Some questions and answers just beg to reach out!
“Hello, I’ve been struggling with [Plantar Fasciitis] in both feet for at least 6 years, have done foot and calf massages, cortisone, tennis balls, laser, tens unit and have a Chiro running a vibrating ball over the bottom of my feet right now. I’m so tired of not being able to walk long walks.
So I’ve also found a website King brand BFST that swears they have a cold compress item to take the swelling down and then they have a hot wrap to apply heat to the PF. They have all good reviews and relief from people that have tried this.
They don’t recommend stretching. In fact, they have posted 10 PF “myths”. I’m so confused. What do you think of the cold/hot method?….Thank you for your advice…”
And here is my response….
Hi Pearl (name changed to protect the innocent),
You are a poster child for the plantar fasciitis herd mentality. If you have not read on my site at all, please do.
The total message for this the problem is that it is not your foot, it is your calf.
The reason you have had plantar fasciitis for 6 years is that you have never treated it. Really!
You are confused because of the strong message all these mostly clueless medicals and non-medicals are feeding us. Just think for a second about cause and effect. The cause is often not obvious or what you think.
In your case, as in the great majority of those out there suffering, looking past the obvious heel pain location is basically impossible. And I get that, but that is what guys like me are here for: to give the right direction.
Just look at the star Mets outfielder Yoenis Cespedes.
Even the pros have it wrong. This guy has been plagued with foot issues for a long time, and I can guarantee you they are related to one thing: equinus or calves too tight. And they have not focused on addressing the calf one bit. Now they are talking about a very unnecessary potential surgery in my opinion of course.
It is getting harder for me to believe how so many can be so vehemently far off track. The scientific evidence of the calf being the source of the problem and that calf stretching totally works almost always is there for all to see.
Here is my suggestion.
Do something different, something that seems so counter-intuitive and stretch your calves. Look away from the obvious, your heel, and treat the problem, your calf.
There is a 95% chance you will be done, but be patient. “Undoing” tight calves will take time because they took years to get that way.
Break from the herd, Pearl!
I get comments all the time how calf stretching has changed your world…but these comments are hidden in the blog comments section, where few will benefit from seeing.
Get out there on social media and spread the word about stretching and where you heard it!
Stay healthy my friends,
AO
Hi AO!
Thank you for your hompage and your knowledge! This stretch-metod saved me from 4 years of heel pain. In just 2 weeks the pain was gone… 2 weeks later i could run 5k
I met one doctor this summer that indicate my tight calfes… then i googled this page.
I´ve tried everything – 2 pairs of orthotics, 3 doctors, 4 fysioterapeuts, massage, strech (wrong type), 2 periods of shockwave, heel raises, and so on…
Now i can go back to running and jumping activities!
Just a few questions:
-How du look at heel raises? Is it a good way to do both calfes-workout and the calf-streches due to heelpain?
-If I do a running session, is it better to do the strech after, or before workout (the same day)?
-Is it “worthless” to do other types of strech (specelly calfes) after workout, or is it a good complement to the 3x3min strech?
-If my feets feels better, can i do a shorter stretch instead, for example 2x2min?
I will try to spread the stretch-message to as many as possible =)
Sorry for bad writing/english…
Regards Johan, Sweden
Hey Johan,
You know what makes me angry about your comment? You can write “bad English” and I understand every word. Yet, my friend, I can utter about six words in another language other than English. Shame on me. Okay, I am calming down after being angry at myself.
I am so glad to hear your response to the stretching, but I am not surprised. In fact far from it. It is truly amazing and is beyond me why calf stretching at a definitive treatment is more or less summarily dismissed by so many. Oh, well at least one person gets it. Now for those answers.
1. Heel raises: you are basically referring to eccentric calf stretches I think. There is nothing special about eccentric calf stretches except they stretch calves. I will say if one has only time or patience to do just one thing, stretch calves. If one was to take the time and do two exercises, then heel raise (calf resistance exercises) is definitely number two.
2. Stretching and relationship to exercise/running. The calf stretches I recommend static and have gotten a bad rap much from work out of Scandinavia. No doubt the evidence shows that static stretching reduces ballistic power by 4-8% for 45-60 minutes after the stretch is completed. So, the quick answer is stretch anytime than an hour before you run. I think a better way is to stretch the same time every day if possible for consistency of habit. That way one lives minute to minute with the normal musculotendinous we were god given. Then when one goes out to beat the world in a run, or soccer, or any athletic activity, they walk onto the track or pitch ready to play. I will say that “dynamic” stretching is the biggest bunch of contrived bull ever conceived.
