Calf Stretching: It’s the AO Way or the Highway (There Are No Back Roads)
I know I consistently promote calf stretching to you all, like here, and here, and even here, but thanks to many of your questions, I realized I have never told you exactly how to do it right: my way, of course..
True, it is a simple concept itself, but it’s not just “any old” calf stretching.
I am not talking about calf stretching before you run. I am not talking about calf stretching after you use the weights at the gym (or however you choose to exercise).
What I am talking about is calf stretching that is done right - everyday - and that is separate from exercise, especially before.
What you see described here is what is proven to be, over time, effective in changing the muscle-tendon units so that our muscles will eventually (patience, people!) return to their optimal (or “normal”) length. Yes, as you age many of your muscles get tighter, especially your calves. You know this because you just get stiffer, but it does not have to be that way.
So you say, “AO, of course I want results. So tell me how!”
…and that is what I have heard more and more lately. And, it is a fair request, which is why I’m sharing that now.
The Skinny on Stretching: The Stuff That Really Counts
Stretching the right way. It’s like something we tell our kids: “There’s no point in doing it if you aren’t going to do it right.” You can stretch off a step in order to get the kind of calf stretch you are really after - which is an isolated and passive static stretch of the calf. The best kind that can be done without the help of another person!
So, what is the biggest, or the most common error I see in stretching?
Not doing it even with the best of intentions. That my friends is far and away the number one cause of stretching failure. Not doing what we know we should be doing for ourselves seems to be basic human nature, including me!
Let'd say you are an engineer, an accountant, or other type of rule follower and you are actually doing it. What might impede your stretching progress? To start, take a look at where you are making contact with your foot. The foot should contact the step against the arch of your foot, not the ball. Believe it or not, the best stretch is obtained this way even though it seems like this would not create as much leverage as out on the ball of your foot. Trust me, I'm right.
In the past, people have found success with an aerobics step, which works well since it is about 8 inches tall or so. It also has a rounded, kind edge. Do a quick Google search if you need to see one.
If you perform the stretching on stairs, as many do, use the bottom stair and hold onto the railing for support. Athletic shoes getting traction and providing a cushion on the edge of the step seem to work best.
Then slowly relax your ankles, and let your heels go downward. Learning this might take more effort and a little more time than you might think to get it just right. Learn to let go. Remember the contact point on the step is your arch, not the balls of your feet. This point can not be over emphasized. Now you should be feeling a pulling (or a tightness) in your upper calf muscle – which is what we want. You should be feeling this stretch high in your calf, just below your knee.
Here’s what else to consider.
Length of time you do it…Every. Day. Through years of tinkering and observation, I have determined that 9 minutes a day is the right number. It’s best to do it 3 minutes, 3 times per day. You should cluster your stretching like sets. In other words, do a 3 minute stretch, go away for a few minutes (brush your teeth, etc.), then do your next 3 minute stretch, go away for a bit, and then complete your final, 3 minutes, and you are done for the day. It’s easy, it’s done and you are on to the next thing. Less does not seem to work for people, and more is no better and is thus a waste of time. Nine minutes!
One alternate timing is possibly all 9 minutes at once or 4 1/2 minutes twice. My wife does all 9 minutes once. However, less that 3 minutes on each stretch session is not adequate except starting out when you might need time to work up to 3 minutes.
How many weeks, or months should you stretch everyday? How long should you keep this up?
Are you going to stop after just a week or two? Again, by overall time span, what I mean is how many weeks or months are spent doing your stretching, each and every day? One of the biggest mistakes I see is that people either want an overnight change, or they just “give up”. Noncompliance!
The one “downside” of calf stretching? It takes time. I’ll tell you again: you have to be consistent. Fortunately, but maybe not in your particular case, the problems we are solving are manageable, until the stretching finally does its job. Good things most often do not came fast. Be patient.
This will work, just be consistent and do it everyday if at all possible. Moderate your stretching intensity to feel it high in your calf. Go easy for a week or so and break in slow.
Download this Guide to see the rest of this program, and share it with your friends and family…Unless you want them to be in pain? (Actually, for prevention purposes, this particular stretch would be good for everyone to do, with or without pain or foot problems.) You can call it the AO way, no kidding! I mean it!
“So If We Do the Stretching The Right Way…When Do We Start to Get Relief?”
I see people take 2 weeks, to as much as 6 months for their calf stretching to “undo” the powerful, damaging effects that the isolated gastrocnemius contracture has exerted on their foot and ankle. Give it time and the results are most often stunning!
Where will you fall on the spectrum of 2 weeks to 6 months - that is, the time frame needed to resolve your tight calves? That’s one of many things I don’t know for sure! But, one thing I do know, if you don’t stretch you will never know now will you?
WARNING: As you start stretching you may experience pain in a different location or a slight increase in your pain. For instance, if you had plantar fasciitis in the past that is now resolved and you are calf stretching for second MTP synovitis you may experience a return of your plantar fasciitis. Instead of scaring you off, this experience should excite you. It means you are working on the root cause, and something positive is happening. And it should also convince you all this is connected and you are on your way to resolution the right way.
Stay healthy my friends,
AO
Archived Comments
A collection of comments from previous versions of the blog, preserved for historical context and the richness they add to our discussions.
RJ on January 18, 2019 at 7:49 pm (Edit)
And I currently have no stairs….alternate plan?
Lisa on April 1, 2019 at 7:07 am (Edit)
As suggested by the Dr./writer, a Reebok step may help or finding a ledge, stump or stable rise where you can get a full stretch.
Cher Hampton on March 21, 2019 at 7:00 pm (Edit)
O m’gosh THANK YOU so much for this info!! I had surgery onmy right foot for plantar fasciitis with no complaints- but about a year ago I started to develop it my left foot- ugh – it was beginning to get so bad I was fantasizing about how good it would feel to have a cortisone shot- like literally envisioning the needle going into my heel and then feeling the blessed relief! LOL – I was considering getting THE sock or a surgical boot when I came across your article- I thought what can it hurt? I had never heard of this kind of calf stretch- WOWSERS what a difference it has made in a few weeks! I started to notice in just a few days! A huge answer to prayer!! Not to mention saving me $$$!! Thank you so so much!!!
aoeditor on July 13, 2019 at 6:01 pm (Edit)
Bingo Cher,
It is never too late is it? This is an all too often scenario. I am glad for you you found me. The stretching is so simple and easy, and as you pointed out, FREE. Why calf stretching does not catch on as the definitive treatment is beyond me. I will keep trying.
Stay healthy my friends,
AO
Lisa on April 1, 2019 at 7:04 am (Edit)
Thank you for taking the time to invest in us MN folks. At 49 years old, an avid runner, lifter and CrossFitter, I have recently been plagued with I believe is MN (I am visiting a podiatrist Thurs). Unfortunately, I suspect my MN is not the result of overuse but a significant change in shoe wear and it’s worrisome. For the past 48 years I have worn running shoes because of my sport and career as an athletic coach. I returned to college a few years ago for a second degree (mistake #1) and it drastically cut my training (which wasn’t a bad thing for my body) but then began an internship that required “business casual” dress. For the past 9 months I have been wearing flat pointy shoes (mistake #2) with no foot pain or discomfort.One night before bed, walking barefoot on my tile (which I also have done for 49 years) I pivoted on the ball of my foot and bam!!!!! I actually thought something stung my foot pad between the 3rd and 5th toe. I looked and didn’t see a stinger. I was confused, stood back up and bam!!!!!! Again, a sharp searing pain. I blew it off to possibly stepping wrong and was certain it would be better in a few days. I was wrong… 2 weeks later and one chiropractic visit, I can not walk bare foot, can’t wear anything besides sneakers or flip flops. The ball of my foot pad feels swollen and there is a dull numbing in my 3rd – 5th toe. When I wear my running shoes, I rarely feel this sharp pain (though haven’t run further than a mile) but with walking, the sharp pain shows up randomly. I do find total relief when I do absolutely nothing (which, as you and your readers very well know will result in other unwanted maladies.) My fear is this will continue to significantly curtail my active life, hence the quality of my life. Ugh!I have scoured the Internet and scholarly articles for conservative treatments, which are slim. Thankfully I stumbled onto your blog with education and reader feedback which it is providing me hope about this condition. (*question below on it being a condition) I have all intentions of starting your routine calf stretch today in a quest for healing and relief.
