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Glutes are arguably the most important muscle group for runners. Unfortunately, they are also the most neglected in terms of maintenance and strength. Studies link glute weakness to achilles tendinitis, runner’s knee, iliotibial (IT) band syndrome and other common injuries.
If your glutes are so important and their weakness contributes to many injuries, why are they neglected. Simply put, most athletes of all ages are unaware of the role their glutes play in their running performance. The goal of this article is to create a better awareness of the function of glutes for runners, what causes glute weakness or imbalance, how to identify if you have a problem and how to stretch & strengthen your glutes.
Your gluteus maximus is your butt, the two smaller, glute muscles (called glutes) are located on the side of your butt, near and slightly above your hip joint. When we run, the glutes’ job is to hold our pelvis level and steady. The gluteus maximus is responsible for hip extension, or raising your leg behind your thigh and knee behind you after pushing off with your foot. Good hip extension creates the energy of that leg swing into forward motion.
The problem is, without good hip extension you won’t have a powerful stride, which means your speed will be limited. The other key role of glutes for runners is providing stability for the pelvis and knees and keep our legs, pelvis and torso aligned. If you have strong glutes, side-to-side motion will be limited and you will be a more efficient runner because your energy is directed forward. Basically you can faster at the same effort level.
Also, when the glutes aren’t working properly, some of the impact forces are transmitted elsewhere down the legs. It’s common for many runners to have strong abs and back muscles but weak glutes.
How does this Glute dysfunction occur?
It’s common for the gluteal muscles to become inhibited which will prevent them from properly engaging and being able to perform their role.
Part of the problem is that glutes aren’t as active as other running muscles during routine activities. This leads to your hamstrings, quads, and calves becoming disproportionately stronger (also called an imbalance).
This imbalance limits the effectiveness of the glutes. The end result is that if we aren’t aware of this imbalance and subsequently correct it, typical movement and habits will place increased emphasis on the stronger muscle groups such as the Quads, rather than allowing the glutes to contribute properly within the running motion.
This kind of strength imbalance can cause injury problems over time as the body learns not to use the glutes as it tries to favor the stronger quads. If not properly identified, a glute weakness/imbalance typically doesn’t get corrected on it’s own because most runners don’t perform strength training exercises that isolate and strengthen the glutes. Exercises you can complete to fix this problem are listed below.
Additionally, excessive sitting can cause tight muscles, in particular the hip flexors, which will then inhibit the glutes, making them weak and ultimately pulling your pelvis out of alignment.
Bottomline, you need to work the smaller glutes to stay injury-free. The following video helps to explain the issue.
Glute Strength Tests
To see if you have weak glutes, you’ll need to perform the following glute strength tests.
Stand with your hands over your head, palms together. Lift your right foot off the ground and balance. Watch the left side of your hips to see if it dips down. If it does, it’s a sign of glute weakness.
In these photos, I’ve inserted a YELLOW HORIZONTAL LINE, to help identify whether or not my hips are dipping. You can have a friend take a photo while performing this test or you can complete the test while in front of a mirror to observe results yourself.
Glute strengthening and stretching exercises
For each exercise start with 10 reps the first week and then progress to 15 reps (switch legs), rest for 30 seconds and complete 3 total sets.
Tight hip flexors can inhibit the firing of your glutes. Complete this stretch after every workout (crossfit / conditioning or run)
Step forward and lower your back knee. Keep your knee over your ankle. Hold for 30 seconds on each side.
This exercise engages the middle-butt and low back.
Start on all “4s” by placing your hands under your shoulders and knees under your hips.
Extend your right knee and hip to even your right leg with your torso. Be sure your foot is flexed and your neck is neutral by looking down towards the ground. Hold momentarily. Return to starting position.
This exercise is a variation of kick backs. While your elbows and right knee are on the ground, lift your left leg until it is parallel with the ground. This is your starting position. Lift your left leg up about 6-12 inches while keeping it straight and then return to your starting position.
