I know I consistently promote calf stretching to you all, like here, and here, and even here, but thanks to many of your questions, I realized I have never told you exactly how to do it right: my way.
True, it is a simple concept itself, but it’s not just “any old” calf stretching.
I am not talking about calf stretching before you run. I am not talking about calf stretching after you use the weights at the gym (or however you choose to exercise).
What I am talking about is calf stretching that is done right – everyday – and that is separate from exercise, especially before.
What you see described here is what is proven to be, over time, effective in changing the muscle-tendon units so that our muscles will eventually (patience, people!) return to their optimal (or “normal”) length. Yes, as you age many of your muscles get tighter, especially your calves. You know this because you just get stiffer, but it does not have to be that way.
So you say, “AO, of course I want results. So tell me how!”
…And that is what I have heard more and more lately. And, it is a fair request, which is why I’m sharing that now.
The Skinny on Stretching: The Stuff That Really Counts
Stretching the right way. It’s like something we tell our kids: “There’s no point in doing it if you aren’t going to do it right.” You can stretch off a step in order to get the kind of calf stretch you are really after – which is an isolated and passive stretch of the calf. The best kind!
So, wheat is the biggest, or the most common error I see in stretching?
Well, besides just not doing it or people ignoring me when I tell them to do it separate from any training or workout session, to start, take a look at where you are making contact with your foot. The foot should contact the step against the arch of your foot, not the ball. Believe it or not, the best stretch is obtained this way.
In the past, people have found success with an aerobics step, which works well since it is about 8 inches tall or so. It also has a rounded edge. Do a quick Google search if you need to see one.
If you perform the stretching on stairs, as many do, use the bottom stair and hold onto the railing for support. Athletic shoes with traction seem to work best.
Then slowly relax your ankles, and let your heels go downward. Learning this might take more effort and a little more time than you might think to get it just right. Remember the contact point on the step is your arch, not the balls of your feet. This point can not be over emphasized. Now you should be feeling a pulling (or a tightness) in your upper calf muscle – which is what we want. You should be feeling this stretch high in your calf, just below your knee.
Here’s what else to consider.
Length of time you do it…Every. Day.
Through years of tinkering and observation, I have determined that 9 minutes a day is the right number. It’s best to do it 3 minutes, 3 times per day. You can cluster your stretching like sets. In other words, do a 3 minute stretch, go away for a few minutes (brush your teeth, etc.), then do your next 3 minute stretch, go away for a bit, and then complete your final, 3 minutes, and you are done for the day. It’s easy, it’s done and you are on to the next thing. Less does not seem to work for people, and more is a waste.
How many weeks, or months should you stretch everyday. How long should you keep this up?
Are you going to stop after just a week or two? Again, by overall time span, what I mean is how many weeks or months are spent doing your stretching, each and every day. One of the biggest mistakes I see is that people either want an overnight change, or they “give up” when the pain goes away.
The one “downside” of calf stretching? It takes time. I’ll tell you again: you have to be consistent. Fortunately, but maybe not in your particular case, the problems we are solving are manageable, until the stretching finally does its job. Good things most often do not came fast. Be patient.
This will work, just be consistent and do it everyday. Moderate your stretching intensity to feel it high in your calf. Go easy for a week or so and break in slow.
Download this Guide to see the rest of this program, and share it with your friends and family…Unless you want them to be in pain? (Actually, for prevention purposes, this particular stretch would be good for everyone to do, with or without pain or foot problems.) You can call it the AO way, no kidding!
“So If We Do the Stretching The Right Way…When Do We Start to Get Relief?”
I see people take 2 weeks, to as much as 6 months for their calf stretching to “undo” the powerful, damaging effects that the isolated gastrocnemius contracture has exerted on their foot and ankle. Give it time and the results are most often stunning!
Where will you fall on the spectrum of 2 weeks to 6 months – that is, the time frame needed to resolve your tight calves? That’s one of many things I don’t know for sure! But, one thing I do know, if you don’t stretch you will never know now will you?
WARNING: As you start stretching you may experience pain in a different location or a slight increase in your pain. For instance, if you had plantar fasciitis in the past that is now resolved and you are calf stretching for second MTP synovitis you may experience a return of your plantar fasciitis. Instead of scaring you off, this experience should excite you. It means you are working on the root cause, and something positive is happening. And it should also convince you all this is connected and you are on your way to resolution the right way.