*Is this an inflammatory issue, a condition that won’t heal or an injury? I wish it was an injury that would heal over time, or an inflammatory issue that could heal with nutrition and time but I “feel” like it is a condition that changes the mechanical structure of the body, resulting in this pain.
Thank you for reading and possibly responding. 🙂 You are appreciated.
aoeditor on June 6, 2019 at 10:46 am (Edit)
Hi Lisa,
Congratulations for degree #2. To your problem, which is a bit odd and an uncharacteristic quick, no, lightening quick onset. However, with what you have presented here a Morton’s neuroma is the leading contender as long as there is no actual swelling, just the sensations of it as you describe.
If you have a Morton’s neuroma the odds are high to will resolve completely with the stretching. Even if it ultimately required surgery the majority return to full activities.
So, back to the inflammation. I will refer you and others to maybe my two most important blog posts, The Bad Rap on Inflammation, Part 1 and Part 2. Very similar to Kill Bill Part 1 and Part 2. The takeaway, that one many of my colleagues can’t seem to get a handle on, is that the inflammation in most cases did not just magically appear like the Leprechaun. When it comes to orthopaedic inflammatory issues, basically the great majority of inflamed things, rotator cuff, plantar fasciitis, IT band friction syndrome, and the list goes on, are there for one reason- “overuse of imbalance”. For instance, plantar fasciitis is a result of equinus. The dominos fall in a predictable way: reduced activities (your case), higher heels??> equinus> increased plantar fascial tension> micro tears at the attachment of the PF to the calcaneus> attempts at repair called inflammation which becomes chronic. The problem is that the vicious cycle can’t be broken until the equinus domino stops falling. When that happens life is good and the chronic inflammation is allowed to naturally do what it intended to do from the get-go, repair the issue and go away. So, YES, you will likely “heal”.
This whole inflammatory issue really does make me mad because while it is a ridiculously simple concept, it seems to be systematically, and maybe intentionally, misunderstood. I feel thousands have unnecessary surgery everyday for problems they could resolve if only someone would tell them how dominos fall.
Stay healthy my friends,
AO
AnthonyL on April 16, 2019 at 1:59 pm (Edit)
Having verified that my right knee strain was reasonably recovered my physio suggested 20min brisk walk a day. I was then 70yrs old and no mention of shoes was made and I have now developed MN in my right foot (diagnosed by podiatrist) after nearly a year of me thinking it was simple metatarsalgia and would go away with rest. Podiatrist has supplied an insole with teardrop metatarsal dome on the underside. I’ve also bought top quality trainers which are wonderful. The MN is a discomfort more than a pain, often feel it more when I awake but I’m not sure the domes are necessarily a good thing so appreciate a comment on that. I’m yet to get into a good regime of calf stretching which is also my intention. (Hope this site is still operational)
Gloria on May 5, 2019 at 2:57 pm (Edit)
Do you recommend wearing tennis shoes or barefoot during the stretches? Someone had recommended doing these stretches barefoot. Also, are there any other exercises or stretches you recommend? What is your opinion on Correct Toes toe separators? Thank you.
aoeditor on June 3, 2019 at 2:30 pm (Edit)
Hi Gloria,
You’ve done riled me girl. Shoes or not is really your choice and what works best for you (the same goes for toe separators). My estimated guess is that likely about 90% is done with shoes. There are a lot of different stretches that can be done and we should be stretching more in general. If this is plantar fasciitis then you could throw in plantar fascial stretches. But here is the deal, don’t take your eye off the ball, make sure those calves are stretched first.
Stay healthy my friends,
AO.
Charlene on June 11, 2019 at 10:49 am (Edit)
Hi, I have had feet issues for 18 months. At first diagnosed as PF, then possibly neuroma or a nerve compression as the symptoms changed to more of the medial inside heel (radiating to under heel) from the whole underfoot and I couldn’t wear a closed shoe anymore as would experience numby/tingling/burning. Can only wear an open sandal.Finally had an MRI which showed “bone marrow edema, including the lateral proceses of the calcaneal tuberocity, potentially representing a bony contusion. (I did not fall or anything like that – I walked a lot, have always worn orthotics, I think my running shoes needed to replaced sooner when this happened. After the PF symptoms started, I did have to change my orthotics to have a much lower arch) Achilles tendinosis. Mild hindfoot valgus.I am wondering what these results actually mean? Is there treatment? and do they explain my symptoms ie. the not being able to wear a closed shoe (numbness/burning/tingling symptoms). Thank you very much.
Charlene on June 11, 2019 at 10:52 am (Edit)
PS: to my question of June 11, 2019 at 10:49 am.Would platelet rich plasma injections help treat or stem cell?Thank you.
Charlene on June 11, 2019 at 11:32 am (Edit)
PS: Couple more things in addition to my comments of June 11 at 10:49am.I have been using an ultrasound therapy machine at home for past 10 months. I did find this was helping originally, now I am not sure. Is this beneficial for my symptoms or my MRI results findings. Also, how long can a person use ultrasound therapy?I also find that I can just move or “stretch” my foot the wrong way and it causes the pain/symptoms to increase. Does this “symptom” sound like it it caused by the MRI findings?I am wondering if something is missing from the results?Thank you.
aoeditor on July 13, 2019 at 5:40 pm (Edit)
Hi Charlene,
First, please direct your attention away from the MRI findings and read on to see why.
Hey Charlene,
I does sound that you may well have a Morton’s Neuroma and of course plantar fasciitis. The MRI findings mean very little I am afraid. While the MRI is very useful, random unintended findings must be kept in check. These generic MRI findings of ‘bone marrow edema’ are routinely read, but most often find no place in the diagnosis, especially when there has been no trauma. That is likely all there is to your MRI findings. As afar as something missed, I cannot make comment.
On the other hand, there is a common thread connecting your bone marrow edema to your other foot problems. This commonality is at the core of the prevailing theme of my work. The root cause of your foot problems is equinus, your calves are too tight. Calcaneal bone edema is quite common ‘incidental finding’ in cases caused by equinus, and that includes Morton’s neuroma and plantar fasciitis. I cannot over emphasize this concept as the singular theme binding the majority of non-traumatic acquired foot and ankle pathology.
PRP and ultrasound may have a place, but they are not aimed at the root cause. You have not even mentioned calf tightness, but I hope this sets you on the right course. I would suggest you just start doing something you have not done, stretch your calves. If you don’t believe me then believe the other’s comments throughout this blog.
Stay healthy my friends,
AO
Karen T. on June 29, 2019 at 12:42 pm (Edit)
My husband has been suffering from undiagnosed foot pain for two years. He describes his pain as walking on rocks. Nothing has relieved the pain. It hurts when he is standing, walking, sitting and sleeping. The pain will often radiate up his calves. Walking up hills or stairs seems to really set it off. Originally they thought the pain was caused from his back (which also hurts) and did find a fatty tumor located very near the sciatica. He has since had that removed. The surgery helped to alleviate the back pain (sometimes) but the feet and calves remain.He has twice had costly cortisone shots in his back which got rid of the pain for two or three days and then it returned.
He has seen a podiatrist. He has very high arches (cavus?) and tried a shoe insert with no help. The only comfortable shoes he owns are flip flops and weirdly one pair of old driving moccasins.
His diagnosis is basically idiopathic peripheral neuropathy. Ibuprofen and massage offer little relief. A hot tub will make the pain unbearable and it starts burning.
After reading your blog I wondered if the root of the problem could simply be the tight calf muscles? I could not find an article that addressed this specific problem. Any thoughts?
aoeditor on July 14, 2019 at 11:45 am (Edit)
Hi Karen,
The short answer is YES, calf stretching can help. While I can’t know his problem for sure, I can say I have had good success for sure in similar sounding scenarios. I will also say just the few words here do not sound like peripheral neuropathy. So, stretch, seriously what have you got to lose. Accepting idiopathic peripheral neuropathy is a problem that is mostly unsolvable after all, which I am sure you have heard. So, as you ar doing look for something that can be solved.
