Ankle & Foot Treatment

Best Exercise for Plantar Fasciitis | Plantar Fasciitis Treatment

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Best exercise for plantar fasciitis

Best Exercise for Plantar Fasciitis | Plantar Fasciitis Treatment

Rathleff et al. in the year 2014 have shown that high-load strength training, which causes tensile loads across the degenerative tendon yields better results than daily plantar-specific stretching. They designed an exercise that uses the windlass mechanism by dorsal flexion of the 1st MTP joint plus Achilles tendon loading to transfer high loads to the plantar fascia

To perform this exercise, you can use a stairway or a little pedestal and put a rolled towel on it to dorsiflex the  ALL MTP joints (unlike shown in the video, where we only focused on the 1st MTP). You can use a chair or similar to hold on to. Then do a heel raise and take 3 seconds for the concentric contraction, hold this contraction for another 2 seconds at the top and take another 3 seconds for the eccentric action when you lower your heels again.

You can start this exercise with 3 sets of 12 repetitions every other day for 2 weeks. To progress, you can use a backpack with books or other weights and do 4 sets but decrease the repetitions to 10 for four weeks. In the study, they then progressed to more weight in the backpack and 5 sets with 8 repetitions and were instructed to keep adding books as they became stronger.

If your patient is not strong enough yet to complete all reps with a good form, they should start with both legs at the same time. It’s okay if your patient experiences slight pain during the exercises, but should contact you if they experience worsening after the exercises or during the next 24 hours.

The reasoning behind this exercise is that collagen type 1 fibers which are abundant in the plantar fascia respond to high-load tensile forces with increased collagen synthesis, which may help to normalize the degenerative changes of the tendon.

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References

Rathleff MS, Mølgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. High‐load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12‐month follow‐up. Scandinavian journal of medicine & science in sports. 2015 Jun;25(3):e292-300.

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