Doctor in Sai Physiotherapy Center
Spinal Surgery Disorders
Treatment of Neurological Problems
Treatment of Nerve And Muscle Disorders
Treatment of Hip Disorders
Neuro Physiotherapy Treatment
Treatment of Knee Injury
Pregnancy Exercise Therapy
Treatment of Sports Injuries
Treatment of Splinting
Treatment of Spondylosis
Arthritis And Pain Management Treatment
Heat Therapy Treatment
Post Pregnancy Classes
Orthopedic Physical Therapy
Treatment of Shin Splints
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Patient Review Highlights
I found the answers provided by the Dr. Ritesh Kharnal to be knowledgeable, very helpful, caring, professional and saved my life. THANK YOU SO MUCH DOCTOR FOR GIVING YOUR VALUABLE TIME...Thank You once Again
I found the answers provided by the Dr. Ritesh Kharnal to be knowledgeable, prompt, sensible and very helpful. Same steps as told by the physiotherapist
I have sever pain in my left heel from last 1 month. I have tested and come to know that both my b12 186 and vit. D 3.12 is low. Suggest me treatment. I am vegan.
What is plantar fasciitis?
You probably never thought much about your plantar fascia until the pain in your heel jolted you. A thin ligament that connects your heel to the front of your foot, the plantar fascia, can be a trouble spot for many people. Heel pain affects more than 50 percent of Americans, and the most common cause is plantar fasciitis. Repetitive motion from running or step aerobics or added pressure from weight gain can damage or tear the plantar fascia, causing inflammation and pain.
Along with runners, plantar fasciitis is common among pregnant women because the extra weight on the ligament can cause inflammation, leading to pain. If you have heel pain, don’t be discouraged. There are simple steps you can take to ease the pain so that you can resume running or another exercise.
Taut muscles in your feet or calves aggravate plantar fasciitis. Soothe or prevent the pain with some of these easy stretches recommended by personal trainer and triathlete Deborah Lynn Irmas of Santa Monica, ca. Irmas is certified by the American Council on exercise (ace). She endured bouts of plantar fasciitis after overtraining with too many sprints. This stretching routine, which she practices and recommends to her clients, keeps her free of heel pain.
- Stretch your calves
- Stand an arm’s length from a wall.
- Place your right foot behind your left.
- Slowly and gently bend your left leg forward.
- Keep your right knee straight and your right heel on the ground.
- Hold the stretch for 15 to 30 seconds and release. Repeat three times.
- Reverse the position of your legs, and repeat.
This stretch targets the gastrocnemius muscle in your calf. As your plantar fascia begins to heal and the pain diminishes, you can deepen this stretch by performing it with both legs slightly bent, says Irmas. Done this way, the stretch loosens the soleus muscle in the lower calf. Irmas cautions that it’s important not to hold the stretches for too long.
Grab a chair and stretch your plantar fascia-
- These three seated stretching exercises will also help relieve plantar fasciitis. Remember to sit up straight while you do them:
- While seated, roll your foot back and forth over a frozen water bottle, ice-cold can, or foam roller. Do this for one minute and then switch to the other foot.
- Next, cross one leg over the other for the big toe stretch. Grab your big toe, pull it gently toward you, and hold for 15 to 30 seconds. Do this three times, then reverse and do the same with the other foot
- For the third seated exercise, fold a towel lengthwise to make an exercise strap. Sit down, and place the folded towel under the arches of both feet. Grab the ends of the towel with both hands, and gently pull the tops of your feet toward you. Hold for 15 to 30 seconds, and repeat three times
- Not only can these stretches help to reduce heel pain, but doing them faithfully before your workout “absolutely can prevent plantar fasciitis,” says Irmas.
Some other tips and precautions
1. Ease up-
You’ll need to give running a rest until the inflammation in your plantar fascia calms down. Runners heal at different paces, but Irmas generally suggests taking about two weeks off. Ice your plantar fascia, perform the stretches, and take an anti-inflammatory medication like ibuprofen if you need it.