Here are two additional potential diagnoses often overlooked.1. Piriformis syndrome- Look online for a stretch like the figure of four for this.2. Emerging Type II diabetes- Not to scare you but Type II diabetes detection can be well under the radar for years while peripheral neuropathy can rage on. But as I said it does not sound like peripheral neuropathy. I would make sure he is checked with Hemoglobin A1c.
Stay healthy my friends,
AO
Karen T. on July 13, 2019 at 6:17 pm (Edit)
PS To my earlier questions. My husband did try the stretches for a few days but the pain increased to the point he could barely walk. Perhaps he needs to ease into the stretching?
aoeditor on July 13, 2019 at 10:26 pm (Edit)
Hey Karen,
While unusual, I have certainly had a handful of my own patients as well as several on this blog have this issue. I would agree to stretch less intensely and ease into it. A great way to do this is just place more of your/his feet on the step to reduce the lever arm and thus the amount of stretch on the calf.
Hope that helps.
Stay healthy my friends,
AO
Jocelyn on September 24, 2019 at 1:46 pm (Edit)
I have metatarsal pain (possibly synovitis according to doc, and less likely MN). I have been stretching my calves for about 2 years because they are chronically tight (years in youth as ballet dancer, lots of plantar flexion plus many standing jobs in early adulthood), but never have I tried that much time, maybe a couple of minutes a day. So 9 minutes is quite a jump, and I hope will have an effect. I have a couple of questions regarding the stair method. 1) I feel a better stretch if I do one leg at a time, so if I am proceeding this way, do I need to do 9 minutes each leg for 18 total, or 9 minutes total? 2) I have an adjustable slant board specifically for stretching calves, and I like this method better. I feel a better stretch this way. Will I get results using the slant board? Or is it better to use the stairs, which sadly, I find awkward, uncomfortable pressure on the arch, and not as good of a stretch?
Also, I should say that I also have Hallux Rigidus and had a cheilectomy to remove bone spurring this February 2019. I had metatarsal pain before the surgery (probably 5 years or so), but it has gotten worse since surgery. I have faithfully performed a lot of physical therapy since the therapy. They said calf stretching was good, but it wasn’t a big part of the therapy.
I am definitely going to try the calf stretching. I have been doing it, but like I said, not anywhere near that much per day. Recovery from surgery was/still is very difficult and I hope to prevent any in the future.
aoeditor on November 27, 2019 at 10:47 am (Edit)
Hi Jocelyn,
Apologies for the late response. First, 3 minutes 3 times per day is the magic number and the main reason calf stretching ever fails is that not enough is done for too little time. Now for your questions:
1) I feel a better stretch if I do one leg at a time, so if I am proceeding this way, do I need to do 9 minutes each leg for 18 total, or 9 minutes total?
9 minutes a day each leg. So, your choice, 9 minutes in all doing both at same time or one at a time for a total of 18 minutes. How much time do you have? I have found doing both is quite effective, but one at a time is fine also.
2) I have an adjustable slant board specifically for stretching calves, and I like this method better. I feel a better stretch this way. Will I get results using the slant board? Or is it better to use the stairs, which sadly, I find awkward, uncomfortable pressure on the arch, and not as good of a stretch?
The slant board is fine. The stairs are not for everyone for sure. As long as you feel the stretch high in your calf you are good, sister. Be patient and you will get there if not already.
It is now 2 months after this comment. How are things going?
Stay healthy my friends,
AO
AJB on January 16, 2020 at 2:05 pm (Edit)
So I am a 63 year old male that developed Plantar Fasciitious. I bought special work out shoes, considered going to a podiatrist for help, inserts and blah, blah, and more blah…but i found this site and everything here made sense to me and what could it hurt to stretch my calves..its FREEEEE!!! Well i am into only a 30 second stretch at this time and i have to say my pain is greatly reduced…i mean GREATLY reduced and if this is what it takes to keep the pain at bay then i am all in…for the rest of my life all in…i will update you when i can get to 3 minute stretches which by the way i initially tried but couldnt even get to 1 minute b4 the stretch pain became to much.
aoeditor on January 19, 2020 at 2:06 pm (Edit)
Hi Andrew,
YOU GET IT! As I can tell you got the right stuff, you will be patient. Take your time building the time up to 3 minutes. The part that makes me angry at others is your statement, “what could it hurt to stretch my calves”. As I have said so many times, try all the other things (that won’t work, but we are told and think they will), but why not stretch at the same time. It is as if people will only do one thing at a time and stretching is rarely on the list and if it is it acmes last. Finally, it is FREEEEE!!!
I look forward to hearing from you.
Stay healthy my friends,
AO
HH on April 10, 2020 at 3:54 pm (Edit)
Hi Andrew,
Big fan of your article. Frequently had trouble with plantar fasciitis on both (flat) feet.Curious if you have any suggestions for any exercise tools for those living in apartments with no steps readily available, eg plastic calf stretcher
Katharine on November 16, 2020 at 1:31 pm (Edit)
Hello AO,
I have tight calves from several years of competing as a dancer and then being a collegiate sprinter and jumper.
I am going to try stretching my calves with this method suggested, 3x for 3 min off a stair. My other question is, should I continue to stretch through a tingling sensation that goes from the back of my knees all the way to my toes? It’s similar to the feeling you get when your foot “falls asleep”.
I’ve read this could be compression of a nerve and that you shouldn’t hold the stretch any longer at that point. Thank you in advance and thank you for being a strong advocate of stretching! It is so hard to find people who value stretching consistently!
aoeditor on November 26, 2020 at 8:20 pm (Edit)
Hi Katherine,
Here are my thoughts. Diagnostically, one thing you should also consider is piriformis syndrome (PS) especially since your were/are a runner and a female. You may want to confirm the diagnosis by seeing a physical therapist or an orthopaedic surgeon. However, beware, this is basically a clinical diagnosis and testing (MRI, EMG/NCS, etc.) is for the most is a waste of time and money except to exclude other possibilities. But as I said, the history, and a simple physical exam can confirm this diagnosis.
Stretching calves will not bother or set back PS, but it won’t help it either. None the less, I would continue calf stretching. One day I will do a blog on PS as it is a big interest of mine for three reasons: 1) this common problem is grossly under appreciated and under diagnosed, 2) it is over-treated, and stretching, when done long enough, is highly successful, 3) both my wife and I have had it and completely solved it with stretching. I have my own unique stretch I will share with my blog. For now please refer to this YouTube link. I would try each of these five exercises in this video and pick the ONE that you feel in your butt the most and stick with that one. I have been vocal here and elsewhere that too many options too often defeats the original objective in that we just quit or never start. Sticking to just one stretch that is effective creates compliance or in other words- keep it simple stupid (KISS).
Finally, my experience with many patients with the numbness you speak of is that it is OK to challenge and even stretch well into it as long as the trend is that the numbness is not progressively getting worse. You suffer while stretching and maybe a bit after, but a week later the trend is no worse and likely getting better. If it is getting worse obviously back off or quit.
Best to you and Happy Thanksgiving.
Stay healthy my friends,
AO
Larissa on January 24, 2020 at 9:12 pm (Edit)
Hello
Yes I am at my wits end with having damn foot trouble… and came upon you. I am very grateful for any and all help. I began stretching immediately after reading your blog. The problem is my foot started hurting like sooooo bad again after stretching for 1.5 weeks. So frustrating!!! I want to believe! I used the stair method but found that it was really pressing on the area of my foot thereby exacerbating the pain. I tried other stretches but didn’t seem to get as much of a stretch. So I gave up!!! What’s a girl to do? Any advice for my poor little foot?
(I have suffered from a neuroma between 2nd and 3rd toes for close to 3 years. Metatarsal pads and orthotics enable me to walk but it hasn’t actually helped)
aoeditor on February 6, 2020 at 5:31 pm (Edit)
Hi Larissa,
I am always at my wit’s end. It is just the nature of being angry. The quick answer to your stretching woes may be that your enthusiasm created a lot of pressure. Clearly there are a few people who can’t stretch freefall off a step or with the pressure under the arch as I recommend. Please find an alternative, less aggressive method, such as leaning against the wall. There are some people so tight and painful that they need to start slow and build up gradually. That my dear is what a girl is to do. Finally, I did a study in the late ’80s and the quickest and best results using the exact same stretching you are attempting created an initial 2-3 weeks of increased pain. I interpreted it that they were actually doing the stretching. I am not telling you to endure terrible pain, but a slight increase in pain may be a sign you are heading in the right direction. Liken it to lifting weights and getting sore afterward. That is a good thing. I wish you well even though you rile me up.