This exercise strengthens the gluteus medius and minimus (smaller muscles in the butt).
Start on all “4s.” Next, make a 90 degree angle with your right leg and then lift your right leg up 6-12 inches while keeping your knee bent. Hold momentarily, then return to starting position.
Lie flat on the ground with your hands by your sides and your knees bent. Pushing up mainly with your heels, keep your back straight and raise your hips up off of the floor. Hold there at the top for a few seconds and then go back to where you started and repeat. For an added bonus, try this exercise with only one foot on the ground at a time!
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Single Leg Squat:
Stand on your left leg. Lift your right out in front of you. Stand tall (don’t round your shoulders), and keep your left knee over your ankle as you lower down into a squat. Your hands can extend out for balance.
Modified Single Leg Squat:
Stand on edge of curb as shown in image. Raise right leg slightly and squat slightly with left leg (note how right foot is higher in 1st photo, side view). Start with 8-10 squats/leg and after completing this exercise 3 times/week for 2 weeks, increase to 15 squats/leg.
Glute & Hip Strengthening Exercises
This video shows some exercises that are completed with a resistance band. Bands may be available at your gym or you can purchase a variety of resistances in a pack through retailers like Amazon. If you don’t have access to a resistance bands, you can complete the exercises below (see photos and descriptions).
I don’t typically feature content from other websites, but I have to admit that I’m a “health nut” and I’m fascinated by the theory of “Blue Zones” and how to live a healthy lifestyle. Secrets of people who live long, healthy lives are discussed in the article I link to below. Blue Zones are certain towns or regions throughout the world where residents are happier and healthier. In order to qualify, there must be an unusually high number of centenarians—people living to over 100 in the area.
The following article not only identifies where these Blue Zones exist, but also details how the people in the most recognized Blue Zones live their lives.
The #1 lesson revealed is all of these healthy people regularly exercise. This is great news for us middle age runners. Other benefits of regular exercise, not just running, include:
It can Make You Feel Happier
It can Help Your Brain Health and Memory.
It can Help With Sleep Quality.
It reduces your risk of heart diseases.
Helps you manage blood sugar and insulin levels.
It can Help With Weight Loss.
It Can Increase Your Energy Levels.
I think two other keys to longevity are healthy eating (the article discusses the benefits of swaying towards a Plant Based Diet) & sleep.
The article doesn’t specifically reveal sleep as a lesson learned from those in the Blue Regions, but I have to believe that they have a history of getting 8+ hours per night. Research shows that consistently getting seven to eight hours of sleep per night is beneficial for adults. Poor sleep is strongly linked to weight gain, which is consistent with findings showing sleep-deprived individuals have a bigger appetite and tend to eat more.
Two months ago I posted a detailed article to help athletes prevent & fix Plantar Fasciitis. I was motivated to complete the research & report my findings because I’ve been suffering from this nagging and common runner’s injury since early in the Summer.
Now as the Summer ends, the pain from my plantar fasciitis is not as sharp, but it still persists. So, I visited my Physical Therapist and found the following video which backs up his strategies for relief.
My PT always seems to find the root causes of my injuries. 99% of the time, they exist above the injury. As you can see in the following video, it’s not simply enough to roll with a lacrosse ball & ice under your foot. This may relieve the pain, but it’s not addressing the root cause.
In my case, I have stiff calf muscles. I have been rolling and stretching, but in the same manner as recommended in this video. It’s a slightly different stretch, but it addresses the root cause of my problem (stiff calf muscles and muscles that connect to the foot).
Watch the video & put this stretching strategy (for calf and gluteus medius).
Periodization training is the process of dividing a training plan into specific time segments or phases leading up to and including a goal performance or race. This article will show you how can train the body in different ways during successive phases, gradually increasing the stress on the body, so you can ultimately combine the benefits of these workouts. The collective result is that with periodization training you can achieve peak conditioning for a desired race or races throughout the year.
UPDATE: Since Publishing this article, I have added a section below discussing Periodized Strength Training as it relates to running & a periodized program. Please scroll through 2/3+ of this post to learn about you can benefit from completing specific strength training exercises into a periodized running program.
