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Our bodies can move in all different directions, but walking is primarily performed in a forward motion. It involves joints that work either solely in that direction (like the knee and ankle that only bend forward and back, not side to side) and other joints that work in many directions (like the hip which goes in virtually all directions). In walking, our foot goes out in front of us, and contacts the ground in front of the body. As the body comes over the foot, we have 3 distinct rocking phases. Seeing image 1 helps to visualize this. The first rocker is the body coming over the heel, we do not yet have full weight on this single limb yet. Then our body comes over our ankle, the second rocker, and now this limb carries 100% of our body weight. As our body continues over the foot we reach the 3rd rocker where the heel lifts off the ground and we rock over the ball of our foot.
There can be very many reasons for the foot/heel to have pain, but we often see patients with foot pain in our office have tight calf muscles which can lead to all sorts of problems! If the calf muscle and achilles tendon are tight, then during the second rocker phase of walking, our body cannot easily move over our ankle. The achilles pulls with an irregular tightness on the heel bone. The heel bone pulls on the plantar fascia. This puts extra strain on the plantar fascia, midfoot joints, and forefoot and can manifest with several types of short-term and long-term foot pain.
Stretching this muscle group takes focused effort and can take months to get results. We are working against years of tightness usually, but the treatment and prevention of foot pain are worth the effort!
Here is the stretch that I like and recommend. It comes from the Journal of Orthopedic and Sports Physical Therapy - Heel Pain Clinical Practice Guidelines in 2014. “The dosage of calf stretching can be either 3 times a day or 2 times a day, utilizing either a sustained (3 minutes) or intermittent (20 seconds) stretching times.
I tend to like the longer stretching as there is a reflex in our muscles that prevents them from completely relaxing for a period of about 10-15 seconds before it relaxes. It is the body’s way to protect from rapid lengthening that can cause injuries. The name for this reflex is the Golgi Tendon Reflex if you are interested in looking up more about that. The short version of it all is that it takes time for our muscles to relax before they actually begin to get a complete stretch.
So here is my recommended stretch:
1 - Find a stair, step or stool in your house
2 – With one foot down and the other lifted behind you, put the edge of the step at the highest part of your arch. This may be a little uncomfortable if it is not a carpeted stair or rounded edge of a stool, so perform this stretch wearing shoes.
3 - Hold on to something like a hand rail or counter top to allow for a safe, controlled stretch.
4 - With your leg straight let the back of your heel drop down past the front of your foot, slowly letting your body weight sink into the heel. You will start to feel a stretch in your calf and behind your knee, that is perfect.
5 - Hold the stretch for about 30 seconds and switch legs
6 - Repeat 2-3 times a day (morning, noon and evening).
7 - Increase your time slowly over a period of 4-6 weeks until you are holding a single 3 minute stretch on each ankle 2-3 times per day.
These stretches may take 3 months before you gain the desired results. In severe cases, there are many surgical options to gain length from this calf muscle group, some require weeks of recovery and others have much shorter recovery periods.
If you have tight calf muscles and tight ankles, this stretching may become a new way of life for you to avoid foot pain. Even if you stretch it out, it tightened in the past and may tighten again. Continue the stretches, even after the pain is gone. You may be able to get away with less frequent stretches once the foot pain is gone to perhaps once per day or a few times per week.
This is the first step in treatment for many kinds of foot pain. If the pain isn’t getting any better after 2-3 weeks of stretching or if the stretching itself hurts anywhere in your foot, that can be a good indication that something else may be going on that we can talk about. There may be an additional and simple step we can take to resolve the issue.
Hill Country Foot Specialist
October 13, 2017 at 5:20 PM ·
Hill Country Foot Specialists would like to welcome Dr. Mathew Cline to the practice. We are excited to have him aboard! Welcome, Dr. Cline!
Dr. Cline is trained in all aspects of foot and ankle medicine and surgery with special interests in ankle scopes and lateral ankle stabilization procedures. Look for his bio on our website, updates coming soon.
Hill Country Foot Specialist will be closed Thursday, February 18, 2021 & Friday, February 19, 2021. We will reopen Monday, February 22, 2021 @ 7:30 am.
Hill Country Foot Specialist will be closed Wednesday, February 17, 2021 due to the Winter Storm. Our office staff will be contacting those patients that had appointments to reschedule them.
Hill Country Foot Specialist has reopened after Winter Storm Uri. Please call (512) 805-7787 to schedule your appointment or if you may have any questions.
Kindest regards,
HCFS