Stay healthy my friends,
AO
James M on April 9, 2020 at 10:28 pm (Edit)
How do you feel about the “prostretch” rocker? Im in an acute phase of pain and when I place my arch on the stair the pain is really bad pressing in on my arch and I just cannot hold it long enough to feel the stretch in my calf. Ive tried the prostretch and it doesnt hurt my arch as much but not sure im getting the same real stretch on my calf.. Your thoughts?
aoeditor on April 12, 2020 at 11:26 am (Edit)
Hi James,
I am not a huge fan of the Pro Stretch for a number of reasons, but it works and anything and I mean anything, by any means or device that will get that calf stretched out is the goal. So, I say use it. I rarely endorse products, but the calf stretching device I like is the One Stretch. It is a bit pricey, but it makes the most sense biomechanically and economically. Best of luck to you.
Stay healthy my friends,
AO
Keith A on August 29, 2020 at 4:57 pm (Edit)
Hi, I noted that you suggested doing the stretch in “sports type” shoes. Is there any additional benefit to doing it in bare feet? Or harm even?
aoeditor on September 7, 2020 at 9:17 am (Edit)
Hi Keith,
Any shoes are fine as long as they don’t slip. It really comes down to whatever you feel most comfortable to stretch in. Barefoot is ok if it works for you. A lot depends on the sharpness of the step edge. A thick carpet edge has a more gradual roll off and is kinder to a barefoot. But historically, mechanically and anatomically I see no advantage. To each his/ her own brother.
Stay healthy me friends,
AO
Keith A on September 1, 2020 at 4:13 pm (Edit)
Hi, and while we’re at it…is there any additional benefit to doing the 3 x 3min routine more than once per day?
aoeditor on September 7, 2020 at 9:28 am (Edit)
Hi again Keith,
This is an excellent question, but bugging me twice could set me off. About 25 years ago when I was working through my stretching protocol over about a five-year period. I made observations based on patient feedback and did a bit of tinkering along the way. What I found was that two minutes three times a day or less didn’t work consistently enough. I also found that four minutes three times a day or more didn’t seem to work any better or faster than three minutes, but maybe occasionally. There is also randomized control evidence in the literature supporting this protocol. One was done by one of my past residents. Having said this I don’t believe there’s any harm in bumping it up to maybe an extra rep or two per day or three minutes four or five times a day in the beginning in the hopes that you might speed things up a bit. Please let us know how things go for you.
Stay healthy my friends,
AO
Al Menzies on October 31, 2020 at 4:53 am (Edit)
Hello Dr, my friend Carl Long has spoken very highly of you over the years especially in the calf stretching department which I have been doing religiously now for about two years for hammer toe. Recently I have developed what was diagnosed as posterior tibial tendinitis of my left foot.The podiatrist I’ve seen In the Detroit area has me wearing an air cast (with bladder under arch) for the last four weeks. In the meantime I am having orthotics made…I’ve had quite a bit of swelling around the ankle that has not gone down. I’ve been trying to stay off my feet as much as possible but I don’t seem to get any relief from the pain. Any suggestions / thoughts?
aoeditor on November 9, 2020 at 2:13 pm (Edit)
Hi Al,
PTTD can stop you in your tracks for sure. I would hope that you arrived here because you slacked off on calf stretching over time. Certainly no shame there, just a lesson learned my friend. The AirCast bladder PTTD brace is a waste of time and I am not sure even one patient has been helped with that thing, Same thing for the orthotics. These interventions are like trying to kill an elephant with a BB gun. These are the typical gyrations my colleagues go thru on their way to finally telling you you need surgery and that does make me angry.
You need to be in an off-the-shelf boot with a 1/2 to 1-inch heel lift. This puts the PTT at rest and keeps you going. Being a friend Carl this means golf and that is out for a while unless you can play in a boot. Finally, DO NOT stop stretching.
Your endpoint with the boot is when the pain stops in the boot past-point wearing it for an additional month. I am serious or you may relapse.
I think it is time I did a blog on PTTD for all those in the AO Nation.
Stay healthy my friends,
AO
N. Judy on November 10, 2020 at 11:47 am (Edit)
Dear Doctor, I hope, I do not make you angry. 5 month ago I started calf stretch, as I have leg pain and my second toe hurts, which is much longer, than the first. I did it for two weeks, but I then I stopped as I got some pain in my hipjoint and hipbone and l also in my grain. Normally I do not have problems in thes areas. Two days ago I decided to start the stretching again, as I thought, it should be useful for my foot, toe and leg issue, but I have the same problem with my hip and grain. The pain is not very bad, but still a bit unpleasant and it makes me worry. I also tried other sort of calf stretch ing, but I also had similar pains in my hip and grain, after doing this exercise. I do not want to quit again, and I am sill very enthusiastic about calf stretcing, but now I do not know, what to do. What are your thought? Thanks. Judy
aoeditor on November 10, 2020 at 1:33 pm (Edit)
Judy,
The fact you had these pains makes angry! I am glad to hear about you enthusiasm. Here are a few of my thoughts:* Your enthusiasm may be translating into an attempt, conscious or subconscious, to give it everything and stretching too hard* Your technique may be incorrect. Maybe you are bending over at the hips.* The likely reason is that the “chain” from the back all the way down to the feet is connected and these hip area pains are telling you they need some stretching as well.I am OK with this pain as long as it levels out/plateaus after a while and does not continue to trend worse. I am quite certain there is no permanent damage going on simply because what you are doing stretching when done correctly is not any different than just standing. So, I say go on with it and adjust as needed and eventually you will get to the next level. I suspect you knew this from your questions, but it always helps to get confirmation. Finally, I am happy (less angry for me) for your question so that others who may be having similar issues and concerns can also benefit.
Stay in touch and let’s all know and benefit from your journey.
Stay healthy my friends,
AO
Christa Boquet on November 10, 2020 at 9:41 pm (Edit)
I am giving you an update. I have been religiously stretching for 3 months and the difference is incredible! I tell everyone about you and your technique. I still have pain in left heel, when I first walk in morning. Is this due to tight calves? I feel my left Achilles is tight. I normally do the Gastroc stretch first thing in morning, then I can walk pain free. Didn’t know if you recommended a better stretch? I appreciate and value your opinion, thank you for time!
aoeditor on November 12, 2020 at 6:00 pm (Edit)
Hi Christa,
Being angry really makes me happy, and your comments have really fired me up sister. I love your persistence and a lot more is coming as you continue to stretch. As you know I rarely recommend any products, but one of my ortho buddies has a device that does the stretch better and makes doing it safer. It is the One Stretch. You be the judge. Regardless, keep stretching and spreading the word. It is truly a shame everyone does not know this, but I will keep trying.
Stay healthy my friends,
AO
Melissa on November 26, 2020 at 9:45 am (Edit)
Dear AO, today is Thanksgiving and it is also the first morning in 6 months that I didn’t experience a searing, stabbing pain in my heel when getting out of bed. For that I’m so grateful for finding this blog and following your advice. Not being able to walk or stand without intense pain has devastated my quality of life, increasing my anxiety and depression in an already challenging time. I’ve spent so much money on shoes, countless orthotics. I’ve done ice, heat, rest, night splints. I’ve been to two doctors and the physical therapist. The physical therapist suggested calf stretching but not emphatically or specifically, which I guess was what I really needed! I put myself in the group of people whose pain significantly increased upon starting your calf stretching regimen, but I’m now two weeks in and stretching 30 seconds 3 times per day, and will continue to build up to the recommended reps and duration. The visual for instructing the proper position for the heel drop was a lifesaver. I also found the One Stretch for myself as I think it will be easier for when I’m up to 3 minutes duration. I’m also grateful to all the other commenters here who shared their experience with this stretching regimen. It gave me hope when I was feeling so hopeless. Last week, I was unable to walk my dog even one block. We used to walk several miles a day. After getting out of bed this morning with significantly less pain, I’m hopeful that I’ve finally turned the corner. Will update again later.Many thanks!
aoeditor on November 26, 2020 at 6:34 pm (Edit)
Hi Melissa,
I may be angry, but I am thankful today and every day that I can make a difference. Thanks Melissa for your kind words!Next to family, you made my day.