Nearly every elite runner uses periodization. I use this system that includes various meso & micro cycles, each with a specific purpose and different physiological goals and psychological benefits. Using periodization allows you to couple hard training periods with easier periods of recovery to avoid over-training and improve components of muscular fitness such as strength, speed, and endurance to ultimately reach your goals. With the information that I share, you can divide your training plan into three parts to run strong and race well, all year.
Most studies of periodization have proved the superiority of this type of system over non-periodized programs in terms of greater changes in strength, body composition and motor performance (Fleck 1999).
Periodization programs involve a progression from high volume and low-intensity effort towards decreasing volume and increasing intensity during the different cycles. Periodization is not randomly changing volume and/or intensity with no consideration other than to introduce variation into the program. In a University of New Mexico paper, the author discusses how with a periodized program, the manipulation of volume and intensity, over a program that just increases total training volume alone, is an important factor in optimizing training effects.
When I set up a periodization program, I have the athlete, whom I’m coaching, gradually increase the stresses or efforts on their body during a variety of training sessions (distance, intensity, duration and type of recovery vary). Although a large percentage of training is completed at easy or conversation pace, in these programs we stress the body and then allow proper recovery, we achieve cardio gain and muscle growth. Basically, the work or a specific workout stresses your system. The planned recovery is what allows your body to adapt.
The overall training period, so it’s the longest of the three cycles and includes all of the elements of training in the entire training period leading up to and including your race. Typically it’s a year in length. Macrocycles are comprised of four stages or Mesocycles.
The mesocycle is a specific (2 – 8 week) block of training that is designed to accomplish a particular goal. The mesocycle is usually classified into 4 stages: recovery + endurance, endurance + strength/lactate threshold, intensity (interval) training and finally competition or peak performance (which includes some kind of taper). Finally, a set of microcycles, which are generally up to 7 days, make up the mesocycles.
I like the 4 week mesocycle because over the course of 3 weeks of similar workouts, we teach the body to adapt to specific stress, until it becomes not stressful. Then after a recovery week, I like to move on to the next stress.
Basic Periodization Program
First, if you can imagine a triangle, the bottom or base includes the longest phases of your training which are comprised of recovery/rest from your race (typically 3 weeks), followed by base or foundation training. Depending on the length of time between races, the base training can be up to 500 miles at relatively easy/conversation pace. During base training, the athlete will focus on the development of aerobic and muscular endurance which is the foundation of any running plan.
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Not every runner I coach starts in the same phase or level of the triangle. Some runners only have 10 weeks until their race, they are more experienced and have a substantial base. They may require some strength runs like tempo or hills, followed by shorter intervals to prepare them for a race. Other runners hire me to help them over the course of 6 – 12 months. I can take them through an entire macrocycle where we develop an entire periodized plan to gradually get them in shape for a few races and eventually a longer race like a half or full marathon.
One of the keys to a successful program is the pacing. Throughout the course of a macrocycle, there’s generally six paces that an athlete will train.
Goal Race Pace (goal the athlete wants to race based on dreams, plan)
Date Race Pace (current race pace, based on a recent performance. Should be reviewed with a qualified coach because variables like temperature, course, competition can affect times)
Lactate Threshold Pace (typically 10k pace for most runners. Moderate heart rate, can be sustained for 30 – 45 minutes).
Interval Pace (faster than date race pace, demanding, can only be sustained for shorter time periods (no longer than 10 minutes)
Rest Pace (slow pace in between intervals or as cool down after hard running).
There are numerous types of running depending on the phase of the periodization program. Some runs like the conversation pace (short, medium or long) runs are completed throughout the program. Other types are tempo, fartlek, hills, long & short intervals and race pace. I posted an article of the essential training runs for middle age marathoners.
