This is great! As I am getting back to hiking and beginning to do stretches and exercises myself, I get to pass on to you all the information I have accumulated.
To help with the pain it is important to stretch your foot and calf several times a day, icing as you go.
Stretching helps the plantar fascia become more flexible and less likely to become inflamed again so it’s important to do these stretches as often as you have a couple of minutes during the day. Once your feet and legs have calmed down you can start building strength back into the plantar fascia and the muscles that support the long arch. (See Homework 1-7 below.)
Throughout the weeks of icing, resting, stretching and strengthening, massage can help immensely. I have worked with runners, hikers and tennis players for years and I have a calf and foot routine that works well initially and progresses as you continue. The routine involves both lengthening strokes (going with the muscle fibers),spreading strokes (across the muscle fibers) and trigger point release to thoroughly loosen the calves. You will actively participate in the session.
We can start this process immediately while waiting for your feet to calm down. Actual massage on your feet will begin gently and with essential oils/liniments to reduce inflammation. We will gradually work more deeply as you begin strengthening to make sure things stay loose and fluid. Eventually you can just come in occasionally for a tune up.
Most of the movements I mention in this blog can be replicated on the massage table. I recommend you come in at least once so I can help you do them correctly and to regulate the intensity. At the end of your session we can do specific stretches together and then ice your feet. I have several clients who tell me they don’t like ice and they prefer heat but they are happy to apply ice to plantar fasciitis; heat just does not feel good on those ‘burning’ feet.
Your homework between sessions will be some of the exercises that follow. Doing them will cut down on the frequency of necessary sessions and any discomfort during sessions. I will always work to your tolerance.
I purchased a new foam roller called ‘the grid’ and began seriously rolling my calves twice each day, pausing for 15-30 seconds on the most tender spots to allow for myofascial release. The top leg provides the necessary pressure.
I roll the arch of my foot on a ball or a frozen water bottle during the day when my feet feel tired or inflamed, as well as manually stretching the big toe and medial arch. Hold for at least 15 seconds to allow the tissue to stretch.
At the same time, I’m doing the towel stretch. Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel or belt around the ball of your foot and pull the towel or belt ends toward you keeping your knee straight. Hold this flexed foot position for 15 to 30 seconds. Repeat 3 times. ***Do this before getting out of bed! It will make your first few steps of the day more comfortable.
A standing stretch for the calves. Place your feet shoulder width apart, one foot a little behind the other and slowly squat down, keeping your heels on the floor. Hold 15-30 seconds.
Alternatively you can put your hands against the wall at eye level. Put your injured foot back, leg straight (heel on the floor) with the uninjured foot forward, leg bent. Turn the front of your injured foot slightly inward and slowly lean into the wall paying attention as you feel a calf stretch. Hold 15-30 seconds.
‘Downward dog’ from yoga is a great calf stretch too!
Soon you can graduate to this ‘drop heel’ stretch for the plantar fascia. Stand on a step on the ball of your injured foot and drop your heel down to feel the stretch. Hold for 15-30 seconds and repeat.
Once your calves and feet start to loosen up and you can stand and walk comfortably, you can start a strengthening regime for the muscles that support the arch.
Begin with resistance provided by elastic tubing.
Have a loop in one end for your foot and a knot in the other to be closed in the door. Sit with your leg out straight, far enough from the door to give some tension and keep it straight while you slowly flex your toes towards you. Hold and then repeat several times. Do a few sets.
Do the same thing, but turn the sole of your foot slightly inwards as you flex. Then do it again and turn the sole of your foot slightly outwards as you flex. Hold as before and repeat several times.
Hold the knot yourself so there is tension between your hands and your foot. Slowly press your toes down away from you. Hold and repeat several times. Do a few sets.
Lastly, try gathering items toward you and picking items up with your toes, keeping your heel on the ground. Start with something light and easy and then progress to heavier items, as you are able.
The Internet abounds with tools to help you stretch and exercise your feet, but one that comes heavily endorsed is the Pilates ‘foot corrector.’ It costs $150 but maybe the investment will make you use it regularly!
Remember, your body is your partner; your symptoms are your guides!