Stay healthy my friends,
AO
Melissa on December 3, 2020 at 2:16 pm (Edit)
Update one week later: up to 3 minutes 3x per day and pain is rapidly trending DOWNWARD! I am off pain killers completely today and can wear slippers instead of my Hoka’s when getting out of bed in the morning (literally have not been able to do this in months and I even bought ridiculously expensive PF slippers!). Three weeks ago, my foot throbbed with pain even when laying on the couch with it elevated. I literally couldn’t stand on the bathmat in my shower because the little rubber mounds were excruciating on my bare foot. Ibuprofen did nothing, ice did nothing. I honestly thought amputation and a prosthesis would be preferable to living with chronic pain from PF! I had a leg scooter in my Amazon cart, but thankfully you saved me yet another unnecessary expense. For me it’s been a little trial and error in terms of intensity and duration of stretching sessions, but I’m doing it consistently. I’m not completely pain free yet, but I walked my dog a half mile yesterday and can spend significantly more time on my feet without pain, and the pain is more tolerable when I have it. I can walk normally without limping. I’m thrilled with the results thus far and am a calf-stretcher for life now!Many thanks again
aoeditor on December 25, 2020 at 9:00 am (Edit)
Hi Melissa,
My pleasure. I just wish more people could experience what you have learned and how simple and FREE it is to do this simple stretch. That makes me angry.
To copy from my answer to Hannah before, what makes me really angry is 95% of runners will predictably shun stretching and tell you it was something else that did the trick. They will continue to enthusiastically comment on all the worthless things they think keep them healthy: shoes, orthotics, compression socks, barefoot running, and the rest of this very long list. People, stop wasting your money and sustaining your “injury”. Do the right thing and trust the stretch.
Stay healthy my friends,
AO
Hannah on December 11, 2020 at 5:14 am (Edit)
I’d been struggling with PF for weeks, then this was posted to my running group on Facebook… and now I’m running again. I know if I’ve ever forgotten to do the stretching because I feel things tightening up again, but a couple of days of making time for this and the pain goes again. Thank you!
aoeditor on December 25, 2020 at 8:46 am (Edit)
Hi Hannah,
I am not even angry, in fact, I am happy for you. What makes me really angry is 95% of those runners on your FB running page will predictably shun stretching and tell you it was something else that did the trick. They will continue to enthusiastically comment on all the worthless things they think keep them healthy: shoes, orthotics, compression socks, barefoot running, and the rest of this very long list.
Please do them a favor and promote stretching and of course me, the AngryOrthopod.
Stay healthy my friends,
AO
patrick on September 19, 2021 at 10:51 am (Edit)
Thanks for all of the information. I have been running in Hoka shoes for the past year and off-and-on before that. Runner of 25 years who took most of 2019 and 2020 off because of low back pain and an OCD of my left ankle. Long story short was back to running around 40 miles a week in June/July and with times I hadn’t come close to in almost a decade. I was getting bored of the Hokas and bought a pair of Asics Kayano, which have a 10mm drop as opposed to the 5mm drop I was used to. Went for a run and felt wonderful, faster, better gait and less pain and stiffness overall. A week later took them out for 16 miles, my calves felt tight around 6 miles and I pushed through for 10 more. My calves have still not recovered, not “pain” but extreme stiffness—feels as if they are stuck “on” or shortened. Have managed to do some great track workouts since (i mention this to kind of rule out and real kind of sprain or tear/ there is no loss of strength), but in the last few weeks the tightness has just been a touch demoralizing as it gets more intense with each mile and eventually just too uncomfortable to want to run any further. I stretch my calves religiously but stumbled upon your method last night and am excited to get started. Otherwise though, does any of this make sense to you, any idea what it could be? Thank you.
aoeditor on September 23, 2021 at 1:30 pm (Edit)
Hi Patrick,
It does make sense. I want to clarify first that by calves that it is indeed both calves. I ask to make sure your talar/ankle OCD is not still involved. BTW, you are doing very well from an OCD.
I have personal experience with exactly what you are experiencing and the upgrade stretching should do the trick. Your issue has no name and in my experience rare. Besides my own experience, I have seen it in only a couple of patients, and calf stretching worked every time. In my case, to be honest I actually do not stretch routinely on purpose. I want to experience the issues, if any, my patients feel and confirm that the stretching indeed works. As confident as I am about the somewhat universal power of calf stretching, critical thinking makes me a born doubter. As I intervened early with stretching, I personally have had plantar fasciitis, insertional Achilles tendinosis twice, midfoot pain with certainly early osteoarthritis, anterior ankle pain (impingement), posterior tibialis tendon dysfunction, and I may have had a couple more I forgot. None got going, so to speak, because I intervened early with only calf stretching. So, I thought that would be an interesting story. Equinus is so pervasive and it is beyond me why no one is talking about it, let alone screaming about it. I know why HCPs are not talking. They either don’t know or don’t want you to know as that will hit them in the most vital bodily orgen, the wallet.
So, please stretch away and keep running!
Stay healthy my friends,
AO
Julie Hash on February 6, 2021 at 7:27 pm (Edit)
Ok, here’s what going on with my stupid, stupid foot. I’ve been stretching religiously for going on 7 weeks. Holy cow, what huge improvement I’ve had, I’m beyond thankful to you for that! The pain has almost vanished from my arch (where it was mostly concentrated) but I’ve now gotten more of a searing type pain on the side, bottom part of my heel on the inside of my foot (as opposed to the outside) It’s not constant, just an intermittent knife in the side of the heel. My first question is, is this normal? And question # 2 when I am on “leg day” in my workout cycle, are calf raises ok? My foot will usually feel a bit more sore, but overall better over the next day or two. Thank you in advance! Hope you aren’t too angry 😉
aoeditor on February 7, 2021 at 1:23 pm (Edit)
Julie,
Thanks for making my Super Bowl LV Sunday by making me angry. It is refreshing to say the least.
Julie, you bring up an excellent point and interestingly I just added it at the end of my calf stretching post just 3 weeks ago. Great minds, huh? The tight gastrocnemius, equinus, is mechanically “connected” to so many structures where it can create its indirect havoc. This includes havoc on these 22 foot and ankle problems:
– General start up pain and stiffness– Foot pain especially associated with start up pain or stiffness– Plantar fasciitis– Sever’s disease– Shin splints– Posterior Tibialis Tendon Rupture(PTTR)-Acquired flatfoot deformity– Second MTP synovitis/plantar plate rupture which leads to hammer toe– Morton’s neuroma– Insertional Achilles tendinosis/Haglund’s deformity– Achilles tendinitis– Recurrent musculotendinous Achilles ruptures– Calf cramps at night/Charley horse– Midfoot osteoarthritis– Navicular stress fracture– Calcaneal stress fracture– Jones/Fifth MT stress fx– Diabetic Charcot arthropathy– Diabetic malperforans ulcer formation– Metatarsal stress fractures (prevention)– Achilles tendon ruptures (prevention)– Hammer toe formation secondary to MTP synovitis (prevention)– Ankle arthritis/Anterior ankle spurs (prevention)
In your case, it sounds like you had the less common mid-substance plantar fasciitis and in stretching you woke up the more common proximal plantar fasciitis. Let’s just say t was just waiting there waiting to be awoken and you poked it. This is clearly an unintended consequence, but it makes perfect sense to me. Keep stretching and this too will pass. It is predictable and happens all too often and if you ponder on it, it should serve to confirm that you are on the right path.
As far as calf strengthening/calf raises; no problem. Calf strength and calf tightness have little if anything to do with each other. Keep stretching and all will go away.
I am glad you reached out because you might do what so many do too often when they have this experience; quit. Please reach out to spread the word on this stupid, free, simple treatment.