As with any personalized plan, mileage and specific workouts during this mesocycle vary. If you’re an experienced runner who can handle 55 – 70 miles/week, your training during this phase includes:
5 mile recovery runs at an easy pace. Gradually build from 6 mile to 11 – 14 mile midweek runs at conversation pace. 8 – 10 mile aerobic or lactate threshold runs at ½ or marathon pace 15 – 18 mile long runs at easy to medium pace (a few runs can include 8 – 10 miles in the middle of these longer runs at marathon pace). These long runs teach your body to run more efficiently.
Training for runners (beginners, less serious or older athletes) who can’t handle consistent higher mileage (including myself) would follow a slightly different program.
4-5 mile recovery runs at an easy/conversation pace. 8 – 10 mile midweek runs at conversation pace Gradually increasing from 10 – 16 mile long runs (runs near the end of the phase that include 6-8 miles at marathon pace) 6-10 mile aerobic or lactate threshold runs at ½ or marathon pace Rest or cross-training twice per week
Speedwork is limited in this phase to strides & “mini-tempos.” Weekly you can either do 6 – 8 100M on a track or 6 – 8 to 20 to 30-second bursts of speed at the end of one or two of your easy runs. Don’t go any faster than ½ marathon pace in your aerobic or lactate threshold runs.
In the second phase or mesocycle we will still work on endurance, but we’ll step up the lactate threshold training. We introduce strength workouts which consist of tempo, hill & fartlek workouts. We want to push yourself a little, so it’s not a shock when you go faster in the next phase. If the overall training plan is 18+ weeks, this mesocycle can last for 9 weeks. According to coach Greg McMillian, “these workouts strengthen the muscles, ligaments, and connective tissues, which will prepare the body for the demands of fast running.”
Key Workouts for Lactate Threshold + Endurance Mesocycle:
6 mile recovery runs at conversation pace 8 – 10 mile lactate threshold at 15k to ½ marathon pace. See this detailed article about Tempo running. Strength Training with hills and fartlek. Hills are a great strength training workout. Run them at a hard, but not all-out effort. Fartlek is an easy way to introduce longer (1 – 2 minutes) of fast running. 16 – 20 mile long runs. Start to introduce finish fast runs (last 4 – 8 miles at marathon pace) in your long runs.
This 2nd phase is essential to strengthening the body for the fast running that comes in the third phase. You continue to build endurance through long runs, but a few of your workouts become tempo miles or hill repeats prepare you for the intensity/race preparation phase where you will complete more & longer intervals (800m to 2miles).
INTENSITY / RACE PREPARATION MESOCYCLE
During the intensity or 3rd phase, the focus switches to additional lactate threshold and then interval pace (VO2 max). The goal is to ready your body to enter the competition phase, so you need a greater emphasis to be placed on boosting anaerobic capacity and neuromuscular power.
During the beginning of this Mesocycle, we will run longer intervals (the exact length depends on the race) at 5k race pace. Typical workouts may include 5 x 1000m or 5 x 1600. Long runs are typically 17 -20 miles with last 8 – 10 miles at Marathon Pace. There should still be plenty of 5 – 7 mile recovery runs included.
Later speed sessions include run tune-up events like 8k to 15k races to help you prepare for your main event and then shorter intervals (such as 600m – 800m) at 5-K pace. The distance of your intervals depends on the length of your race & your athletic ability. Besides 100m strides, there’s no need to complete 200m– 400m repeats if you’re training for a marathon. If you’re a novice or training for a 5k, these shorter intervals are perfect.
TAPER / PEAK PERFORMANCE MESOCYCLE
This last, peak phase includes short, fast workouts that simulate racing. These workouts fine-tune the speed you began in phase two by recruiting fast-twitch muscle fibers. During this phase, one of the goals is to improve running economy (how efficiently your body uses oxygen) and strengthen muscles. You accomplish this by gradually increasing the intensity of your workouts and then in last few weeks before your race, decrease the overall volume while maintaining intensity. Coach Greg McMillan calls it “keep the engine revved.”