Stay healthy my friends,
Hello AO and thank you for your blog. I am working my way through my first experience with PF or what I’m assuming is PF. I had pain for about 5-6 months before I came across your blog. I have been on your stretching regimen for a little over three months. At first I felt great, so great that I started exercising in the morning before stretching and then stretching later in the day. Now, for the past few weeks, the pain is back. So, I have two questions:
1) By not stretching before exercise, did I undo the good I did from the previous stretching? Or could there be another reason the pain is back?
2) I can feel the stretch in my upper calves (mostly in the first three minutes), but I also feel some pain in my heel while stretching. Is that typical? Or am I overdoing it? Mostly the left foot, which is the primary source of pain.
I still know you are on the right track. One of the bad things about stretching is the time it takes to get the job done. And that can be months. I have definitely seen patients improve then move backwards temporarily while continuing to stretch. I do think you have done it correctly. Now for your answers:
#1 The pain is back for unknown reasons to me, but as I said given time you will break thru again. While you could stretch before exercise, maybe lighter/less time, but as you intimated stretching is best done away from exercise. I do not think your method has anything to do with the return.
#2 As long as the pain is mild and tolerable there is nothing wrong with feeling the pain in your heel. However, too aggressive stretching , while not damaging generally speaking, cold be a reason for your “relapse”. So, trying backing off tactic might be beneficial for the immediate time.
I hope this helps and apologies for the delayed response.
Stay healthy my friends,
Hi Angry—wondering if calf stretching will help with toe flexion. When on my toes in a push-up position, I have stiffness that is preventing them from flexing/curling to grip the ground. Since calf tightness causes so much to go haywire, I figured I would start there to rule out any issue. I do have tight calves (and ankles) and have started your protocol. I used to do it regularly and see the error in letting the habit lapse! Fingers crossed!
I’ve returned to the stretching protocol after lapsing, and it’s certainly helping some aches and stiffness that have accumulated during some pandemic inactivity. I have been having an issue with my toes flexing correctly and fully to grab the floor when in a push up position. Will calf stretching eventually help with that? Is the stiffness there caused by tight calf muscles too? Curious if I’m helping to correct this at the same time too. Thanks!
First of all I do think the calf stretching will likely take care of this. It has mostly in my patients. To be honest, I can’t give you a good answer as to what it is or any anatomic rational, but it does happen. As much as I don’t like plantar fascial stretching I would suggest you throw that in also just in case. But, don’t not stretch your calves. I wish you the best.
Stay healthy my friends,
I also wanted to heartily thank you. I was an active walker/hiker but after 2 months of hobbling around with sudden PF and trying “everything” which did not seem to help, I came upon this site. This stretch has been extremely helpful and I am finally encouraged with improvement. I sent back expensive sneakers I had ordered in desperation as part of the “everything”, not now needing them. I am sharing this information with family and friends who also suffer with PF. Thank you again, I am very grateful!
So glad you are doing well, but so expected, at least by me. So simple it is stupid. It always seems the simplest and most effective solution is summarily dismissed and that makes me angry.
Stay healthy my friends,
Hi AO, I’ve been doing the calf stretches for almost two months and I have a couple of questions. When I do the calf stretches, is my ankle supposed to be sore and tender? Is having weak ankles from previous injuries related to my plantar fasciitis? I’ve been dealing with plantar fasciitis for almost three years now and after I started doing the calf stretches for two weeks, I felt really good. However, I feel like my pain has gotten worse again even though I haven’t changed anything to my daily regimen. Is this to be expected? Thanks in advance!
Okay, that makes me angry, but what doesn’t. Great description of the issue. Typically ankles can hurt, although not often, early on as we “wake” things up, but this almost always resolves. You might modify the stretch to a more comfortable position or reduce intensity or backing off a bit and restart. Another explainable reason might be that you may be reaching the max or end point of your ankle dorsiflexion (upward motion) and compressing the front of the ankle together. This reason usually comes later. This would not happen in a normal ankle, but if you had previous injuries (week ankles) and have developed anterior ankle spur(s) (a normal response to previous injuries) that is quiescent you may be exposing things. You are not causing injury or damage, but no reason to endure that pain. I would say to modify, but keep trying to stretch.
BTW way weak ankles can only be related to plantar fasciitis in that weak ankle will modify ones activities and create additional calf contracture. My impression is that you will pass through this phase and get the job done.
Stay healthy my friends,
Hi AO, this might be a dumb question but… for this stretch to be effective (or comfortable), do I need to be wearing shoes? I go barefoot a lot and when I’m not I’m usually in minimalist shoes anyway. 😀
Also, is something like a slant board an okay substitute, or is the pressure on the arch part of the point of it? I don’t really have any stairs or blocks to stand on, unless I go out to the street and use the curb, but I’ll definitely buy an aerobic step if I need to.