2. Start slowly-
When rest and ice have alleviated your heel pain, then you can try “tiny runs,” Irmas says. “run a short distance slowly, like from one telephone pole to the next. Stop at each telephone pole to stretch.” lengthen the runs gradually by running the distance between two telephone poles, two houses, two trees, or other markers you identify on your route. Continue to stop at each marker and punctuate your run with calf stretches, Irmas says.
3. More support-
While rest and regular stretching help mend plantar fasciitis, be sure you have sturdy shoes when you get back out there for your runs. The AmericanAcademyy of orthopaedic surgeons points out that adequate support and proper fit are also important to avoid heel pain and prevent other running-related injuries. Be sure to buy new shoes as frequently as you need to so that they provide the support and cushion your body needs to stay free of injury.
Heel spur, calcaneal spur and plantar fasciitis are often caused by short muscles, especially in the lower legs and foot sole. Therefore, it is important to make these flexible and longer again. These short muscles cause a constant strain on the plantar fascia, and this must be avoided. Stretching is very important then.
Several stretching exercises are advised to treat the heel spur. The most advised ones are listed here. It is not necessary to do all of these, as some exercises have a similar effect. Just experiment to find out which one fits you best. Make sure to find a good balance, stretching all muscles involved. Make sure not to exaggerate, stretching too hard can damage muscles and tendons.
Make sure to perform these stretches a few times a day. A general guideline would be 3 to 4 sessions each day. Then try to perform 3 to 4 exercises, repeating each exercise 2 -3 times with 10-15 repetitions.
￼exercise 1: stretching the plantar fascia and the calves: stand on a stair step or a bench with your toes, with the foot sole horizontal. Lower the heel until you feel a stretch. Maintain a few seconds and go up again. Repeat this a few times.
Note that this exercise is also good for strength in the calve muscles. Especially when you go upwards again, proceed to stand on your toes.
￼exercise 2: stretching the plantar fascia and the calves: sit down on the floor or your bed with your legs stretched out in front of you. With a towel around your toes, pull them towards you until you feel a stretch.
￼exercise 3: stretching the plantar fascia. This is a very effective exercise. This exercise is explained for a heel spur on the right foot: sit down on a chair, cross the right leg over the left one. Then grab the toes of the right foot with your left hand and pull your toes towards you. You will actually see the fascia protrude in the foot and of course experience the stretch.
￼exercise 4: stretching the calf muscles: lean forwards against a wall or a pole. Leave one leg stretched behind you and place the other one bent under you. Then lean further forward until you feel a stretch in the behind the leg.
￼exercise 5: again lean against a wall, placing both feet behind each other. Then slowly squat down, bending both legs. You will feel a stretch deep in the calf of the behind leg, the so-called" soleus.
With all these exercises, be aware to be aware of how hard you stretch. If you stretch too excessively, you might even do further harm. Just listen to your body, nothing should hurt.
Exercises for foot strength-
Next, to the stretching exercises, it can also pay to strengthen your legs. Training the muscles in feet and legs (especially the calf) can support healing from heel spurs and plantar fasciitis. Even runners or cyclists do not necessarily have strong legs. They may only be strong in a one-sided direction. Performing these exercises may strengthen the muscles then.
A much-advised training for the feet is to lay out a towel in front of you on the floor and to try and roll it up using your toes. When this goes well you can even put small weights on the towel to make it a bit harder. Similarly, you can also try to pick up small objects with your toes. Both are useful exercises, without any risk of hurting the heel.
A nice exercise that stimulates the tissue of the fasciitis is to roll a golf ball under your foot. Do this for 1-2 minutes and repeat this a few times per day. You can easily do this at work, simply sitting at your desk. This specific exercise is often found helpful.
Next to these exercises, strengthening the upper legs may be useful. Several exercises are possible, like standing on one leg, lowering yourself by bending the knee and standing up again.
When in doubt it is always a good idea to consult a physiotherapist before doing these exercises. Some gyms even have one on-site.
If you’ve recently had acl surgery, exercises are an important part of your recovery, in addition to a physical therapy program.
These level 1 exercises should be done for 1-4 weeks after surgery. The goal of these exercises is to regain neuromuscular control of the quadriceps, strengthen the hip and maintain knee and ankle range of motion on the affected leg.
