Overview
The video explains a high load strength training exercise for plantar fasciitis, highlighting its effectiveness over traditional stretching and providing detailed instructions and progression advice.
Evidence for High Load Strength Training
- Rathleff et al. (2014) found high load strength training more effective than daily plantar-specific stretching for plantar fasciitis.
- The technique leverages the windlass mechanism and Achilles tendon loading to target the plantar fascia effectively.
Exercise Instructions
- Use a small pedestal and towel to dorsiflex the first MTP joint.
- Hold onto a chair for support during the exercise.
- Perform a heel raise, taking three seconds to lift, hold at the top for two seconds, and lower over three seconds.
Exercise Progression
- Start with three sets of twelve repetitions every other day for two weeks.
- Progress to four sets of ten repetitions with added weight (e.g., a backpack with books) for four weeks.
- Further progression involves five sets of eight repetitions, continuously increasing the weight as strength improves.
- If unable to maintain correct form, begin with both legs simultaneously.
Safety Considerations
- Mild pain during the exercise is acceptable, but worsening pain after exercise or within 24 hours should prompt consultation with a healthcare professional.
Rationale for the Exercise
- Collagen type 1 fibers in the plantar fascia respond to high tensile forces by increasing collagen synthesis, potentially reversing degenerative changes.
Recommendations / Advice
- Patients should perform the exercise as described and progress gradually, monitoring for pain and adjusting load accordingly.