Conditioning: Phase 3

The following is the third of four phases that will guide you from Plantar Fasciitis toward healthy running. Progress from each phase as instructed.

Duration: 3 Weeks (at least)
Goal: Progressive Loading and Strengthening
Frequency of Exercises: 3 x per week (day off in between)
Warm Up: For at least 5 minutes before activity (e.g. Pre-Run Warm up)

Single Leg Glute Bridges: 3 x 10 reps. Placing your legs shoulder width apart with knees bent, bring your hips up and down. You should feel your hip and thigh muscles working. Purpose: increase hip strength to reduce pressure on arch and prevent knee caving in.
Single Leg Balance (Moving): 3 x 30 seconds (each leg). Stand with both hands on your hips and your feet directly under you. Keeping your pelvis as stable as possible, bring one leg up without causing your pelvis to tilt or rotate. Once stable, bring one leg slightly up, moving it out, forward, out, and then back in an arch-like motion. Purpose: improve postural balance and stability.
Single Leg Heel Raises (On Step, Towel Under Toe): 3 x 12 reps. Standing on a step with one leg, a towel under your toes (raise toe), come down on your heels toward the ground and feel some discomfort. Go slowly (3 count going down, 3 count going up). Pain within the 3-4/10 range is expected. If too easy, place more weight on the involved side. Purpose: increase load on the plantar fascia to improve resilience.

Captain Morgans (Along Wall): 3 x 30 seconds (each side) or 3 x 8-10 reps. Next to a wall, stand straight and bring your “wall side” knee up; you can use a ball, but if you don’t have one just use the wall. Keeping your torso straight with your hands in front, begin to squat down by bringing hips back then bending knee. On one leg, without that knee caving in, push your knee hard against a ball/wall. If it’s too easy, it can go up and down slowly. You should primarily feel your hip and thigh muscles working. Purpose: increase hip strength to reduce knee from caving in.
Jump Roping: 3 x 30 seconds. Purpose: begin plyometric loading.
Side Planks: 3 x 30 seconds (each side). Elbows aligned with shoulders, come up on your side. Keep your body straight throughout. Purpose: strengthen postural stability.
Front Plank: 3 x 30 seconds or until fatigue. On your elbows and knees, bring your knees off the ground and hold. Try to keep your body level throughout this exercises by keeping your hips level and engaging your abdominals and glutes. Keep your elbow below your shoulders and push up to engage your scapular muscles. Purpose: strengthen core and glutes for running form stability.

Cross Fiber Massage: 3-5 minutes daily, mild pain okay. Focusing on the pain area of the plantar fascia, put moderate pressure on the spot going back and forth. While it initially may feel too painful, you should notice pain subsiding with time. You can also place a tennis ball under your arch while sitting and roll/massage your plantar fascia that way. Purpose: reduce scar adhesions and stimulate healing.
Walk/Run Interval: If you are able to do 20 single leg calf raises without pain on a step, and the Windlass Test (see video at bottom of page) is negative then you may start a Run/Walk Progression on a flat, shock absorbing surface like a track or grass field.

Stretching:
- Gastrocnemius: In a split stance with shoes on, keep your heel on the ground, lean forward while keeping your knee straight for 1 minute
- Soleus: Next, holding a split stance, bend your knee and get a lower stretch for 1 minute. Purpose: reduce pressure on the plantar fascia through increased ankle mobility.
- Hip Flexors: In the kneeling position with your arms supported on the wall, engage your abdominals by doing a posterior pelvic tilt (i.e. low back is flattened with a limited curve). Engage your glutes on your kneeling side and keep your body as a unit until you feel a stretch in the front of your hip. You may increase your stretch by leaning away from the side.

TO GRADUATE TO PHASE 4

Required: No pain with first steps in the morning for 2 weeks
Required: Negative Windlass Test (see below)
Required: Negative tenderness to palpation (touch) along plantar fascia

Principles of Plantar Fasciitis: A Review

CAUSE – overloading the ligament/fascia at the bottom of the foot
NEED – reduce pain as well as scar tissue adhesions, and increase tissue flexibility
PLAN – once pain is alleviated, progressively load the fascia to improve strength and range of motion

Still Need Help?

You are welcome to meet virtually with our PT for additional feedback and assessment. Otherwise, continue to the next step to learn how best to manage the pain from your injury.