Hip and leg exercises for Plantar Fasciitis: How they can help your heel pain
If you’re suffering from this often infuriatingly frustrating injury, you’ve probably read almost every blog post about it. You might also have tried most of the popular remedies out there, like stretching the plantar fascia. But you are still in pain.
What's the reason why you are still in pain?
Most plantar fasciitis treatment programs focus only on stretching and strengthening the calves and plantar fascia itself. Of course, this is important, but it’s only part of the picture.
An often-overlooked component to plantar fascia recovery is targeted hip and leg exercises that correct your body alignment and reduce the strain on the plantar fascia.
Let’s take a look at this in more detail.
Why should you do hip and leg exercises for plantar fasciitis?
There are two primary components of movement that help keep you injury-free:
What is your kinetic chain?
Think of your body as a series of interconnected and corresponding links formed by your muscles, tendons, and bones.
We call this your kinetic chain. It runs from your feet up through your legs, hips, spine, and, finally, your shoulders, neck, and head.
These links work together to manage forces in your body and create and support your movement.
What is body alignment?
Body alignment is how the parts of your body in your kinetic chain are ‘stacked’ or positioned relative to each other.
How do your kinetic chain and body alignment relate to injury?
When your body is well-aligned, forces can flow freely from one link to the next along the kinetic chain. As a result, movement happens effortlessly and without restriction.
However, if a link in your kinetic chain is not aligned well, it can lead to injury. Either due to a pooling of forces in that area, or redirecting forces into another area not designed to take repetitive loading. Both can result in tissue overload and strain.
Often, this is how plantar fasciitis develops.
The hip/plantar fasciitis link
What do your hips have to do with plantar fasciitis?
The muscles around your hips and pelvis control your hip alignment.
Suppose your hip muscles are weak, tight, or lacking control. In this instance, you will lose control of your hip alignment, and your leg may turn inward excessively.
With your leg rotated inwards, your foot follows and turns in (pronate) to adapt to this force, your arch flattens, and your plantar fascia pulls taut.
In this example, your hip’s poor alignment, disturbs the kinetic chain in your leg. This causes your leg to absorb less of the force. When forces eventually reach your foot, your plantar fascia takes on much more load than usual.
Now, this is okay as a one-off every so often because a healthy foot arch and plantar fascia have good rebound capabilities. However, plantar fasciitis is a genuine risk if this situation becomes your new normal.
So, how do you stop overloading your plantar fascia? One way is with targeted strengthening exercises of your legs and hips.
The best hip and leg exercises for plantar fasciitis
Goals of hip exercises
Keeping the hip/plantar fascia link in mind, your hip and leg exercises should:
- Improve your hip and leg alignment
- Increase the shock absorption capacity of your legs
- Teach better movement patterns while running
To help you achieve these goals, research has shown that you should do exercises that target your core muscles, gluteals, thigh muscles, hamstrings, and calves.
When your hips and legs are more robust, they take some of the load off your plantar fascia, which can help it heal and protect you from future injury.
The hip exercises you select should help you achieve the specific goals of each phase of rehab. Where you start will depend on the severity of your injury, how long you’ve had symptoms, and your baseline strength.
We designed the Exakt Health App to help you through every phase of your recovery. First, it starts you off with gentle exercises and assesses your progress. Then, it sets specific tests for you to pass and targets to reach before you can safely progress to the next stage of your rehab.
The early phase of rehab
This phase focuses on settling down your injury, decreasing your pain, and reducing any immediate strain on your plantar fascia.
You can begin with hip and leg exercises that build strength and control while working in positions that keep high loads off your painful foot.
Examples of exercises that work really well during this phase include:
Clams
Why: It strengthens your hip stabilizer muscles and develops your hip control in a position that does not strain your foot.
Instructions:
- Lie on your side with your hips bent to about 60 degrees and your knees at a 90 degree angle
- Tighten your stomach muscles to help stabilize your trunk during the movement
- Keep your feet touching each other while you rotate your top knee up and back so that your legs separate and open like a clam
- Hold the position for 2 seconds and then SLOWLY lower your leg back down
- Your aim is to do 15 repetitions, but don’t force it. If you find it hard, do what you can and just add a few repetitions as you get stronger.
- Rest 60 seconds
- Do 3 sets
Progression
Side leg lift
Why: This is another great exercise that strengthens your hip stabilizer muscles without loading your plantar fascia.
Instructions:
- Lie on your side with your legs stacked or bend your lower leg for extra stability
- Contract your core and slowly lift your top leg up
- Make sure that your leg does not drift forward during the exercise
- Also make sure that you don’t roll back – your hips must stay stacked on top of each other
- You may not be able to lift it very high and that’s OK
- Slowly lower it back down
- Do 15 slow lifts and lowers
- Then rest for 60 seconds
- Do 3 sets
Progression
Free squats
Why: Squats strengthen several of your big leg muscles (glutes, hamstrings, quads) in a position that is similar to walking and running. It also teaches you good movement patterns.