One of my favorite runs 2-3 weeks prior to the marathon is a 12 – 13 miler at race pace. This gives you a great indication of your fitness and how close to your goal time you can expect to finish. During the last week prior to the race, I also like to complete a 6 mile run with 4 miles at marathon pace.
In order to peak for key races, I recommend you mark your event on a calendar and either work with a coach or develop a plan that maps out your base, endurance, preparation, and peak phases. Each should be four to eight weeks long (you can extend the base or preparation phase beyond eight, but not the peak, to avoid burnout). I recommend that every fourth week, recover by reducing your miles by 10 to 20 percent. Also ease up on strength training. Once you peak, start again with recovery and base training and work your way through the phases over and over again.
PERIODIZED STRENGTH TRAINING
Just as completing a periodized running program with a progression of planned workouts will optimize your performance, it’s important to ensure you have the same kind of progression and variance in your strength workouts. Runners need to build strength during their training so they they can be more efficient, be more resistant to injury and build power.
If you’re new to strength training, it’s not a good idea to start with heavy lifts. Instead, start more basic with body weight exercises that can be performed at home, such as:
Bridges with basketball
Dips & Pull-Ups
Other basic exercises can be added gradually, but after 4-5 weeks you can transition to using kettle bells, dumbbells & medicine balls. The key is you want to strengthen your core, hips, glutes, quads and lower legs & ankles.
Light Weights to Heavier Weights
Eventually you transition to heavier weights at the gym. I recommend starting with lighter/smaller barbells and completing exercises with 25 – 35lbs at first. You should concentrate on proper form before you increase the weight. Some of these exercises include:
Bench Press – performed with a longer/heavier barbell
General rules for lifting are: complete 6-8 reps/set and lift so the final set is challenging (not so much weight that you can only do 2-3 reps). Try to complete 3 sets for each exercise and take about 2-3 minutes of recovery between sets.
As Coach Jay Johnson always preaches, keep easy days easy and hard days hard. This means, it’s best to complete lifting & body weight exercises after long runs and intervals. You should already be tired, but lifting in what’s considered a “pre-fatigued” state where the body already has low glycogen stores will teach your body to perform in this state. You’ll notice a difference in the late stages of a race.
There are countless stories of elite athletes getting better because they are stronger. Mo Farah, for instance, gives much credit to his strength which he says helped him to win numerous Olympic Gold Medals. Using a periodized strength program within your training cycle will allow you to maximize the benefits of all of your training.
In conclusion, you can get the most out of your training by having a good understanding of each of the three cycles of periodization and then using these cycles to create a plan that allows you to peak for your most important events throughout the year.
Plantar fasciitis is one of the most common causes of heel pain. It’s not unusual for people to manage their plantar fasciitis effectively, only to have their symptoms come back when they stop treatment. For this reason, it’s important to develop strategies to help prevent recurrence. This article will present the risk factors, diagnosis, treatment & a proven prevention program.
I’m not a trained medical professional, so please use the contents of this post as guidance. As a certified coach, I have used a network of medical professionals as resources for my injuries to whom I refer my local clients. If you’re experiencing any kind of pain that forces you to change your gait, then you should stop running and seek professional medical attention to properly diagnose, treat and prevent recurrence of your injury.
Similar to many other running injuries, Plantar Fasciitis is often an overuse injury. It’s described as a stabbing pain that usually occurs with someone’s first steps in the morning. As the athlete gets up and continues to move around, the pain normally decreases. However, it might return after long periods of standing or after rising from sitting.
The pain comes from inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia).
There are a number of factors believed to increase a person’s risk for developing plantar fasciitis. Plantar fasciitis is most common in, but not limited to runners. It’s often reported in athletes between the ages of 40 and 60, although anyone can get it. People who are overweight and those who wear shoes with inadequate support have an increased risk of plantar fasciitis. People who are overweight and run, can put extra stress on their plantar fascia.
The most common causes of plantar fasciitis are either structural (in the foot) or muscle/tendon weakness. For example, people who have problems with their arches, either overly flat feet or high-arched feet, could be more prone to developing plantar fasciitis.
