Q: My client has plantar fasciitis. Can you recommend some exercises to help?
A: Plantar fasciitis, more commonly known as heel spurs, is an inflammation on the underside of the foot, and is often quite painful. The irritation usually occurs on the plantar fascia attachment of the medial calcaneus, and is often seen in people with high arches and tight Achilles tendons or leg length discrepancies.
When someone has plantar fasciitis, more tension is placed on the plantar fascia in pronation, and it can rupture with forceful plantarflexion, as in descending stairs or during rapid acceleration. Pain can also come from calcaneal apoplysitis at the calcaneus, or calcification of the heel bone. Heel spurs are often caused by poor biomechanics, excessive pronation or supination and maximal ankle plantar flexion and simultaneous dorsiflexion of the metatarsal phalangeal joints.
Working with clients with heel spurs means the focus should be on correct biomechanics in the lower kinetic chain with low-load or non-weightbearing exercises until the client is able to accept more load.
Try these exercises from the STOTT PILATES® repertoire: Footwork on Jumpboard or Padded Footbar on the Reformer, Foot Press on Long Box with the Stability Chair™ when they are able to stand, or use the Rotational Diskboard on the Reformer for useful proprioceptive feedback to the lower kinetic chain.