Instructions:
- Stand with your legs hip distance apart. It’s OK if your feet point a few degrees out to the side, they don’t have to point straight ahead if it’s uncomfortable
- Stretch your arms out in front of you – this will help you to balance
- Squat down by pushing your bottom out to the back (pretend that you want to sit down on a chair) and bending your knees
- Try to reach a 90 degree angle in your knees
- Check that your feet don’t roll in as you squat down and your knees should move in line with the middle of your feet
- Pause at the bottom and then return to upright
- Your aim is to do 15 repetitions, but DON’T force it. If you find it hard, do what you can and just add a few repetitions as you get stronger
- Rest 60 seconds
- Do 3 sets
Top Tip
The Middle Phase of Rehab
Once your foot pain has settled and your plantar fascia has gained some strength, it’s time to progress.
Introduce hip exercises with slightly higher loads in functional positions and increase this load as your foot recovers. Examples of hip and leg exercises that work well during this phase include:
Squats with weight
Why: This is a natural progression for the free squats. It offers all the benefits mentioned before plus a bit extra.
By adding weight to your squats, you increase the load that goes through your feet. This helps to strengthen your foot muscles as long as you ensure that you do it with good form and don’t allow your feet to roll in.
Instructions:
- Stand with your legs hip distance apart
- It is OK if your feet point a few degrees out to the side; they don’t have to point straight ahead if it’s uncomfortable
- Use relatively light weights. If you’re using dumbbells, you can rest them on your shoulders or hold them by your sides. If you’re using a single dumbbell or a kettlebell, you can hold it against your chest
- Squat down by pushing your bottom out to the back (pretend that you want to sit down on a chair) and bending your knees
- Try to reach a 90 degree angle in your knees
- Check that your feet do not roll in as you squat down and your knees should move in line with the middle of your feet
- Pause at the bottom and then return to upright
- Your aim is to do 15 repetitions, but DON’T force it. If you find it hard, do what you can and just add a few repetitions as you get stronger
- Rest 60 seconds
- Do 3 sets
Progression
Split squats
Why: This exercise is another great all-in-one exercise that teaches you control and builds strength in your hip, leg (hamstrings and quads), and foot muscles.
Instructions:
- Stand with your feet apart (one forward, one back)
- Place your hind leg on a low stool or step
- Lower your body by bending your front knee so that your knee at the back drops towards the floor, without actually touching it
- Make sure that your front knee stays aligned with the middle of your foot throughout the movement
- Then return to upright
- Your aim is to do 10 repetitions, but DON’T force it. If you find it hard, do what you can and just add a few repetitions as you get stronger
- Switch legs and repeat on the other side
- Do 3 sets on each side
Progression
Box jumps
Why: Box jumps develop the explosive strength in your glutes, hamstrings, quads, and foot muscles. It also teaches you good movement patterns during fast movements.
Instructions:
- Jump up and down from a low step/box without stopping
- Land lightly on the balls of your feet
- Ensure that your knees stay aligned with the middle of your feet
- Jumping up + down counts as 1 repetition
- Complete 5 repetitions
- Rest 60 seconds
- Do 3 sets
Progression
The Later Phase of Rehab
The main goals in the later rehab phase are starting a return to running program and regaining your pre-injury running endurance.
Focus on your running style and form. We’ll discuss running form and it’s link to plantar fasciitis in more detail in a future article.
When you first ease back into running, you should view running as strength training. Start with very small volumes and build it up over time.
Using a run/walk program can be a brilliant way to get you safely back to running. We’ve included one in the treatment plan in the Exakt Health app.
Continue with the hip exercises to maintain the strength and control gained in the previous phases. Having a routine in place will help keep your plantar fascia safe and protected from (re)injury.
Getting the most out of your strengthening program
Can you help your plantar fascia heal or move your recovery along quicker?
Unfortunately, there are no quick fixes with this one. However, we recommend a few ‘golden rules’ to keep your recovery on track and ensure you don’t slow down your progress. These include:
- Start at the right level for the severity of your condition and YOUR unique situation.
- If an exercise causes you pain during and/or after you’ve done it, then it’s likely not the right exercise to do at this moment in your recovery.
- Only progress to the next level of the program once you’ve mastered your current level.
- Don’t stop exercising once your pain is better; keep going with a maintenance program to prevent re-injury.
Finding lasting relief from plantar fasciitis
Is it possible to find permanent relief from plantar fasciitis?
Plantar fasciitis is one of the trickiest conditions to treat in runners. Not only because there are so many factors that can combine to cause it, but because of the unique physical and environmental elements that can affect your healing process and recovery.
Treating plantar fasciitis often feels like trying to hit a moving target. Never really getting your recovery where you want it.
In a study examining peoples’ experiences of plantar heel pain, one person expressed this feeling astutely: “I’m a mouse on a wheel. I can’t seem to get off. I don’t know what to do.”
Hopefully, this article has offered you a different perspective or another tool for your toolbox in treating plantar fasciitis.
Hip and leg strengthening added to your broader plantar fasciitis rehab program may help improve your body alignment and reduce the strain on your plantar fascia.
Perhaps this can finally help you get off the wheel and say goodbye to your plantar fasciitis for good!
The Exakt App can help you recover from plantar fasciitis. Start your own personalized rehab program today! It’s available to download from the Google Play and app store.