Updated: Jul 3
THE PLANTAR FASCIITIS SELF-TREATMENT SERIES:
Self-treatment – stretching (this article)
There is strong evidence that stretching the plantar fascia can help reduce your pain when you have plantar fasciitis, but some people can get even better results by including stretches for all the muscles in the back of their legs. In this article, I'll answer common questions patients have about doing stretches for plantar fasciitis and provide you with general guidelines as well as demonstrations of the stretches I find most useful.
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In this article:
We've also made a video about this:
Questions about stretching and plantar fasciitis
Why does stretching help plantar fasciitis?
Although the research has shown that especially calf and plantar fascia stretches can help to reduce plantar fasciitis pain, we don't yet have a clear answer as to how this work.
One theory is that by relaxing the muscles, you reduce the pull or tension on the injured part of the plantar fascia, which reduces the irritation.
Stretching also has a way of calming the sensors in your muscles and fascia that send messages to your brain about pressure and stretch. When you have plantar fasciitis, these sensors often become too sensitive and overreact to any pressure you put through your foot, causing the brain to create pain that is disproportionate to the severity of your injury. So, calming the sensors down through gentle stretches can reduce the intensity of your pain.
Does plantar fasciitis cause calf or leg pain?
If plantar fasciitis carries on for a long time and becomes so painful that it affects the way you walk, it can cause your calves to feel painful or even cause leg pain higher up. Pain in one area of the body can also cause the muscles in the areas next to it to become tense and irritated.
However, if you feel that the pain started in your leg and then moved to your heel, then it may be a different injury masquerading as plantar fasciitis.
Can tight calves cause plantar fasciitis?
No. A recent review of the available research that specifically looked at what risk factors may predispose you to getting plantar fasciitis found no evidence that tight calves cause plantar fasciitis. The most common cause of plantar fasciitis is overuse.
However, there is research that shows that people who already have plantar fasciitis often also have tight calves. So, it seems that plantar fasciitis can cause your calves to tighten up over time, but not the other way around.
Conclusion: Calf stretching has a role to play in the treatment of plantar fasciitis. but it will probably not prevent you from getting it.
Can tight glutes cause foot pain or plantar fasciitis?
Tight glutes can cause foot pain but not really plantar fasciitis. However, all the muscles that run down your lower back and the back of your legs are connected via thick layers of fascia and tendons. They are in turn connected to the plantar fascia via the Achilles tendon.
So, the same applies here as for the calves; once you have plantar fasciitis, tight glutes may irritate it further as it increases the general muscle/fascia tightness in the back of the leg.
How can tight glutes cause foot pain? Your sciatic nerve runs through your glutes all the way to your foot. If the glutes are tight, they can sometimes compress the sciatic nerve or stop it from sliding freely, which irritates it, and this then causes referred pain around your heel or under your foot.
Pain in heel when stretching hamstrings
Typically there are two places around the heel where you may feel pain when stretching the hamstrings:
The first is right under the heel or the foot. If this is the case, it may be that the pain is actually coming from your lower back. The hamstring stretch position also stretches your sciatic nerve, and if that is irritated or not hundred percent free to slide, it can cause pain in your heel.
The second is pain at the back of the heel, where the Achilles tendon attaches. If you're using a belt or band to pull your ankle back when you stretch your hamstrings, that can also stretch the Achilles tendon. If your Achilles tendon is injured, stretching it in that position may cause pain at the back of the heel.
General instructions for plantar fasciitis stretches
A WORD OF CAUTION: None of the stretches should be painful to do, nor should they cause you pain or discomfort afterwards. You should not try and stretch as hard as you can, but rather just take it to where you start to feel a gentle stretch and then maintain it for about 30 seconds. These stretches may not be right for you, so please check with your physio before doing any of them.
I always prescribe three sets of 30 seconds for each stretch. Hold still while you stretch and do not bounce.
It is important to understand that stretching alone will not resolve your plantar fasciitis. It is only a small part of a wider treatment plan. You can learn about the different components of plantar fasciitis treatment here.
If you would like help with your rehab exercises, check out the Plantar Fasciitis rehab plan in the Exakt Health app. I've helped to design the app to guide you through the rehab process from the moment your foot becomes painful all the way back to your sport.