2 yrs in on PF and I’ll see docs and tell them I’ve been reading about how the problem is actually the calf, and they’ll AGREE and then aim treatment at my feet still??? Or YouTube videos will talk about the calf being the issue and then not tell you at all how to address the calf. I feel like I’m taking crazy pills. 😀 Thanks very much for this specific advice, can’t wait to stretch the hell out of my painfully tight calves.
Dumb questions do make me angry, but this one is not dumb, so thanks for that.
You know, at the end of the day I don’t care how you stretch or what you are wearing when you do it as long as you do it long enough and feel it high in your calf.BTW, barefoot is fantastic, in fact if you think about it we were not born with shoes. Just sayin’. The method I have explained and recommend is the method that I have determined through years of trial and error in thousands of patients that works best for the most. Most importantly it is the easiest to do which creates compliance. Face it, if you don’t do it, it can’t work, right? Slant board, aerobic step, whatever, all have a chance to work, just find what works for you.
Finally, your last paragraph does and has always made me angry. For some inexplicable reason healthcare providers, etc., even my closest colleagues will do just what you describe. How is this to be interpreted? They don’t believe stretching works! And they don’t want it to work. Maybe this is why there is a current trend, if not craze, for surgically lengthening the calf. Why? I am about to start back up contributing blogs angrier than ever and this will be addressed.
Stay healthy my friends,
I’ve been dealing with plantar fasciitis for a month now. Calf stretching definitely makes sense to me. The only problem is that I have mobility and balance issues. Trying to stand on the edge of a step terrifies me. I’d probably fall and break my neck. Is there any kind of calf stretch I could do while sitting that might be almost as effective?
While uncommon, your situation is not unheard of and I agree it can be scary to stretch, especially on stairs unless you have good stability. There are many ways to stretch the calf, specifically the gastrocnemius. While the step is the best and easiest, in my angry opinion, other methods can get it done. The problem with other methods is that they require more concentrations to get relaxed to get deep into the stretch and a lot of attention to technique detail. It can be done, but is just a bit more tedious and slower as the intensity of the stretch will not be that of the step. However, you get it, which is 90% of the way there, so I think you will succeed. Just be patient and know that between intensity of the stretch versus duration of stretch, duration is the most important.
– sitting on a bed, floor or couch with one leg straight out (knee straight) you can use a belt, or yoga strap, or towel with it looping around your ball of foot and pull back like on a reigns of a horse. Switch and repeat 3 minutes per day on both sides. Amazon sells many stretch straps and this could be a resource for you.
– Stretch against the wall with one foot nearer to the wall, the non stretch leg, and the other farther way from the wall with knee straight, the leg to be stretched.
– While I don’t love slant boards, that can get it done. Just put near wall and face wall and hold on. Amazon has tons of them.
Make sure to concentrate on the stretch being higher in the calf, closer to the back of the knee, not lower. I wish you the best and a happy (un-angry) New Year.
Stay healthy my friends,
Maybe you talk about this elsewhere on the site and I just haven’t come across it yet, but wouldn’t this type of static stretching trigger the stretch reflex, sooner or later bringing the muscles back to their original length — or even shorter? And how would stretching in this way help the gamma loop to adapt? Thank you.
I have not discussed this before. Thanks for bringing up a subject I would like to talk about, so much so, I think I will do a blog post on it. Everything I will say is my opinion thru the lens of an orthopaedic surgeon with 32 years of experience, much of it focused on calf stretching.
To be perfectly honest, I know just enough about all the stretching methods, the neurologic component of muscles, and their control mechanisms to be dangerous. I don’t know your training, or experience, but it is safe to say you likely know more than me sizing up your question. So, this seriously begs the question, “If the AO is such a dunce regarding stretching, why is he out there promoting static stretching like a fool?” The short answer is because static stretching works. While there is plenty of published evidence that it does work, it is my heuristic experience that tells me that it most definitely works. Maybe my conviction is quixotic, but I don’t think so.
The long answer will be in a blog post. The medium answer I will cover here in simple terms, not that you need simple, but because I am simple and that it is the only adequate way I can explain and simple for the sake of other potential readers.
This is where I ask you to open your mind to entertain the possibility of a paradigm change regarding stretching. Static stretching is indeed resisted by the stretch reflex and gamma loop, but these, as you know and alluded to, can adapt and reset.
