Plantar Fasciitis and Achilles Tendonitis Messing Up Your Day?

We hear quite frequently new clients come to us with complaints of excruciating lower leg pain which often follows with a self diagnosis of plantar fasciitis or Achilles tendinitis.

The reported pain is usually worse in the morning, often causing severe pain just walking to the bathroom or simply walking down a flight of stairs.

It is important to note that we never diagnose a client with an injury, but we do however listen to the client, test the clients functional range of motion and strength, and give feedback as to strategies that would help to address deficiencies in their specific range of motion and strength.

About 80 percent of the time we are able to help address these clients issues within a few weeks of them starting with us.  Most report being relatively pain free after 6 months of disciplined, consistent training.

Extreme or unresolved cases result in us referring out to medical professionals to help diagnose the specific injury.

For those of you suffering through similar issues, and who want to be proactive about addressing your issues, keep reading to find some key concepts and specific exercises we typically use to help address our clients foot and ankle related issues.

As you might imagine, typically we find that these nagging painful lower leg issues such as Achilles tendinitis and plantar fasciitis, arise as a result of weak and tight lower legs. 

Often times, due to our modern lifestyles that include wearing footwear most of our waking hours, and sitting much more than is optimal for us, we see extreme limited range of motion in important joints (such as the ankle).

The ankle dorsiflexion test is our go-to tool for assessing ankle dorsiflexion mobility because it doesn’t require any tools or training, can be quickly performed, and is very reliable.

In addition to addressing the weak and tight areas, and incorporating targeted strength and flexibility exercises, the importance of a well-structured rehabilitation program for plantar fasciitis and Achilles tendinitis involves a multi-faceted approach that includes increasing blood flow, followed by strengthening exercises and stretching. 

Blood Flow Stimulation

When discussing the ankle and foot it cannot be overstated that relative to the rest of the body, this area (along with the wrist and hands) has many more bones packed into a small area.  

Where there are many bones there are many joints, and where there are many joints there are the accompanying connective tissues that help connect these bones to other bones and muscles.

It is this connective tissue (specifically the tendons that attach your muscles to bones) that tends to be a “problem child”.  Our connective tissues have a much poorer blood supply than our muscles, and thus keeping them healthy tends to be an issue.  A much more larger issue however, is the fact that when we injure our connective tissues, the healing rate is much slower (it has been estimated that connective tissue heals at ⅛ to 1/10 the rate of your muscle tissue).

So what does all of this mean?  It means that the first stages of healing everyday need to be focused on getting the blood pumping down in your feet and lower leg.

This can be accomplished as simply as slowly and gradually performing 20-50 Calf Raises. When performed pain free and with blood flow and restoration as the emphasis, this can help get some blood and valuable nutrients pumped into the lower leg which can help alleviate any specific pain as well as helping to promote healing.

Promoting blood flow into the feet, ankles, and calves can help jump start the healing process.

Following this up with a quick set of 20-50 Tibialis Raises will continue the healing and restoration process.

We find that the front shin muscles are almost never directly trained. Start giving these muscles some love!

Once you have gotten the blood moving and you are out of pain, continuing on for another 2-3 cycles would be ideal, but this is not always an option given our current lifestyles.

If you do have the time, once adequate bloodflow is achieved, working the same movements but focusing on strengthening as well as lengthening the muscles above and below the ankle is a great way to starting the rehabilitative process.

Once a proper strengthening and stretching session is underway, we can then start to focus on doing some specific stretching exercises to really address some serious mobility limitations.

These static stretches, including the wall calf stretch and seated calf stretch, aiming to improve flexibility and reduce muscle tension. 

The key takeaway with the sequencing of these exercises is that stretching becomes much more effective after blood flow has been increased and muscles are adequately warmed up.

Tight calves often lead to tighter hamstrings and disrupt the natural function of our legs and back.

The Importance of the Sequence:

The suggested sequence of increasing blood flow first, followed by strengthening exercises, and concluding with stretching is rooted in sound rehabilitation principles. 

Dynamic warm-up exercises stimulate blood flow, preparing the muscles for the subsequent stress of strengthening exercises. 

Strengthening exercises then target muscle imbalances, weakness, and instability, providing a foundation for improved function.

After the muscles have been engaged and strengthened, static stretching becomes more effective. 

Stretching tight muscles post-strengthening helps enhance flexibility, reduce muscle tightness, and improve overall joint range of motion. 

This sequence aims to optimize the benefits of each component, creating a well-rounded rehabilitation program.

Sometimes, in addition to specific exercises to help promote bloodflow, we encourage our clients to perform a little “self massage”.

You can start with soft foam roller and slowly progress to harder/denser objects while using your own body weight to adjust the pressure on your foot, calf, shin, etc.

The Calf Smash can help “unglue” some of the sticky tissues around the calf.
After plenty of exposure to the Calf Smash using a foam roller or lacrosse ball, the Bonesaw can help provide more stimulus on the calves to help loosen up and “unglue” stubborn structures in the lower leg.

In summary, incorporating blood flow stimulation, strengthening exercises, and stretching into a prehab and/or rehab routine for plantar fasciitis and Achilles tendinitis offers a comprehensive approach. 

These videos provide practical demonstrations of exercises aligned with this sequence, offering you a structured and effective strategy for recovery. 

It’s important to remember that this a general summary for what has been effective for many of our clients, but is in no way a specific prescription for you. 

We have found that working towards greater mobility and strength in the muscles and connective tissues surrounding the ankle, the healthier the feet become, and thus the nagging issues such as Achilles tendinitis and planar fasciitis tend t go away.

Take these slow, be patient, and prioritize pain-free range of motion over loading at the initial stages of training.