Gentle plantar fascia stretch
This stretch may be more appropriate if your foot is still very painful and sensitive. It often works well if you do it first thing in the morning before you get out of bed. But still be gentle with it. Remember, it should not cause an increase in pain.
Sit on the side of your bed, on a chair, or on the floor.
If sitting in a chair, rest your ankle on your opposite thigh. Otherwise, simply have your leg bent up in front of you.
Pull your foot and toes back until you feel a gentle stretch under your foot.
Hold the stretch for 10 to 30 seconds.
Let go of your foot and move it around a bit.
Repeat it up to three times.
Do this once or twice a day.
Stronger plantar fascia stretch
Please be careful not to over-stretch the plantar fascia by pushing to vigorously. This stretch should not be done directly after a sudden injury of the plantar fascia.
Place your toes against the base of a wall as shown in the picture (your toes may likely not bend as much as mine as my foot joints are a bit hyper-mobile).
Bend your knee towards the wall.
You should feel a stretch underneath your foot and low down in the calf.
Hold the plantar fascia stretch for 30 seconds.
Repeat three times.
You can do this once or twice a day.
Calf stretching for plantar fasciitis
Research suggests that you should do the calf stretches more than once a day to see results. I would recommend that you test what works best for you.
Stand facing a wall or chair with the foot to be stretched at the back. Your toes must point straight forward. Lean against the wall or hold on to the chair.
Keep your back heel on the floor and bend the knee of the front leg until you feel a stretch in the calf of the back leg.
Maintain the calf stretch for 30 seconds before switching legs.
Repeat three times with each leg.
Do these once or twice a day.
Glute and lower back stretch
Hold on! It’s my foot that hurts. Why do I have to stretch my glutes and back?
As mentioned before, all the muscles that run down your lower back and the back of your leg are connected via thick layers of fascia and tendons. They are in turn connected to the plantar fascia via the Achilles tendon. Tight muscles further up the body could therefore irritate the plantar fascia when the latter is injured.
Place the outside of your right ankle just above your left knee.
Take hold of your left thigh with both your hands and pull it towards your chest. If you struggle to keep your neck in a comfortable position, you can put a pillow under your head.
You should feel the stretch in the right buttock/thigh/back depending on which part is the tightest.
Hold the glute stretch for 30 seconds and repeat on the opposite side.
Repeat three times on each side.
Do this two or three times a week.
Hamstring stretch for plantar fasciitis
It is important to make sure that the pain in your foot is in fact plantar fasciitis and not due to nerve pain from your back before attempting a hamstring stretch. Doing the hamstring stretch will make your pain worse if the pain is due to nerve irritation. The first post in this series tells you how to diagnose plantar fasciitis, but you may want to consult a physiotherapist if you suspect that your back may be the problem.
Sit with your one leg straight and the other bent up.
Your knee must remain straight throughout the stretch.
Put your chin on your chest and lean forward with both your arms (this will help to stretch a whole lot of muscles down the back of your body). You may not be able to stretch as far as that - that is OK. We're all different, so do what is comfortable for you.
Hold the stretch for 30 seconds and repeat three times with each leg.
Do this two or three times per week.
Like I said previously, stretching on its own won’t fix your plantar fasciitis. Combining it with other treatments like supportive insoles, strengthening exercises, or doing self-massage is often a more effective way of dealing with this injury. If you would like a more structured plan to help you recover, I've included stretches, strengthening exercises, and massage videos in the rehab plan in the Exakt Health app. The app also adapts the exercise intensities according to your feedback.
How we can help
Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Morrissey D, Cotchett M, Said J'Bari A, et al. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. British Journal of Sports Medicine 2021;55:1106-1118.
Robroy L. Martin, T. E. D., Stephen F. Reischl, Thomas G. McPoil, James W. Matheson, Dane K. Wukich, Christine M. McDonough, Roy D. Altman, Paul Beattie, Mark Cornwall, Irene Davis, John DeWitt, James Elliott, James J. Irrgang, Sandra Kaplan, Stephen Paulseth, Leslie Torburn, James Zachazewski, Joseph J. Godges. (2014). Heel Pain—Plantar Fasciitis: Revision 2014. Journal of Orthopaedic & Sports Physical Therapy, 44(11), A1-A33.