Stay healthy my friends,
AO
Ursula on April 8, 2021 at 7:24 am (Edit)
I wanted to thank you. I was diagnosed with a Morton’s Neuroma a couple of years ago. I was well aware that the NHS would do nothing about it. (and reading your blog, I didn’t really want them to) I started to do these calf stretches, and my foot is now fine. It took a few months but the foot is completely pain free. I have recommended this site and the stretches to anyone who will listen. They also help enormously with cramps and restless legs syndrome. Thank you again! I would have happily paid good money for therapy as good as this. Interestingly, I was told by my GP, when he phoned to confirm the diagnosis, that I also had arthritis in two of my toes. When I said “Really? The radiologist said there was no sign on arthritis in that foot” He replied “Oh! ….. In that case it’s probably just the neuroma” Hmmmm! It didn’t do a lot for my confidence in them. Thank you again. God bless you.
aoeditor on April 28, 2021 at 10:19 am (Edit)
Hi Ursula,
We are a match made in heaven, or hell, madwoman and angryorthopod. I would bet neither of us is really mad of angry.
Unfortunately, you story is the rule, not the exception. Mainstream, western medicine is in a phase of ignoring, either due to stupidity or conveniently, the root cause of an issue. We pile on unfocused, palliative treatments and medicine that does little more that treat symptoms. THAT MAKES ME ANGRY. We practice sick care, not health care.
As a side not, I am a Bart’s man, as they say. In 1984 I was a Sr. Registrar for six months at St. Bartholomew Hospital in London. What a wonderful time, country and people.
Stay healthy my friends,
AO
Phil on April 17, 2021 at 8:00 pm (Edit)
Hi AO,
Apologies if you’ve covered this but any difference if I use a slant board instead of s step for the calf stretch.
aoeditor on April 18, 2021 at 10:20 pm (Edit)
Hi Phil,
Good question. At the end of the day I don’t care how you stretch as long as your knees are straight, you feel it high in your gastrocnemius and you do them for a good length of time and stay with it. I have had better success with the step with my patients, but some did fine on a slant board. My only issue with the slant board is that it is sort of awkward and as such people may give up. In addition it gives a slightly less aggressing stretch, but again it works for many. Best of luck.
Stay healthy my friends,
AO
Alexandra Jones on May 8, 2021 at 4:55 pm (Edit)
Hello AO,
I am an active 31y.o. female who took a 6/7 week workout hiatus from my normal Kettlebell program due to a hand injury. I jumped right back into my normal workouts not taking into the account the time off. My calves and achilles felt exceptionally tight (actually my whole lower body did) after working out and within days I started to develop an aching and pain in both of my feet, which I imagine must be PF. Interestingly, the hand injury I am recovering from is diagnosed as trigger finger, in all ten fingers. The PF feels oddly similar in nature to the trigger finger I am dealing with. Anyways, can this type of chain of events cause PF to occur? Also, I know I suffer from ankle restriction/equinus, will this stretching routine help with ankle mobility?
Lastly, your content is incredible! Thank you for your time and dedication.
Best,
Alexandra
aoeditor on May 9, 2021 at 9:01 pm (Edit)
Hi Alexandra,
Thanks for the kind words, but they do nothing to stoke the anger which I so desperately seek. Sorry about your hand injury, but it seems to be on the mend. I will say trigger finger in more that two fingers is unusual, but not unheard of.
I will say that you likely have plantar fasciitis as it often comes about after a reduction of activities. There is a phenomenon called the Law of Davis where connective tissue will shorten if not brought to a point of regular length or tension, which occurs when you are down. This happens to the collagen in and around the gastrocnemius (actually any muscle tendon unit), but note, this does not happen to the muscle itself. It is a minor, but important point.
Just in case, there is only one “equivalent” of trigger finger in the foot- Flexor Hallucis Longus (FHL) Tenosynovitis. Now that is a mouthful. It is a stenosing tenosynovitis, but does not trigger per se, it is just pain in the posteromedial aspect of the ankle. It is basically an issue of teenage girls, but can occur in any age.
Calf stretching will not only improve your ankle dorsiflexion ROM, is the only way to do it short of a knife. Using a roller, or any of these other cockamamy treatments are not supported by evidence, but they are the rage. I feel bed that so many waste their time with such nonsense.
So, Alexandra, you be patient and stretch away my friend.
Stay healthy my friends,
AO
Kapil on March 10, 2022 at 1:40 pm (Edit)
Hello AO, I recently started running and looks like I over did it and soles of both my feets hurt very badly, making it hard to stand longer or walk. It appears to be plantar fasciitis. Should I also do calf stretching? Also, please suggest if I can still do running/cycling or body weight workout? Sorry if I made you angry
Dave on May 9, 2021 at 6:45 pm (Edit)
This may or may not be connected to equinus etc. but you seem to be on to stuff others have missed so I’ll give it a shot.
My wife, who is disabled, has been suffering from a 20 year bout with severe foot/ankle tendinosis that was the end result of a 30 year bout with Reflex Sympathy Distrophy (RSD) which thankfully has been driven into remission (that’s another long story). She walks (barely) with a walker — like 50 feet or so — and then she’s done. She can bear almost no weight on her feet. Nevertheless, would some reduced form of your calf stretching have any effect on resolving the tendinosis? Thanks.
aoeditor on May 9, 2021 at 9:17 pm (Edit)
Hi David,
So sorry to hear about your wife, but happy the RSD is in remission. Folks, reflex sympathetic dystrophy (RSD) really sucks. Talkin’ about making me angry!
I can’t say if calf stretching will help or not without specifics about the tendinitis, but in general no matter the issue calf stretching will likely help. If it is Achilles tendinitis or Insertional Achilles tendinitis, then calf stretching will help. As you said though, go very slow, and I mean slow because of the history of RSD.
Over the years I have had a number of patients with RSD secondary to a non-traumatic acquired foot and ankle pathology arising from equinus. It was a bit hit or miss, but many did very well with calf stretching where nothing else helped.
So, proceed with caution my friend.
Stay healthy my friends,
AO
Dave on May 9, 2021 at 10:06 pm (Edit)
I have PF in just my right foot. Should I only stretch that calf? Or is that too much weight on 1 leg?
aoeditor on May 10, 2021 at 9:28 pm (Edit)
I am really confused. You wrote in regarding your wife, but now we are talking about you and plantar fasciitis. You can stretch one calf at a time, but there is usually no reason to do it that way, so I would stay with both. Too much stretch- one calf – could be too much, but yo will know it.
Stay healthy my friends,
AO
Julie on May 23, 2021 at 2:19 am (Edit)
Is it ok to stretch in bare feet? My trainers now have PF orthotics in them so my foot won’t move much in them.
aoeditor on June 2, 2021 at 8:32 pm (Edit)
Hi Julie,
Most people do best stretching with sports/tennis/running shoes on. It provides some cushioning and traction. But some like it barefoot. It would be your choice. As long as you feel the stretch high in your calve I don’t care how you do it.
Stay healthy my friends,
AO
Ann Ulrich on June 22, 2021 at 10:09 am (Edit)
Does your recommended stretch also stretch the soleus muscle? I have a stiff leg further down in the calf. Do I need to add a different stretch for this particular muscle?
Ann Ulrich on June 24, 2021 at 3:50 am (Edit)
Hello again!Sorry if I didn’t express myself clearly in my former email. There seems to be different stretches for the gastro muscle and the soleus muscle. Straight leg vs bent leg stretches. Curious if your recommended stretch takes care of both muscles. It certainly seems like I am experiencing a good stretch throughout my calf during my stretching, especially high in the calf. I have now been doing The Stretch for several weeks and my foot pain is lessening! My main foot issue is a tight fascia under my foot. The problem started after surgery for removal of an extra navicular bone. I ended up being in a cast. The surgeon informed me that I had a classic gastro muscle contraction. No enthusiastic stretching recommendation was given.Thank you so much for all your helpful advice — and anger.
aoeditor on July 2, 2021 at 10:45 pm (Edit)
Hey Ann,
Well, I am angry indeed. I am glad your doc pointed out your equinus, but basically no stretching recommended, pair for the course my dear. Actually you hit the nail on the head, “No enthusiastic stretching recommendation…” The is an excellent point and observation. If a doc even recommends stretching it is usually half hearted and in passing. No wonder so many people fail calf stretching. And it does make me angry. I mean millions are missing out on this simple, almost 100% effective solution to so many foot and ankle problems.
