A potential cause of plantar heel pain is a loss of strength in the calf muscles and muscles in the foot, although there is a lack of evidence that a loss of strength is actually a risk factor for plantar heel pain. It is believed that weakness in either of these muscle groups may lead to an increase in strain on tissues of the foot.
The aim of strength based exercises is to improve the strength of muscles in the leg and foot to help reduce tension on the heel, although such exercises are not considered to be part of the ‘core’ approach to plantar heel pain.
We would recommend that you see a clinician (e.g. podiatrist or physiotherapist) who can assess your strength and determine if you require a series of exercises that you can perform yourself. Included below is a program of exercises that can be used for people with plantar heel pain.
There are many different calf strengthening programs that can be used, although the evidence suggests that there is not one program that is better than another. Included below is a reference to an article (Riel 2019) that evaluated two different strength programs for plantar heel pain.
Both programs were associated with a reduction in pain but neither program was superior to the other. In addition, only a small percentage of people who completed the program believed that no further treatment was required.
The simplest calf strengthening program includes:
- Number of repetitions: >8 and up to 12
- Additional load: hold as much weight as possible
- Number of sets: 4 to 5
- Rest between sets: 2 minutes
- Session frequency: every second day
- Duration of program: 12 weeks
- Recovery between sessions: at least 48 hours
The following video provides a demonstration of how to perform the exercise program.
This is a very safe treatment. When you first start strengthening, you may notice you have sore muscles after you start. This is normal, and if you rest for a day or two you should be able to continue with the exercises as recommended.
Currently, there is little evidence to suggest that strengthening is better or worse than other treatments.
Links to research
- Riel H, Jensen MB, Olesen JL, Vicenzino B, Rathleff MS. Self-dosed and pre-determined progressive heavy-slow resistance training have similar effects in people with plantar fasciopathy: a randomised trial. Journal of physiotherapy. 2019 Jun 13.
- Rathleff MS, Mølgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. High‐load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12‐month follow‐up. Scandinavian journal of medicine & science in sports. 2015;25(3):e292-300.
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