Perform these exercises 1-3 times per day, only within pain-free range of motion. Stop the activity if it causes increased pain.
Please consult with your doctor before starting any home exercise program. These exercises should not replace instructions from your doctor.
1. Long sitting towel calf stretch-
Sit up with good posture and place towel on the bottom of your foot, while holding on to the ends.
Now pull the towel across the foot, so that your toes are being pulled towards you. Repeat for 2 sets for 30 seconds.
2. Supine hamstring stretch-
Sit up and place towel over your foot, while holding on to the towel with both hands.
Lie down on your back and bring your leg up until you feel a stretch in the back of your leg. Hold this for 30 seconds. Repeat twice, 30 seconds each time.
3. Quad sets-
Lie down on your back, place a small towel roll behind your knee.
Tighten the muscles at the front of your leg, and hold 3-5 seconds. Repeat for 2 sets of 10 repetitions.
4. Ankle pumps-
Lie on your back, or sit in a chair.
Life your ankles and toes up, then point them down. Repeat this for 2 sets of 10 repetitions.
5. Heel slides-
Sit down with a towel over your foot.
Slide your foot back by pulling the towel with your arms, bend your knee as far as you can. Hold it bent for 3-5 seconds. Continue to bend and straighten your knee for 2 sets of 10 repetitions.
6. Prone hip extension-
Lie on your stomach with your head on a pillow.
On your stomach, lift your leg up with your knee completely straight.
Continue this for 2 sets of 10 repetitions.
Start exercising your injured leg when some of the swellings have gone down and you are able to put about half of your weight on that leg.
Quad sets: sit on the floor with your injured leg straight and your other leg bent. Press the back of the knee of your injured leg against the floor by tightening the muscles on the top of your thigh. Hold this position 10 seconds. Relax. Do 2 sets of 15.
Seated quad sets: sit in a straight-back chair with your injured knee bent at a 90-degree angle. Try to tighten the top of your thigh muscles without moving your leg. Hold for 10 seconds. Do 2 sets of 15.
Knee stabilization: wrap a piece of elastic tubing around the ankle of your uninjured leg. Tie a knot in the other end of the tubing and close it in a door at about ankle height.
- Stand facing the door on the leg without tubing (your injured leg) and bend your knee slightly, keeping your thigh muscles tight. Stay in this position while you move the leg with the tubing (the uninjured leg) straight back behind you. Do 2 sets of 15.
- Turn 90 degrees so the leg without tubing is closest to the door. Move the leg with tubing away from your body. Do 2 sets of 15.
- Turn 90 degrees again so your back is to the door. Move the leg with tubing straight out in front of you. Do 2 sets of 15.
- Turn your body 90 degrees again so the leg with tubing is closest to the door. Move the leg with tubing across your body. Do 2 sets of 15.
- Hold onto a chair if you need help balancing. This exercise can be made more challenging by standing on a firm pillow or foam mat while you move the leg with tubing.
Straight leg raises: Lie on your back with your legs straight out in front of you. Bend the knee on your uninjured side and place the foot flat on the floor. Tighten the thigh muscle on your injured side and lift your leg about 8 inches off the floor. Keep your leg straight and your thigh muscle tight. Slowly lower your leg back down to the floor. Do 2 sets of 15.
Wall squat with a ball: stand with your back, shoulders, and head against a wall. Look straight ahead. Keep your shoulders relaxed and your feet 3 feet (90 centimeters) from the wall and shoulder's width apart. Place soccer or basketball-sized ball behind your back. Keeping your back against the wall, slowly squat down to a 45-degree angle. Your thighs will not yet be parallel to the floor. Hold this position for 10 seconds and then slowly slide back up the wall. Repeat 10 times. Build up to 2 sets of 15.
Step-up: stand with the foot of your injured leg on a support 3 to 5 inches (8 to 13 centimeters) high --like a small step or block of wood. Keep your other foot flat on the floor. Shift your weight onto the injured leg on the support. Straighten your injured leg as the other leg comes off the floor. Return to the starting position by bending your injured leg and slowly lowering your uninjured leg back to the floor. Do 2 sets of 15.
