How should stretching exercises for plantar fasciitis be performed?

How to Perform Stretching Exercises for Plantar Fasciitis

For plantar fasciitis, perform plantar fascia-specific stretches as the primary intervention, holding each stretch for 10-30 seconds and repeating 2-4 times per session, performed 2-3 days per week, ideally after warming up or at cooldown. 1

Specific Stretching Technique

Plantar Fascia-Specific Stretching

• Perform plantar fascia-specific stretches as weight-bearing exercises against a wall, which have shown superior pain reduction compared to calf stretching alone 1, 2
• Hold each stretch to the point of tightness (not pain) for 10-30 seconds 3
• Repeat each stretch 2-4 times per stretching session 3
• Perform stretching exercises 2-3 days per week on non-consecutive days 3

Calf Muscle Stretching (Gastrocnemius-Soleus)

• Incorporate regular calf-muscle stretching exercises alongside plantar fascia-specific stretches for optimal outcomes 1
• Maintain correct lower limb alignment during calf stretching to avoid strain on the plantar fascia 4
• Gastrocnemius tightness is associated with ankle dorsiflexion stiffness and plantar fascia injury, making this stretch essential 5

Timing and Frequency

When to Stretch

• Perform stretches after aerobic activity or during cooldown when muscles are warm 3
• For older adults (60-69 years), stretch ≥20 seconds per muscle group ≥4 times per week 3
• Stretching can be preceded by a warm shower or application of superficial moist heat 3

Duration Guidelines

• Hold terminal stretch position for 10-30 seconds before slowly returning to resting length 3
• For general flexibility training, hold stretches for 15-30 seconds 3
• Breathe normally during each stretch and avoid breath-holding 3

Important Execution Details

Proper Technique

• Stretch to the point of tightness or tension, not pain 3
• Perform movements slowly and extend through the comfortable range of motion 3
• Relax before beginning stretching exercises 3
• For older adults (70-79 years), perform gentle stretches at least 8 times per direction, 3 days per week 3

Common Pitfalls to Avoid

• Do not walk barefoot during the treatment period, as activity modification is essential 1
• Modify stretching exercises to avoid pain or when the joint is inflamed by decreasing the extent of range of motion or duration 3
• Avoid overstretching beyond the point of tightness, which can cause injury 3

Treatment Algorithm

Initial Phase (First 6 Weeks)

• Start with plantar fascia-specific stretching combined with calf stretching 1, 2
• Add ice massage and NSAIDs for pain control 1, 6
• Perform stretches 2-3 days per week consistently 3

If No Improvement After 6 Weeks

• Add night splinting to the stretching regimen 1
• Consider referral to a podiatric specialist 1

Evidence Quality Note

• Moderate-quality evidence supports that plantar fascia-specific stretching is more effective than calf stretching alone for pain reduction 2
• Approximately 80-90% of plantar fasciitis cases resolve within 12 months with proper conservative treatment including stretching 6, 5