This week’s blog has a clinically useful exercise that I picked up at Greg Lehman’s Reconciling Biomechanics with Pain Science course. As discussed in my course review blog post earlier this week, a big piece of the rehab puzzle that can often be overlooked is progressive tissue loading. Some injuries do a decent job of this being included as a part of the rehab program. Achilles injuries have their various heel raise protocols, proximal hamstring tendinopathy has the nordic hamstring curl, tennis elbow has isometrics/eccentrics and so does the shoulder. However, one area that I often haven’t seen this type of tissue loading rehab strategy with is plantar fasciitis. Yes, recently there has been the research and circulating youtube video of the heel raise exercise with one’s toes loaded on a towel. The research and exercise are in theory great. I personally tried the exercise and didn’t necessarily feel the load. At least in comparison to the second exercise video posted at the bottom. Below is the toe elevated exercise.
In the exercise below, I am eccentrically loading the plantar fascia by letting my arch collapse followed by actively trying to squeeze my arch back into a supported position. All my body weight is on this leg and the back leg is in the air. If the back leg is supported as well there likely won’t be enough load to feel the exercise, though it could be used as a progression point if someone is quite painful. Considering this rotational torque is often the cause of PF, this exercise gives the added benefit of controlling the range and loads during the motion which will help with tissue tolerance during rehab along with other movement retraining exercises and a return to activity program. Give the exercise a shot and let me know your thoughts!