Stubborn heel pain: Treatment of plantar fasciitis using high-load strength training

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Figure 1.
Calcaneal enthesis, typical site of injury in plantar fasciitis
AT—Achilles tendon, Ca—calcaneal enthesis, Mt—metatarsus, PF—plantar fascia, Ph—phalanges, Ta—talus.
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Figure 2.
Loading of the Achilles tendon in conjunction with dorsal flexion of the metatarsophalangeal joints (windlass mechanism) can be used to synergistically cause high-load tensile forces across the plantar fascia
AT—Achilles tendon, Ca—calcaneal enthesis, Mt—metatarsus, PF—plantar fascia, Ph—phalanges, Ta—talus.
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Figure 3.
Muscle-strengthening program to treat plantar fasciitis: Patient instructions.
RM—repetition maximum.
^*Remember that it will hurt to do the exercises. “Good pain” occurs when it hurts to do the exercise but the next day the pain is not worse. “Bad pain” is pain that increases the day after treatment. If you experience “bad pain,” you might have to cut back on the number of repetitions or the amount of weight used.
^†Use the progress sheet as a resource to record your heel-raise exercises.
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Figure 4.
Unilateral heel raises with a rolled-up T-shirt