Plantar fasciitis not getting better despite stretching and strengthening? The problem might not be the exercises, but when you’re doing them. Learn why timing matters and how we approach persistent plantar fasciitis at Body Zest in Banstead.
Why Isn’t My Plantar Fasciitis Getting Better?
If you’ve been stretching your foot, doing heel raises and trying strengthening exercises but your plantar fasciitis keeps flaring up, you might assume you simply need to work harder at your rehabilitation.
But sometimes the problem isn’t what you’re doing.
It’s when you’re doing it.
Strengthening can be an important part of recovering from plantar fasciitis. But if your heel is already painful and irritated, jumping straight into loading exercises can sometimes aggravate your symptoms.
At Body Zest in Banstead, we often approach plantar fasciitis in stages. Rather than throwing strengthening exercises at an already painful foot, we first look at what may be keeping the area irritated before gradually building its capacity back up.
What is plantar fasciitis?
Plantar fasciitis is one of the most common causes of pain underneath the heel and foot.
The plantar fascia is a strong band of connective tissue running along the bottom of the foot from the heel towards the toes. It plays an important role in supporting the foot and managing load when you stand, walk and run.
When the plantar fascia becomes painful, people commonly notice:
- Pain underneath or around the heel
- Pain during the first few steps in the morning
- Discomfort after sitting for a long time
- Pain that increases with prolonged walking or standing
- Symptoms that settle and then repeatedly flare up again
And that last point is particularly important.
The plantar fasciitis strengthening problem
If you search online for plantar fasciitis exercises, you’ll quickly find strengthening exercises.
And that’s not necessarily bad advice.
Building the strength and capacity of the foot and lower leg can be an important part of longer-term rehabilitation.
But there’s an important piece of context that often gets missed:
The right exercise at the wrong stage can still be the wrong exercise.
Imagine someone whose heel is already very painful. Walking around during a normal day is enough to aggravate it.
If we immediately add more and more load through strengthening exercises, their symptoms may flare further.
The patient then understandably thinks:
“These exercises are making my plantar fasciitis worse.”
So they stop.
This is why we prefer to think about progressive rehabilitation rather than simply giving everyone with plantar fasciitis the same list of strengthening exercises.
Stage 1: Calm things down
When someone comes into Body Zest with particularly irritable plantar fasciitis, our immediate priority isn’t necessarily making their foot stronger.
First, we want to understand why it keeps getting irritated.
That means looking beyond just the painful spot underneath the heel.
One thing we commonly find in people presenting with plantar fasciitis is significant tension through the calf and Achilles region.
The calf, Achilles tendon and structures underneath the foot don’t operate independently of one another. How the whole lower leg is moving and managing load can influence what is happening at the foot.
Depending on the individual, treatment during this stage might therefore involve hands-on treatment, advice around activity and footwear, mobility work and appropriate stretching.
For suitable patients, we may also use shockwave therapy.
Can shockwave therapy help plantar fasciitis?
Shockwave therapy is one of the treatment options we use at Body Zest for persistent plantar fasciitis.
It uses acoustic waves applied to the affected area and is commonly used for persistent tendon and soft-tissue problems.
But shockwave isn’t something we view as a magic fix.
We usually combine it with addressing other factors that may be contributing to the problem and then progressively reintroducing movement and load.
The objective is to create an environment where the patient can start doing more again without continually triggering significant flare-ups.
Stage 2: Get the foot moving again
Once symptoms are becoming more manageable, we can begin increasing movement.
This might include mobility exercises and stretching through the calf and lower leg.
There’s an important distinction here too.
Someone who has already spent months randomly stretching their calf without improvement doesn’t necessarily need to be told to simply stretch more.
We want to understand what is restricted, what aggravates their symptoms and what their foot currently tolerates.
Rehabilitation should progress with the patient rather than being a static sheet of exercises they’re expected to repeat indefinitely.
Stage 3: Start building strength
This is where strengthening becomes particularly important.
Once someone is tolerating movement better and their symptoms are heading in the right direction, we can gradually increase the load going through the foot.
That doesn’t mean immediately jumping into difficult single-leg exercises.
We might start with something as simple as:
Towel scrunches: Using the toes to gently pull a towel towards you can provide an accessible introduction to loading the muscles of the foot.
Two-legged heel raises: Raising both heels off the floor allows us to begin loading the calf and foot while controlling how much demand we’re placing on the painful side.
From there, exercises can gradually become more challenging as the person’s tolerance improves.
The principle is simple:
Calm it down. Get it moving. Build it back up.
Avoid the flare-up cycle
One of the biggest mistakes we see with persistent plantar fasciitis is repeatedly bouncing between doing too much and doing nothing.
Your foot feels slightly better.
So you walk further, return to running or dramatically increase your exercises.
It flares up.
You stop everything.
It settles.
You try again.
And the cycle repeats.
A better approach is to find a level of activity your foot currently tolerates and progress from there.
Some discomfort during rehabilitation doesn’t automatically mean you’re causing damage, but significant or persistent increases in symptoms can be a sign that the current load needs adjusting.
What else should be considered?
Exercises are only one part of the picture.
When we’re assessing someone with persistent heel pain at Body Zest, we may also consider things such as:
- Their normal activity levels
- Recent changes in walking or running
- Footwear
- Calf and ankle mobility
- Strength and capacity
- How long they’ve had the problem
- What they’ve already tried
- Which activities repeatedly aggravate their symptoms
That’s why two people who both say they have plantar fasciitis may not necessarily receive exactly the same treatment plan.
Plantar fasciitis treatment in Banstead, Surrey
If you’ve been dealing with plantar fasciitis for weeks or months and feel like you’ve already tried stretching and exercises without getting anywhere, simply adding more exercises may not be the answer.
The question is why your foot isn’t currently tolerating the load you’re putting through it.
At Body Zest in Banstead, Surrey, we work with people suffering from persistent plantar fasciitis and heel pain using a combination of assessment, hands-on treatment, rehabilitation and, where appropriate, shockwave therapy.
The aim is to help settle the problem, restore movement and then progressively build the foot back up so you can return to the activities that matter to you.
Struggling with plantar fasciitis? Contact Body Zest to arrange an appointment or find out whether our approach could be suitable for you.