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The injury can be brought on by certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, among other activities, can contribute to an earlier onset of plantar fasciitis. Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces may damage their plantar fascia.
Plantar fasciitis is typically aggravated by tight muscles in your feet and calves.
Wearing non-supportive footwear on hard, flat surfaces can put abnormal strain on the plantar fascia and can also lead to plantar fasciitis.
All of these risk factors can cause plantar fasciitis. Understanding which, if any risk factors you exhibit can help you prevent or minimize the effects of this injury.
You should AVOID self diagnosis of injuries. Plantar Fasciitis is not limited to the following symptoms. Instead, these are the most common symptoms reported by runners.
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The pain described by people suffering from plantar fasciitis is usually the worst with the first few steps after awakening, although it can also be triggered by long periods of standing or rising from sitting. The pain is usually worse after exercise, not during it.
Under normal circumstances, the plantar fascia acts like a shock-absorbing bowstring. It’s purpose is to support the arch in one’s foot. If tension and stress on that bowstring become too great, small tears can arise in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed.
Ignoring plantar fasciitis may result in chronic heel pain that hinders an athlete’s regular activities. If a runner changes the way they walk or run (their gait) to minimize plantar fasciitis pain, this might lead to foot, knee, hip or back problems. Bottomline, if you suspect you may have plantar fasciitis, seek positive diagnosis from a qualified medical professional.
Because heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation or in some rare cases, a cyst. It is important to have it properly diagnosed by a medical professional. A foot and ankle specialist is able to distinguish between all the possibilities and to determine the underlying source of your heel pain. Proper diagnosis will lead to correct treatment and hopefully speed recovery.
Accurate diagnosis begins with the athlete describing symptoms and discussing specifics of their injury. The doctor will examine the foot to pinpoint the source of the pain. The exam, along with the patient’s medical history, will help properly diagnose the condition. During the examination the doctor will look for areas of tenderness in the foot. While holding the affected foot, the doctor may bend the patient’s toes toward their shin and then press along the plantar fascia from the heel to forefoot.
A doctor may also order imaging tests so he or she can rule out any other causes of the pain, such as fractures or heel spurs.
Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. In my research, an MRI scan only seemed to be used if the heel pain was not relieved by initial treatment methods.
After diagnosis, the first priority with plantar fasciitis as with other injuries is to treat the pain. There are a few options your doctor could try to ease the pain and reduce inflammation. In my experience & research, it’s often recommended to try a few therapies at the same time to resolve the issue as quickly as possible.
Nonsteroidal anti-inflammatory drugs (NSAIDs) will help reduce pain and inflammation of the plantar fascia. A doctor may prescribe multiple doses a day for several weeks.
Depending on the severity of the pain, decreasing or even stopping the activities that make the pain worse are typical first steps. It’s common for a doctor to direct an athlete to temporarily stop activities like running.
Other typical treatment options include rolling affected foot over a cold water bottle or ice for 20 minutes. This can be done 3 to 4 times a day. Putting an ice pack on your heel for 20 minutes several times a day helps reduce inflammation. Place a thin towel between the ice and your heel; do not apply ice directly to the skin.
Some people find that massage helps with symptoms. Focus on massaging the arch of the foot around the injured area. If surrounding muscles have become tense because of the pain, massage those areas as well.
Tip: Dealing with early morning Plantar Fasciitis pain provided by the Hanson’s:“If you run early and find it difficult until the plantar warms up (or loosens), I suggest putting the foot in the bath tub under running warm water & keep adjusting the temperature until it is as hot as you can stand. This (will) help the early run hobble.”
Exercises that stretch out the calf muscles help ease pain and assist with recovery. When you walk without shoes, you put undue strain and stress on your plantar fascia.
