Conditioning: Phase 4
The following is the final phase that will guide you from Plantar Fasciitis toward healthy running. Progress from each phase as instructed.
Duration: 2 Weeks
Goal: Plyometrics and functional training, increasing load on tibialis muscles
Frequency of Exercises: Daily (2-3 days per week)
Warm Up: For at least 5 minutes before activity (e.g. Pre-Run Warm up).
- Up and Backs: 3 x 1 minute. Run up and back for 1 minute per set. Purpose: load and increase demand on tibialis anterior.
- Single Leg Balance (On Toes): 3 x 30 seconds each. Stand on one leg and come up on your toes, holding that position for 30 seconds. Purpose: increase ankle balance and strength.
- Mountain Climbers (With Band): 3 x 1 minute. In a full plank position, wrap a band around your toes and anchor the other end. Keeping your core stable, bring your knees up to your chest by alternating sides. Purpose: increase load on tibialis anterior to build up resilience.
- Arch Exercise (3 Parts): Think of your sole as having three key points of contact with the ground: two points on the ball of the foot and one at the heel. Stand with your feet shoulder-width apart and lift up all your toes. Hold that position for 10 seconds, maintaining the three-point anchor and a stable curved arch. Next, still maintaining the sole’s 3-point connection to the ground, lift up your big toes while keeping the little toes down for 10 seconds. Finally, bring your big toes down with little toes up, watching that your foot does not rotate inward, collapsing your ankle. Hold that for 10 seconds. If difficult, you may have to train your toes by positioning them with your hands. Purpose: improve arch posture and tissue strength to absorb the impact forces of foot strike while stabilizing the foot and shin muscles.
- Arch & Shin Exercise (3 Parts): Standing with your feet and knees together, assume a crouched position balanced on your forefeet while you sit on your heels. You should primarily feel your arch and toe muscles working to stabilize your weight. Your legs should be mostly relaxed while doing so. Hold that position for 10 seconds and then slowly lower your knees to the ground. Briefly hold that position and then return to the first position. Finally, shift back to your heels while maintaining a tight crouched position. Here, you should feel your front shin muscles working the hardest. Purpose: strengthen feet and shin muscle groups.
- Single Leg Calf Raises (with Weight, On Step): 2 x 20 reps. Standing with your toes over the edge of a stair, bring your heel down and then come up as high as you can. Preferably do this with a slight knee bend to target the soleus muscle, but if it feel more comfortable to keep your knee straight then do so. Purpose: increase calf strength to support ankle when running.
- Single Leg Jump Ropes: 3 x 30 seconds (each leg). You don’t even need a jump rope; the emphasis is on the motion of jumping up and down. Purpose: strengthen the shin muscles.
- Run/Walk Progression to Hills
- Stretching: 1 minute per side.
- Gastrocnemius: Standing with one foot back, place your toes on a half roll or rolled up towel to increase stretch. Lean forward while keeping your knee straight.
- Soleus: Next, holding a split stance, bend your knee and get a lower stretch. Purpose: improve calf mobility to decrease strain on the tibialis anterior.
- Foot/Arch (3 Parts): Keeping your feet and knees together, sit on your knees with an emphasis on the balls and toes of your feet, and place your weight back onto your heels. You should feel your arches stretching. Next, settle your weight on the knuckles of your toes, which should stretch the top of your feet. If painful, shift some of your upper body weight off the heel. Finally, plantar flex your foot so as to rest your weight on the front of the ankle, thereby stretching your shin muscles.
TO GRADUATE FROM PHASE 4
Pain is minimal and manageable, allowing you to continue your running progression while implementing exercises from previous phases as needed or desired to maintain form.
Principles of Shin Splints: A Review
- CAUSE – overloading the muscle attachment to the bone of the shin (tibia), generally rooted in muscle weakness from either the soleus, tibialis anterior, and/or foot arch
- NEED – manage pain, such as by self-massage and/or icing, and strengthen mechanics
- PLAN – once pain is reduced, progressively load and strengthen the tissue
Need help with a running plan?
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.