Video and Transcript: Learn Nerve Glides for Alleviating Heel Pain Known as Plantar Fasciitis

Hi! Dr. Orit Hickman here from Pain Science Physical Therapy.

I wanted to put together a quick video to address a treatment for plantar fasciitis. So, plantar fasciitis is a term that we use to describe pain felt in the arch of the foot and heel pain. Oftentimes, the pain is something that is most commonly felt after you’ve been resting for a period of time. So, let’s say you sit, you go put your foot down on the ground, and you start to move. And, you feel — you can feel some sharp pain under the arch of the foot. It’s something that plagues patients for many, many months and sometimes years.

So, the first question that I typically ask a patient is, “How long have you had this for and what brought it on?” And, if you don’t have a really good answer as to what caused it or the pain started many, many, many months ago, more than likely the cause now of the pain is more related to nerves and nerve sensitivity.

So, there is an exercise that I like to give for patients who are having heel pain and it’s not what you would think. So, a lot of times, if you find videos on plantar fasciitis, they’ll say — you know — roll your foot on an ice — iced bottle of water or do calf stretches. Well, in the moment, that might feel really good. But, if your pain that you’re experiencing is actually related to nerve sensitivity, then the stretches over the course of time may not actually help and may actually make you feel worse.

So, let’s talk about — let’s —let me show you an exercise, a simple exercise. I’m going to show you how to do it in sitting and laying down. And, it’s a — it’s called a nerve glide. And, what I would recommend that if you have pain when you first go to stand after you’ve been laying or sitting for a period of time, that you do some nerve glides before you go to stand and before you get out of bed. That way, if in fact the symptoms are related to nerve sensitivity, the nerves will already have gotten some movement, which they really like, and some blood flow, which they also really like.

So, the exercise I’m going to show you, same exercise. We’re going to do it laying down, and then we’re going to do it sitting up. You can do this in your bed. You can do this laying on the floor, either of them works. So, let’s say it’s my right foot that’s having plantar fasciitis symptoms or heel pain/arch pain when I first get up and it’s keeping me from walking. What I’m going to do is I’m going to lay down, and I’m going to hold behind the right leg while I keep the foot relaxed. And, I’m just gently going to lift and lower the right leg. So, this is just what we call a very gentle nerve glide. My foot is relaxed, and I’m not pushing, pushing, pushing, pushing to the end range. I’m just going up a little bit and back down. And, what that should do is start getting the nerves in my leg moving a little bit more and getting some good blood flow. Over the course of time, if I feel like it’s more — if I feel like I can tolerate it, I might add in a little bit of a foot pump. So, take my leg up and then do a little foot pump.

Now, symptoms that are really okay to feel right now are tingling, almost like if your foot feels like it’s waking up from being asleep. But, what we don’t want you to — I don’t want you to feel is numbness. So, if you feel numbness when you do this exercise and do you want you to stop doing it. It’s not about having the desired effect. So, that’s what I would do —get before getting out of bed and that should help with the symptoms once I go to stand and keep walking.

Now, if I know that I have pain when I get out of the chair and I put my foot down and the first thing I feel is arch pain, I’m going to do the exact same exercise sitting down. So, I’m going to do what’s called a leg swing. So, my foot is resting, and I’m just straightening and bending the knee. And, I’m keeping my foot pretty relaxed while I do this. And, I might do about five or ten repetitions before I go to stand. And, if I feel like that’s pretty comfortable and I want to add a little bit more of a complex glide, then I might add in a little bit of toe tep. Again, five or ten repetitions is really all I need.

Then, I go to stand, and I see how my heel pain feels, how my arch pain feels. If in fact that helps, then we know that the cause of your symptoms is not actually due to tissue. So, it’s not inflammation of your plantar fasciitis and it’s not irritations of the structures that are necessarily right up under the foot. It could be more related to nerves. In which case, the best thing to do is try these for a period of time, see how they work, and then contact a physical therapist and get working with them so that they can treat your nerves and your nervous system rather than just spot treating the heel and the arch.

I hope this helps. Let me know how it goes. If you have any questions, definitely put them in the comments below. And, if you thought this was a video, I’d really appreciate a thumbs-up. Thanks and have a great one!