3. Johan, you were on a roll and then you got me a bit riled up buddy. The beauty of this method is simplicity. Just one thing does so much and it generally works best if it is actually done. The problem is if we give too many things to do most of us resort to doing nothing. Human nature says that most people can only do one thing if that much, including yours truly. Of course, I welcome any and all stretching of resistance training of the calves and any other muscles you can fit in there but do not forget the simple 3×3 method.
4. Johan, you are back on track. For years I had my patients do 3 x 3 until one-month past resolution of their problem, then do just what you suggested, maintenance of 2 x 2 indefinitely. It seemed to work. I say go with 3 x 3 for another 6-8 weeks then go to 2 x 2. If symptoms of any kind creep back in just go back to 3 x 3. Here is the truth- the majority of people just quit because the pain is gone, as is the reason or stimulus to stretch. I had a hard time understanding this until I read extensively of forming habits, then I understood. So, here is my best advice learned from my patients who taught me so much. Try to continue to stretch daily, 3 x 3 or 2 x 2, if possible. Then one day when a random foot or ankle pain creeps back into the picture just start stretching again. Pretty simple, huh?
Jag älskar mina AO-följare där ute. Tack så mycket. Och tack Google översätt.
Håll dig frisk mina vänner,
AO
Thank you AO!
I´ve got some more questions, thanks to you good answers. =)
– How do you look at different types of shoes according to tight calves?
– Do you see as a good option with “barefoot shoes” to restore the calves, or do you prefare cushioned shoes? (especsially on hard surfaces) Orthothics?
– How about shoe drop, is it a good option to use some heel-rise in shoes when running, or is it better with 0-drop due to tight calves?
– To use toe separators like correct toes? Is it a good way for good foot health?
https://www.correcttoes.com/foot-help/articles-studies/
Dr Ray Mccl. desribes some theories around foot problems here.
By myself, i have a low arch, wide feet. I´ll try to change between diffrent types of shoes, also barefoot shoes….
Good swedish!
Regards Johan
Hi Johan,
Here are the answers my friend. I do hope to meet up with you in the future when I am in Stockholm getting my prize.
How do you look at different types of shoes according to tight calves? Shoes are simple and this answers all questions:
1. You generally get what you pay for.
2. If the shoe fits wear it. And the wearer is the only and final judge no matter what the fitter says. Common sense.
3. As far as stability, cushion, flexible sole, arch, no arch, etc., it is all about personal preference. There is so much marketing that gets in our ear. As an aside I have been a Nike consultant for years and I know what moves their needle. Ignore it and do what is right for you and this includes heel drop or Earth Shoes. BTW, these shoes are not a substitute for calf stretching. Orthotics no doubt help many, but not as much as we are lead to believe.
Finally, if one was to say pick the one type shoe that would cast the biggest net it would the lower/flat heeled, zero arch/flat insole, wider toe box shoe. Actually, barefoot ain’t bad, but too much concrete these days. All the rest of the shoe add-ons is just fluff and marketing. Of course, all of these gimmicky things, including correct toe/separators are helpful to someone, but still marketing based doodads.
Just think about it, and Johan you and I are old enough to know this; there ain’t nothing like a good pair of genuine all leather shoes. No gimmicks, just rawhide brother. In fact, I remember my first pair of bona fide running shoes in high school, the Adidas Italia. EVA sole and all leather Kangaroo upper. Okay PETA, I am not advocating leather, I am just reminiscing.
Stay healthy my friends,
AO
Ok, I started doing this a few days ago for my PF and I really think it’s already working. However, I’m already pretty flexible and if I just hang off a step as you describe I don’t really feel a stretch–I have to bend over and lean on the stair. Is this okay? Is it too intense? (I also feel it then in my hamstrings, which is nice, and my ankles/feet, which I’m ambivalent about.) Is the fact that I don’t feel a stretch doing it the “normal” way mean that my calves aren’t really the problem? Thanks.
Lin,
Extension on the last reply and late. Apologies. The addition of hamstrings is a great thing to do and not too much, except maybe for those who are really tight. The hamstring addition does one important thing, it forces additional knee extension creating more stretch to the gastrocnemius as well as does double duty stretching the hamstrings. So, to answer the dilemma as to your questioning the role of equinus as the possible source of your problem, you tell me. Do your own little experiment with a single variable, calf stretch. I know the answer, I just want you to see that for yourself. Best of luck and please let us know how it goes for you.