If you have access to a wobble board, do the following exercises:
Wobble board exercises
- Stand on a wobble board with your feet shoulder-width apart.
- Rock the board forwards and backward 30 times, then side to side 30 times. Hold on to a chair if you need support.
- Rotate the wobble board around so that the edge of the board is in contact with the floor at all times. Do this 30 times in a clockwise and then a counterclockwise direction.
- Balance on the wobble board for as long as you can without letting the edges touch the floor. Try to do this for 2 minutes without touching the floor.
- Rotate the wobble board in clockwise and counterclockwise circles, but do not let the edge of the board touch the floor.
- When you have mastered the wobble exercises standing on both legs, try repeating them while standing on just your injured leg. After you are able to do these exercises on one leg, try to do them with your eyes closed. Make sure you have something nearby to support you in case you lose your balance.
Frozen shoulder (also known as adhesive capsulitis) is a condition in which the shoulder is stiff, painful, and has limited motion in all directions.
Stretching exercises are usually the cornerstone of treating frozen shoulder.
Always warm up your shoulder before performing your exercises. The best way to do that is to take a warm shower or bath for 10 to 15 minutes. You can also use a moist heating pad or damp towel heated in the microwave, but it may not be as effective.
In performing the following exercises, stretch to the point of tension but not pain.
1. Pendulum stretch-
Do this exercise first. Relax your shoulders. Stand and lean over slightly, allowing the affected arm to hang down. Swing the arm in a small circle — about a foot in diameter. Perform 10 revolutions in each direction, once a day. As your symptoms improve, increase the diameter of your swing, but never force it. When you're ready for more, increase the stretch by holding a lightweight (three to five pounds) in the swinging arm.
2. Towel stretch-
Hold one end of a three-foot-long towel behind your back and grab the opposite end with your other hand. Hold the towel in a horizontal position. Use your good arm to pull the affected arm upward to stretch it. You can also do an advanced version of this exercise with the towel draped over your good shoulder. Hold the bottom of the towel with the affected arm and pull it toward the lower back with the unaffected arm. Do this 10 to 20 times a day.
3. Finger walk-
Face wall three-quarters of an arm's length away. Reach out and touch the wall at waist level with the fingertips of the affected arm. With your elbow slightly bent, slowly walk your fingers up the wall, spider-like, until you've raised your arm as far as you comfortably can. Your fingers should be doing the work, not your shoulder muscles. Slowly lower the arm (with the help of the good arm, if necessary) and repeat. Perform this exercise 10 to 20 times a day.
4. Cross-body reach-
Sit or stand. Use your good arm to lift your affected arm at the elbow, and bring it up and across your body, exerting gentle pressure to stretch the shoulder. Hold the stretch for 15 to 20 seconds. Do this 10 to 20 times per day.
5. Armpit stretch-
Using your good arm, lift the affected arm onto a shelf about breast-high. Gently bend your knees, opening up the armpit. Deepen your knee bend slightly, gently stretching the armpit, and then straighten. With each knee bend, stretch a little further, but don't force it. Do this 10 to 20 times each day.
Starting to strengthen-
As your range of motion improves, add rotator cuff–strengthening exercises. Be sure to warm up your shoulder and do your stretching exercises before you perform strengthening exercises.
6. Outward rotation-
Hold a rubber exercise band between your hands with your elbows at a 90-degree angle close to your sides. Rotate the lower part of the affected arm outward two or three inches and hold for five seconds. Repeat 10 to 15 times, once a day.
7. Inward rotation-
Stand next to a closed door, and hook one end of a rubber exercise band around the doorknob. Hold the other end with the hand of the affected arm, holding your elbow at a 90-degree angle. Pull the band toward your body two or three inches and hold for five seconds. Repeat 10 to 15 times, once a day.
For more exercises to improve your balance and prevent falls, increase your flexibility, and even help relieve arthritis, back, and knee pain, buy the Harvard special health report stretching: 35 exercises to improve flexibility and reduce pain.