For some strange reason there is a pretty large contingent out there who push soleus stretching. I have nothing against it, but human nature says we are lucky if we will do one thing, and two, forget it! So, if one is going to stretch make sure it is the gastrocnemius, straight legged. And as you pointed out, you stretch both soleus and gastrocnemius straight legged, but only the soleus gets stretched bent kneed. Clinically speaking there is really no pathologic issue that results from a soleus contracture, unless is a fixed equinus, and that is a different thing altogether and rare. So, put all your eggs into the gastrocnemius stretching basket.
I am glad, but not surprised that you are seeing positive results. Stupid simple ain’t it? Spread the word.
Stay healthy my friends,
AO
Jennifer on July 10, 2021 at 7:20 pm (Edit)
Hello AO and thank you for your blog. I am working my way through my first experience with PF or what I’m assuming is PF. I had pain for about 5-6 months before I came across your blog. I have been on your stretching regimen for a little over three months. At first I felt great, so great that I started exercising in the morning before stretching and then stretching later in the day. Now, for the past few weeks, the pain is back. So, I have two questions:
1) By not stretching before exercise, did I undo the good I did from the previous stretching? Or could there be another reason the pain is back?
2) I can feel the stretch in my upper calves (mostly in the first three minutes), but I also feel some pain in my heel while stretching. Is that typical? Or am I overdoing it? Mostly the left foot, which is the primary source of pain.
Thank you!
aoeditor on September 23, 2021 at 5:13 pm (Edit)
Hi Jennifer,
I still know you are on the right track. One of the bad things about stretching is the time it takes to get the job done. And that can be months. I have definitely seen patients improve then move backwards temporarily while continuing to stretch. I do think you have done it correctly. Now for your answers:
#1 The pain is back for unknown reasons to me, but as I said given time you will break thru again. While you could stretch before exercise, maybe lighter/less time, but as you intimated stretching is best done away from exercise. I do not think your method has anything to do with the return.
#2 As long as the pain is mild and tolerable there is nothing wrong with feeling the pain in your heel. However, too aggressive stretching , while not damaging generally speaking, cold be a reason for your “relapse”. So, trying backing off tactic might be beneficial for the immediate time.
I hope this helps and apologies for the delayed response.
Stay healthy my friends,
AO
Jen on August 10, 2021 at 9:46 pm (Edit)
Hi Angry—wondering if calf stretching will help with toe flexion. When on my toes in a push-up position, I have stiffness that is preventing them from flexing/curling to grip the ground. Since calf tightness causes so much to go haywire, I figured I would start there to rule out any issue. I do have tight calves (and ankles) and have started your protocol. I used to do it regularly and see the error in letting the habit lapse! Fingers crossed!
Jen on August 21, 2021 at 8:39 am (Edit)
Hi AO,
I’ve returned to the stretching protocol after lapsing, and it’s certainly helping some aches and stiffness that have accumulated during some pandemic inactivity. I have been having an issue with my toes flexing correctly and fully to grab the floor when in a push up position. Will calf stretching eventually help with that? Is the stiffness there caused by tight calf muscles too? Curious if I’m helping to correct this at the same time too. Thanks!
aoeditor on September 23, 2021 at 1:36 pm (Edit)
Hi Jen,
First of all I do think the calf stretching will likely take care of this. It has mostly in my patients. To be honest, I can’t give you a good answer as to what it is or any anatomic rational, but it does happen. As much as I don’t like plantar fascial stretching I would suggest you throw that in also just in case. But, don’t not stretch your calves. I wish you the best.
Stay healthy my friends,
AO
Laurel Ludy on September 21, 2021 at 9:08 am (Edit)
I also wanted to heartily thank you. I was an active walker/hiker but after 2 months of hobbling around with sudden PF and trying “everything” which did not seem to help, I came upon this site. This stretch has been extremely helpful and I am finally encouraged with improvement. I sent back expensive sneakers I had ordered in desperation as part of the “everything”, not now needing them. I am sharing this information with family and friends who also suffer with PF. Thank you again, I am very grateful!
Brad M on November 30, 2021 at 9:53 am (Edit)
Hi AO, I’ve been doing the calf stretches for almost two months and I have a couple of questions. When I do the calf stretches, is my ankle supposed to be sore and tender? Is having weak ankles from previous injuries related to my plantar fasciitis? I’ve been dealing with plantar fasciitis for almost three years now and after I started doing the calf stretches for two weeks, I felt really good. However, I feel like my pain has gotten worse again even though I haven’t changed anything to my daily regimen. Is this to be expected? Thanks in advance!
aoeditor on December 12, 2021 at 8:43 am (Edit)
Hi Brad,
Okay, that makes me angry, but what doesn’t. Great description of the issue. Typically ankles can hurt, although not often, early on as we “wake” things up, but this almost always resolves. You might modify the stretch to a more comfortable position or reduce intensity or backing off a bit and restart. Another explainable reason might be that you may be reaching the max or end point of your ankle dorsiflexion (upward motion) and compressing the front of the ankle together. This reason usually comes later. This would not happen in a normal ankle, but if you had previous injuries (week ankles) and have developed anterior ankle spur(s) (a normal response to previous injuries) that is quiescent you may be exposing things. You are not causing injury or damage, but no reason to endure that pain. I would say to modify, but keep trying to stretch.
BTW way weak ankles can only be related to plantar fasciitis in that weak ankle will modify ones activities and create additional calf contracture. My impression is that you will pass through this phase and get the job done.
Stay healthy my friends,
AO
MK on December 12, 2021 at 2:30 am (Edit)
Hi AO, this might be a dumb question but… for this stretch to be effective (or comfortable), do I need to be wearing shoes? I go barefoot a lot and when I’m not I’m usually in minimalist shoes anyway. 😀
Also, is something like a slant board an okay substitute, or is the pressure on the arch part of the point of it? I don’t really have any stairs or blocks to stand on, unless I go out to the street and use the curb, but I’ll definitely buy an aerobic step if I need to.
2 yrs in on PF and I’ll see docs and tell them I’ve been reading about how the problem is actually the calf, and they’ll AGREE and then aim treatment at my feet still??? Or YouTube videos will talk about the calf being the issue and then not tell you at all how to address the calf. I feel like I’m taking crazy pills. 😀 Thanks very much for this specific advice, can’t wait to stretch the hell out of my painfully tight calves.
aoeditor on December 12, 2021 at 8:59 am (Edit)
Hi MK,
Dumb questions do make me angry, but this one is not dumb, so thanks for that.
You know, at the end of the day I don’t care how you stretch or what you are wearing when you do it as long as you do it long enough and feel it high in your calf.BTW, barefoot is fantastic, in fact if you think about it we were not born with shoes. Just sayin’. The method I have explained and recommend is the method that I have determined through years of trial and error in thousands of patients that works best for the most. Most importantly it is the easiest to do which creates compliance. Face it, if you don’t do it, it can’t work, right? Slant board, aerobic step, whatever, all have a chance to work, just find what works for you.
Finally, your last paragraph does and has always made me angry. For some inexplicable reason healthcare providers, etc., even my closest colleagues will do just what you describe. How is this to be interpreted? They don’t believe stretching works! And they don’t want it to work. Maybe this is why there is a current trend, if not craze, for surgically lengthening the calf. Why? I am about to start back up contributing blogs angrier than ever and this will be addressed.
Stay healthy my friends,
AO
Carrie on December 31, 2021 at 9:36 am (Edit)
I’ve been dealing with plantar fasciitis for a month now. Calf stretching definitely makes sense to me. The only problem is that I have mobility and balance issues. Trying to stand on the edge of a step terrifies me. I’d probably fall and break my neck. Is there any kind of calf stretch I could do while sitting that might be almost as effective?
aoeditor on January 3, 2022 at 12:55 pm (Edit)
Hi Carrie,
While uncommon, your situation is not unheard of and I agree it can be scary to stretch, especially on stairs unless you have good stability. There are many ways to stretch the calf, specifically the gastrocnemius. While the step is the best and easiest, in my angry opinion, other methods can get it done. The problem with other methods is that they require more concentrations to get relaxed to get deep into the stretch and a lot of attention to technique detail. It can be done, but is just a bit more tedious and slower as the intensity of the stretch will not be that of the step. However, you get it, which is 90% of the way there, so I think you will succeed. Just be patient and know that between intensity of the stretch versus duration of stretch, duration is the most important.
