Key points

• Heel pain can be caused by stress placed on the plantar fascia ligament when it is stretched irregularly, which causes small tears and inflammation. Stretching and strengthening exercises can help the ligament become more flexible and can strengthen muscles that support the arch, in turn reducing stress on the ligament.
• Exercises for plantar fasciitis-when combined with other steps such as resting, avoiding activities that make heel pain worse, using shoe inserts, icing, or taking pain relievers-usually succeed in relieving heel pain.
• Exercises for plantar fasciitis may be especially helpful for reducing heel pain when you first get out of bed.
• If you have questions about how to do these exercises or if your heel pain gets worse, talk to your doctor.

Exercises that help relieve heel pain from plantar fasciitis include:

• Stretching exercises, especially to stretch the plantar fascia on the bottom of the foot and to stretch the calf muscles.
• Strengthening exercises, to strengthen the muscles of the foot and ankle.

Exercises to avoid

Some exercises may make your heel pain worse. One example is exercise that involves repeated motions and pounding of the foot against a hard surface such as running or jogging. You should avoid this type of exercise.

People who have plantar fasciitis may have less flexible feet and ankles, and weaker foot muscles. Their feet may tend to flatten and roll inward (pronate) more when they walk or run.

Exercises can protect the plantar fascia from injury and inflammation by making the plantar fascia and calf muscles more flexible and by strengthening the foot and ankle muscles that support the arch.

• Warming up and stretching before sports or exercise may make your plantar fascia more flexible and may decrease the chance of injury and inflammation.
• You may want to take a pain reliever such as a nonsteroidal anti-inflammatory drug (NSAID), including aspirin, ibuprofen, or naproxen, to relieve inflammation and pain. Some people take NSAIDs at least 30 minutes before doing recommended exercise, to relieve pain and allow them to do and enjoy the exercise. Other people take NSAIDs after they exercise.
• After you exercise, ice your heel to help relieve pain and inflammation.

Stretching exercises before getting out of bed

Many people with plantar fasciitis have intense heel pain in the morning, when they take their first steps after getting out of bed. This pain comes from the tightening of the plantar fascia that occurs during sleep. Stretching or massaging the plantar fascia before standing up can often reduce heel pain.

• Stretch your foot by flexing it up and down 10 times before standing.
• Do toe stretches to stretch the plantar fascia.
• Use a towel to stretch the bottom of your foot (towel stretch ).

Other steps can help reduce heel pain when you take your first steps after getting out of bed. You can:

• Wear a night splint while you sleep. Night splints hold the ankle and foot in a position that keeps the Achilles tendon and plantar fascia slightly stretched.
• Massage the bottom of your foot across the width of the plantar fascia before getting out of bed.
• Always wear shoes when you get out of bed, even if it is just to go to the bathroom. Quality sandals, athletic shoes, or any other comfortable shoes with good arch supports will work.

Exercises to do each day

Stretching and strengthening exercises will help reduce plantar fasciitis.

• Stretching exercises should create a pulling feeling. They should not cause pain. It's best to do each exercise two or three times during the day, but you do not need to do them all at once.¹ Stretching exercises:
  • Use a rolling pin or tennis ball. While seated, roll the rolling pin or ball with the arch of your foot. If you are able to, progress to doing this exercise while you are standing up.
  • Toe stretch
  • Towel stretch
  • Calf stretch
  • Plantar fascia and calf stretch
• Strengthening exercises:
  • Towel curls
  • Marble pickups

There are other exercises you can use to stretch and strengthen your foot and leg. Ask your physical therapist or doctor which exercises will work best for you.

For more information about exercises to reduce heel pain from plantar fasciitis, talk to:

• Your doctor.
• A physical therapist.
• An occupational therapist for job-related activities.

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