Achilles tendon.

When the study ended, the plantar fascia stretch was taught to all the participants. Two years later, 66 of the original patients were re-examined; 94% of these patients reported feeling no pain or less pain than they had experienced before the study, and only 30% had undergone further treatment with a physician or physical therapist.

Stretches for plantar fasciitis: The plantar fascia stretch requires pulling the toes to create tension in the plantar fascia.

  • Step 1. Cross your legs so that the foot you will be performing the stretch on rests on top of the opposite knee.
  • Step 2. Hold the base of the toes in your hand and pull back towards the shin. You should feel a stretch in the bottom of your foot.
  • Step 3. To check that you’re performing the stretch correctly, touch the bottom of your foot with your other hand. You should be able to feel the plantar fascia tense under the skin.

In the study, the stretch was done 10 times, three times a day.

Posted in Healthy Living on December 5, 2007
Reviewed June 2008

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