Stay healthy my friends,
AO
Your stretching advice has saved my life. I had so much foot pain and so many treatments and won’t bore you with all that. I got so much better, I had to have my orthotics reshaped a little.
In some of the comments I read people don’t have steps. Since I moved recently, I don’t either. I bought a $9 folding stool from Walmart to continue my stretches.
My husband has neuromas and a bunion. He did the stretches for about a year with me, he says the stretches cause severe *calf* pain, he cut down to 2 a day, 1, now none.
What could he do differently?
Thanks so very much.
Hi Nancy,
Bravo on all counts for you. I must say I am not sure what to say about your husband. He could do them and now has difficulty. You might have someone have a look at him. Does not sound serious mind you, but may be best to get it seen.
Stay healthy my friends,
AO
I have had PF for 6-8 mos. now, stopped running entirely a few months ago, have been trying stretches and strengthening exercises and night brace for 6 weeks. My calves are pretty flexible and to feel any stretch standing off a step I have to bend over and achieve some pretty acute dorsiflexion, and then my foot and heel are stretched to the point where it becomes painful. I know PF stretching is recommended, but should it hurt? If my calves are not tight, are they still definitely the problem?
Dear Angry Orthopod,
In addition to neuromas, I now have also developed a burning pain in my heel for about 6 months. The burning pain is much worse at night and during resting, but also after long walking. There is pain when I tap my tarsal tunnel (albeit a light pain, but it is present.) The pain shoots up my calf, too. I have a constant burning in both of my feet. I have seen 5 doctors who do not know what is wrong with me, or tell me something like ‘Ice your foot and use some paracetamol.’ Sometimes I move my foot wrong and a sharp shooting pain comes into my foot, which is unbearable.
Is it possible to have TTS in BOTH feet, but with a negative EMG? My EMG showed normal nerve conduction and velocity.
I am at my wit’s end here and this is giving me thoughts that I cannot cope with it anymore. Especially when I hear stuff like to take paracetamol for neuropathic pain, it makes me cry after the doctor’s visit because of frustration.
Do you have any clue as to what this could be? My plantar fascia on the left side is doubly as thick as it should be.
Could this burning pain be really bad PF? Are the doctors right that I am better off taking paracetamol for this? Because I took it many times and it didn’t help my pain.
Thanks so much,
Anna Smith
Anna,
This is a lot to process. I am going to give you some tough love and it is not critical in any way. I know you feel lost and your docs don’t sound supportive. Now for the tough love part. You sound like my patients who go away and don’t do the calf stretching, but somehow feel they have, only to come back and tell me they have done it. Everything is failing, right. Because I know how powerful calf stretching is all I can say is set yourself a MISSION and start calf stretching everyday. As simple and as weak as calf stretching may sound, in the words of Nike, “Just DO It”, it works!
Stay healthy my friends,
AO
Hi AO,
You’ve helped me before, showing me how regular calf stretching can seemingly take all my MN pain away. But a hurdle: I recently moved from a two-story house to a smaller one-level apartment (job relocation). With no staircase inside or out, I realized I’ve stopped stretching regularly. Will one of those commercial calf rocker stretchers work? Any suggestion for someone with no stairs and minimal space for another gadget? Thanks!
Hi Jennifer,
I am going to recommend building a stairway to no where. Okay, not such a good suggestion I guess. Seriously, the “rocker” you refer to is the ProStretch and various imitations do stretch the calf, but there is far better. Not to mention the ProStretch is sort of wonky to balance on and a bit unsafe. I have recommended the One Stretch here before. Maybe the One Stretch does not look all that cool, but it gives the best and easiest stretch I know. So, you ask, the AO delivers. While the One Stretch is better than stairs, it is a bit more expensive unless you have no steps.
Stay healthy my friends,
AO
I love your blogs. I have learned a lot about calf stretching and it’s importance. I try and do about 9mins a day. I use a stretch board. I find that after 9 minutes, the soles of my feet get sore. I take it they are being stretched? My MAJOR problem is pain, feels like nerve pain, in my second toe – no other toes affected. I feel that if the pressure was taken off this tie, this would help me greatly. Health Service Podiatrist (I live in N Ireland) told me my arches were quite flat, hips are okay but calves are very tight. She advised me to do toe raises – with one foot off the ground while I am doing them as well as stretch the calves. She made me half orthotics and cut out an area to take pressure of my toe. It helps a bit. I also wear silicone toe separators – they definitely help. But, the pain has not gone away. I just try and manage it. I believe in the stretching. I definitely do – just would love to get rid of this pain – especially when running. I am 54, femalw, wore high heels for years.