Fundamentally, there are only two structures to stretch, the muscle and the connective tissue. Of course, there are blood vessels, nerves, lymphatics, etc. but for the sake of discussion, let’s count them as negligible. When I think of stretching actual muscle, which indeed brings in the stretch reflex, gamma loop, etc., I think of stretching only for today. This is basically for pre-athletic performance stretching and I am in complete agreement that in this setting static stretching is more or less a waste of time. Alas, I am thoroughly uninterested in that endpoint. The endpoint I am interested in is getting the musculotendinous unit back to its “original” designed, god-given length. And I can assure you that our muscles, our connective tissue, actually shortens as we age.
So, what structure needs to be stretched? This is a subject discussed about infrequently as it is assumed it is only the muscle that needs to be stretched. After all, we do call it “stretching muscle”. However, my clinical-based focus, especially for those of us past our mid-twenties (or old like me, try it), is that we are stretching the intertwining connective/collagen tissue (endo, peri and ectomysium) that holds things together. This is what gets tight and, in the case of equinus, and ultimately causes all the havoc on the human foot and ankle. Another comparable example is tight hamstrings and low back pain. To make static stretching work, it takes time as far as each stretch sequence (my protocol is 3 min 3 times per day, every day if possible) and time in doing it for weeks and, in some cases months. The connective tissue took years to get this way, and the reset or realignment is a slow process.
Failure to have the required patience or knowledge, or conviction is precisely why static stretching fails. My patients, in excess of 10,000-maybe 20,000, I lost count, were educated and convinced, and as a result they succeeded greater than 95%, and that includes the folks that would never fess up to not actually stretching. This is opposed to the typical stretching 2-3 times per week, hold it for 30 seconds max, for 2 to 6 weeks- and that is pushing it. No wonder static stretching fails.
I hope this explanation sheds some light on your question.
Stay healthy, my friends,
I’m excited about finding your post. I’ve been struggling with PF for about a year and it really bums me out. Can I continue to walk/run what I can handle while I start the stretch program?
I came across a site called KingsBrand that promotes BFST wraps and other stuff. What are your thoughts on that?
Thank you for all you do! I’m starting on the stretches tomorrow.
I’m also excited. You can definitely remain active, even push it, and endure some pain while you get the stretching done (be patient) as long as you don’t see a progressive worsening of things. Daily activity related ups and downs are fine as long as you are not worse in a week or two or so. Then it may be time to back off, but this usually does not happen.
You just had to go and mention those other things like BFST. I’m angry now. No doubt this sort of stuff might assist your recovery, but they are aimed at the last domino to fall, not the finger that pushed the first domino, the root cause. Thus they will not “fix” it. Addressing the root cause is where the money is. So, do the BFST, or or any other acronym, but don’t not do CS (calf stretching).
Stay healthy, my friends,
Hi! I just came across your blog and love it! I have metatarsalgia and have started following your calf stretching recommendations. The pain started several years ago after a metatarsal fracture and has increasingly gotten worse. Is there anything else you recommend in conjunction with the calf stretching regimen? I have read about foot and toe strengthening exercises but I’m worried it may do more harm than good? Any advice?
Very interesting story, one I have heard numerous times. I will address your points and questions one at a time, but first I have a few questions myself:
1. What MT fractured? Was it a stress fracture or traumatic? Did it heal as is, meaning straight, not angulated? I ask because if it angulated the forces can shift to the MT next door, i.e., 2nd MT fractured and displaces upward and 3rd now takes load instead of second.
2. Historically, based on my observations if this was a stress fracture there is a 75% chance you had plantar fasciitis prior to the MT fracture. What say you?
No doubt stretching will help, if not solve things completely, but the answers to the questions will shed light on what you odds are of there degree of help you might receive.As far as additional things to do in while you stretch, I would guess you have tried much of the standard crapolla that is out there, such as orthotics, rollers, massage, to name a few. No doubt foot and ankle strengthening is good for you and not harmful, but they are basically a waste of time when it comes to the primary focus, addressing the root cause, equips or calves too tight. I would advise you to look read part 1 and 2 of Plantar plate repairs & the pre-dislocation syndrome: what the f$@%. In particular, look at the two videos. While you may not have second MTP synovitis., the forces and mechanism of action is identical. So, back to the strengthening, do it is you wish, just don’t not do the stretching.
To answer your second question, which not gonna lie angered me a bit (thanks). It sounds like you have second MTP synovitis and if this is the case, you will be running before you know it.
Stay healthy, my friends,