by Dr. Emily Splichal, DPM MS
To stretch or not to stretch, that seems to be one of the biggest questions in physical medicine and rehab.
For anyone who has ever experienced plantar heel pain and gone to a podiatrist, most likely they were told to “stretch the calves”. But how effective is calf stretching in minimizing heel pain? And is there potentially a more effective way to reduce stress to the plantar fascia?
To answer this, let’s take a look at the calf anatomy.
The Calf : Plantar Fascia Connection
The calves or calf muscles are a group of strong muscles found in the lower leg which insert as the Achilles tendon into the heel bone of the foot. Like all tendons in the human body, there is a blending of the tendon fibers into the surrounding tissue, joint capsule and fascia.
In fact, this blending of the Achilles tendon into the foot is so extensive that many consider the Achilles tendon to be a part of the plantar fascia. This means that any tightness or restriction in the calves, Achilles tendon or ankle can increase stress to the plantar fascia and even cause plantar fasciitis.
This is the reason why calf stretching is often recommended to those diagnosed with plantar fasciitis.
The Plantar Fascia : Great Toe Connection
Recent research has suggested that perhaps calf stretching alone is not as effective as once thought and that recommending stretches that are specific to the plantar fascia will improve results.
So how does one stretch their plantar fascia?
For this we need to understand the anatomy of the plantar fascia.
The plantar fascia is a thick band of connective tissue on the bottom of the foot, originating at the heel and inserting into the base of each toe. Because the plantar fascia crosses the toe joints (also known as the MPJs), when you dorsiflex or extend the toes up, you put a stretch on the plantar fascia.
Simply pulling your toes up and holding for 30 – 60 seconds is a form of a plantar fascia stretch.
Combining Calf & Plantar Fascia Stretches
If we go back to the research, what was seen is that combining the well accepted calf stretch with a toe extended plantar fascia stretch is what provided the greatest benefit to those with plantar heel pain.
So how do you perform a calf and plantar fascia stretch? Below we share 3 variations of this stretch. Each stretch should be held for 30 – 60 seconds and repeated 5 times.
Lying Calf Stretch
Using a yoga strap or belt, pull the foot down to create a stretch in the back of the leg. To include the plantar fascia in the stretch, dorsiflex or extend the toes down towards the face.
Seated Calf Stretch
In a seated position with the legs directly in front of the body, use a yoga strap or belt to hook around the feet. Pull on the strap and gently lower the chest towards the leg, creating a stretch in the back of the leg. To include the plantar fascia in the stretch, dorsiflex or extend the toes down towards the face.
Standing Calf Stretch
Place the foot against the wall with the toes extending up the wall and the opposite leg behind you. Begin to bend the front knee towards the wall, creating a stretch in the bottom of the foot and calves.
If you have consistently performed the above stretch for several weeks and still experiencing persistent foot pain, then I recommend seeing your podiatrist for a more thorough evaluation.