HI Mary,
My apologies for being so tardy. I am angry at myself. Just to get to the point, slant boards are not that effective and the load is on the metatarsal heads or ball of the foot. It seems you are doing the right things except for the slant board.
Stay healthy my friends,
AO
Hi AO
I am struggling after 4 years of no relief from plantar fasciitis pain in one foot despite trying all of the usual recommended treatments. I discovered your blog yesterday and started the stretching for 9 mins. I know I will stick to it as I am desperate and have no other avenues left to try. I have done daily calf stretching for a long time but not for the length of time recommended by you. At the moment my pain is so bad I hobble around, only walking when I absolutely have to, have had to delegate many normal household tasks like grocery shopping ( for our family of 6), because of the walking involved. Even saying goodnight to our children, as their bedrooms are downstairs and I can’t walk down at the end of the day! I love my teaching job but again it is challenging. Of course walking for exercise and pleasure was abandoned years ago. Very sad. Could I ask what is your opinion of strapping the foot? My podiatrist has showed me how to strap my foot and I find it gives some relief for a couple of days. Thank you for all of your in depth explanations in your blogs – I’ve found them very helpful.
Hi Allison, So sorry for the late rely, but work got in the way.
OK, you got it bad and I am seriously angry. Wouldn’t be so cool if the stretching actually worked. Here’s the thing. I know it will if you stay patient.
Then I want you to get angry because something so stupid simple was the solution all along. I have seen this play out all too often, routinely actually.
Of course, there are a lot of things that can be done in the meantime, but as I keep saying they are only palliative. Definitely strap, especially if it helps and now you know how.
Please check back in.
Stay healthy my friends,
AO
Dear Angry, I hope you’re still on line (and mad) and can offer some insight about side effects of the intra-articular cortisone injection. I see you have suggested an injection can help if the core calf stretching is done. There is quite a bit of information in the med lit that would suggest that the steroid crystals can lead weakening the plantar plate and result in dislocation. Do you agree and if so, how would you determine if an injection is worth the risk?
BTW, i had a partially torn Achilles tendon repaired about 2.5 years ago and every since have been dealing with diffuse swelling directly under the 2nd metatarsal even after trying a metatarsal raise and meloxicam – I will start my 3×3 calf stretching today (Grrrrrrrrrrr)
Hi Dan,
Indeed I am angry, just asking gets me fired up. FIRST, STRETCH. Be patient and you will get to the root cause, equinus. Please read my post carefully. The whole crystal thing is just plain old old BS my friend and not supported by evidence. Frankly it is nothing more than an excuse for those who don’t understand the critical role of calf stretching. That includes much greater than 95% of my colleagues BTW.
In my experience, the intraaerticular cortisone not only makes you feel much better, fantastic actually, it temporarily eliminates the cause of the plantar plate tear and ultimately the hammertoe and even a MTP dislocation, THE JOINT SWELLING. I have treated hundreds of patients successfully using stretching (on you everyone), periodic cortisone injections, cushy shoes and staying away from things that flare it up like barefoot on hard floors or activities that provoke it.
My own wife had it on both sides. One started and the other followed maybe a month later and of course we caught hers early. Being my lovely bride, she faithfully stretched and I had to inject one side 3 times and the other 4 months, each about 4-6 weeks apart. As soon as she said it was ‘coming back’ I injected her fairly quickly before it got too flared up. It took about 3-4 months for each side to resolve. She said the relief from that point was sort of iffy and she felt if she did too much like running or other aggressive activities it might get going again. But, it didn’t and about 2-3 months later (6-7 months in) she came in the room one day and said, “It’s gone” and that was it. She continues to stretch today. This is pretty much the experience that my patients talked of over the years. Finally, the hammertoe is a function of how long and how much swelling one has had and how early things are addressed, nit to mention not stretching. Here is the thing, you can be injected ‘forever’, but it won’t stop until the cause, equines, is corrected.
I ask myself everyday, “Am I the only one who gets this?, and I think the answer still is basically yes, except for my wife and the many patients who have seen the success. Spread the word of the AO nation.
Stay healthy my friends,
AO