Wearing supportive shoes with extra cushioning and orthotics if prescribed by a medical professional can reduce pain, especially if the patient is frequently standing and walking. I wear and recommend custom orthotics that fit into my running shoe. Although orthotics are not for everyone, if prescribed, they help correct underlying structural abnormalities that contribute to plantar fasciitis. A cushioned shoe or insert reduces the underlying tension and microtrauma that’s causing pain with the plantar. Soft heel pads can also provide extra support, they are inexpensive and work by elevating and cushioning your heel.
Although medication, rest and ice often eliminate the pain, working with a physical therapist (PT) can address bio-mechanic, muscle weaknesses or imbalances that were actually the root causes of the injury. A Physical Therapist will help with strengthening and stretching exercises (discussed below) that can prevent injuries to the plantar fascia, achilles tendon, and also lower leg muscles.
Kinesiology tape, straps and splints
Although I could write multiple detailed posts about the use of tape, straps and splints. I’ll keep it simple here. I have experience with using tape to alleviate pain (either myself or athletes I coach). Tape can help, but it must be applied correctly to achieve it’s maximum benefit. Below are a few videos that may be of interest. Proper taping of the foot or use of straps help support the foot and reduce strain on the fascia. The tape & straps will allow your foot and ankle to move well. Before applying kinesiology tape to your foot, be sure to speak to your physical therapist or doctor to ensure you are applying it properly.
Wearing a night splint can help to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some athletes. Remember that these devices help relieve the pain, but they don’t correct the root cause. The good news is that they won’t be needed once the pain is gone. As long as a regular preventative routine is implemented to address risk factors.
For those patients who don’t show progress after several months, a small percentage of patients may require surgery. From my research, the surgical option was rarely used and typically only considered after 12 months of aggressive nonsurgical treatment. A foot and ankle surgeon would discuss the surgical options with their patient and determine the most beneficial approach.
A few other treatment options are ultrasound, which is used to target and remove scar tissue. This procedure may allow the patient to get back to their regular routine much sooner than with surgery.
Stretches & Strengthening
Stretching exercises should create a pulling feeling. They should not cause pain. Ask your physical therapist or doctor which exercises will work best for you.
People can speed recovery, relieve pain and prevent recurrence with specific foot and calf stretches and exercises. Perform these exercises two or three times every day. Often, muscle tightness in the feet and calves can make the pain of plantar fasciitis worse. So, a good strategy is to gently stretch the plantar fascia, as well as the muscles around your foot and ankle. The more frequently you do this, the more you will improve foot flexibility, mobility and promote healing of the irritated fascia.
Calf stretch – Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
Plantar fascia stretch – This stretch is performed in the seated position. Cross the affected foot over the knee of opposite leg. Grasp the toes of the painful foot and slowly pull them toward the body in a controlled fashion. If it is difficult for the patient to reach their foot, then wrap a towel around the big toe to help pull toes inward. Place the other hand along the plantar fascia. The fascia should feel like a tight band along the bottom of the foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or walking.
Placing a round object under the foot and roll it back and forth. This will help loosen up the foot muscles. People also use a rolling pin, golf or tennis ball or specialized foam roller for this.
Flexing the foot increases blood flow to the area and relieves tension in the calves, which can help with pain. This exercise uses a towel or elastic stretch band, which people can buy from sports stores or online.
Curling a hand towel or facecloth with the toes can stretch the foot and calf muscles. Try doing these stretches before walking or doing any other morning tasks.
Picking up a marble with the toes will flex and stretch the foot muscles. This exercise is tough, but highly effective.
If you’ve read through this whole article, you understand the pain resulting from plantar fasciitis and how frustrating and what a painful problem it is to manage. The upside is that there are steps you can take to help alleviate your symptoms, address the root causes of the injury and prevent it from returning. Regardless of the treatment you undergo for plantar fasciitis, you must address the underlying causes. Therefore, it’s important to continue with preventive measures which may include long term wearing of supportive shoes, regular stretching, strengthening and possibly using custom orthotic devices as discussed above.
I used many sources in my research for this article. I interviewed a Physical Therapist and numerous athletes who have suffered through plantar fasciitis. I also used articles from the following online sources.