– sitting on a bed, floor or couch with one leg straight out (knee straight) you can use a belt, or yoga strap, or towel with it looping around your ball of foot and pull back like on a reigns of a horse. Switch and repeat 3 minutes per day on both sides. Amazon sells many stretch straps and this could be a resource for you.– Stretch against the wall with one foot nearer to the wall, the non stretch leg, and the other farther way from the wall with knee straight, the leg to be stretched.– While I don’t love slant boards, that can get it done. Just put near wall and face wall and hold on. Amazon has tons of them.
Make sure to concentrate on the stretch being higher in the calf, closer to the back of the knee, not lower. I wish you the best and a happy (un-angry) New Year.
Stay healthy my friends,
AO
turtlegurl on January 5, 2022 at 6:24 pm (Edit)
Maybe you talk about this elsewhere on the site and I just haven’t come across it yet, but wouldn’t this type of static stretching trigger the stretch reflex, sooner or later bringing the muscles back to their original length — or even shorter? And how would stretching in this way help the gamma loop to adapt? Thank you.
aoeditor on January 8, 2022 at 8:13 am (Edit)
Yo Turtlegurl,
I have not discussed this before. Thanks for bringing up a subject I would like to talk about, so much so, I think I will do a blog post on it. Everything I will say is my opinion thru the lens of an orthopaedic surgeon with 32 years of experience, much of it focused on calf stretching.
To be perfectly honest, I know just enough about all the stretching methods, the neurologic component of muscles, and their control mechanisms to be dangerous. I don’t know your training, or experience, but it is safe to say you likely know more than me sizing up your question. So, this seriously begs the question, “If the AO is such a dunce regarding stretching, why is he out there promoting static stretching like a fool?” The short answer is because static stretching works. While there is plenty of published evidence that it does work, it is my heuristic experience that tells me that it most definitely works. Maybe my conviction is quixotic, but I don’t think so.
The long answer will be in a blog post. The medium answer I will cover here in simple terms, not that you need simple, but because I am simple and that it is the only adequate way I can explain and simple for the sake of other potential readers.
This is where I ask you to open your mind to entertain the possibility of a paradigm change regarding stretching. Static stretching is indeed resisted by the stretch reflex and gamma loop, but these, as you know and alluded to, can adapt and reset.
Fundamentally, there are only two structures to stretch, the muscle and the connective tissue. Of course, there are blood vessels, nerves, lymphatics, etc. but for the sake of discussion, let’s count them as negligible. When I think of stretching actual muscle, which indeed brings in the stretch reflex, gamma loop, etc., I think of stretching only for today. This is basically for pre-athletic performance stretching and I am in complete agreement that in this setting static stretching is more or less a waste of time. Alas, I am thoroughly uninterested in that endpoint. The endpoint I am interested in is getting the musculotendinous unit back to its “original” designed, god-given length. And I can assure you that our muscles, our connective tissue, actually shortens as we age.
So, what structure needs to be stretched? This is a subject discussed about infrequently as it is assumed it is only the muscle that needs to be stretched. After all, we do call it “stretching muscle”. However, my clinical-based focus, especially for those of us past our mid-twenties (or old like me, try it), is that we are stretching the intertwining connective/collagen tissue (endo, peri and ectomysium) that holds things together. This is what gets tight and, in the case of equinus, and ultimately causes all the havoc on the human foot and ankle. Another comparable example is tight hamstrings and low back pain. To make static stretching work, it takes time as far as each stretch sequence (my protocol is 3 min 3 times per day, every day if possible) and time in doing it for weeks and, in some cases months. The connective tissue took years to get this way, and the reset or realignment is a slow process.
Failure to have the required patience or knowledge, or conviction is precisely why static stretching fails. My patients, in excess of 10,000-maybe 20,000, I lost count, were educated and convinced, and as a result they succeeded greater than 95%, and that includes the folks that would never fess up to not actually stretching. This is opposed to the typical stretching 2-3 times per week, hold it for 30 seconds max, for 2 to 6 weeks- and that is pushing it. No wonder static stretching fails.
I hope this explanation sheds some light on your question.
Stay healthy, my friends,
AO
Jennifer Ugarte on February 4, 2022 at 9:44 pm (Edit)
Hi doc!I’m excited about finding your post. I’ve been struggling with PF for about a year and it really bums me out. Can I continue to walk/run what I can handle while I start the stretch program?
I came across a site called KingsBrand that promotes BFST wraps and other stuff. What are your thoughts on that?
Thank you for all you do! I’m starting on the stretches tomorrow.
aoeditor on February 7, 2022 at 9:25 pm (Edit)
Howdy Jennifer,
I’m also excited. You can definitely remain active, even push it, and endure some pain while you get the stretching done (be patient) as long as you don’t see a progressive worsening of things. Daily activity related ups and downs are fine as long as you are not worse in a week or two or so. Then it may be time to back off, but this usually does not happen.
You just had to go and mention those other things like BFST. I’m angry now. No doubt this sort of stuff might assist your recovery, but they are aimed at the last domino to fall, not the finger that pushed the first domino, the root cause. Thus they will not “fix” it. Addressing the root cause is where the money is. So, do the BFST, or or any other acronym, but don’t not do CS (calf stretching).
Stay healthy, my friends,
AO
Ashley on February 20, 2022 at 12:42 pm (Edit)
Hi! I just came across your blog and love it! I have metatarsalgia and have started following your calf stretching recommendations. The pain started several years ago after a metatarsal fracture and has increasingly gotten worse. Is there anything else you recommend in conjunction with the calf stretching regimen? I have read about foot and toe strengthening exercises but I’m worried it may do more harm than good? Any advice?
aoeditor on February 21, 2022 at 9:39 am (Edit)
Yo Ashley,
Very interesting story, one I have heard numerous times. I will address your points and questions one at a time, but first I have a few questions myself:1. What MT fractured? Was it a stress fracture or traumatic? Did it heal as is, meaning straight, not angulated? I ask because if it angulated the forces can shift to the MT next door, i.e., 2nd MT fractured and displaces upward and 3rd now takes load instead of second.2. Historically, based on my observations if this was a stress fracture there is a 75% chance you had plantar fasciitis prior to the MT fracture. What say you?
No doubt stretching will help, if not solve things completely, but the answers to the questions will shed light on what you odds are of there degree of help you might receive.As far as additional things to do in while you stretch, I would guess you have tried much of the standard crapolla that is out there, such as orthotics, rollers, massage, to name a few. No doubt foot and ankle strengthening is good for you and not harmful, but they are basically a waste of time when it comes to the primary focus, addressing the root cause, equips or calves too tight. I would advise you to look read part 1 and 2 of Plantar plate repairs & the pre-dislocation syndrome: what the f$@%. In particular, look at the two videos. While you may not have second MTP synovitis., the forces and mechanism of action is identical. So, back to the strengthening, do it is you wish, just don’t not do the stretching.
To answer your second question, which not gonna lie angered me a bit (thanks). It sounds like you have second MTP synovitis and if this is the case, you will be running before you know it.
Stay healthy, my friends,
AO
Ashley on February 20, 2022 at 12:44 pm (Edit)
Also another quick question if I may. The pain in the ball of my foot worsens when I run. To the point that I cannot put weight on my foot. Will I be able to get back to running after stretching for a few months? Any other exercises or stretches you’d recommend?
Petra on May 27, 2022 at 10:36 pm (Edit)
Sounds like Morton’s neuroma.
Kapil on March 10, 2022 at 9:30 pm (Edit)
Hello AO, I started running/skipping lately and I overdid it which caused plantar facsittis to both my feets and my feets soles hurt when I stand Or walk…please suggest what should I do? Also can I keep doing my workouts – jogging, skipping, weight training? Thank you. Sorry don’t be angry at me
aoeditor on March 16, 2022 at 2:42 pm (Edit)
Yo Kapil,
I am all fired up. You are in real trouble now. First, contrary to most of the morons out there recommending rest to basically everyone (this actually does make me mad!), you can continue working out on any level you want. Here are the general rules on that. If continued workouts create an escalation in your pain over time then back off to where the pain is steady. Acceptable is a scenario where your pain is improving (with calf stretching) or a steady daily cycle of get worse with activity and followed by recovery, but not gradually worsening over time. A great reference analogy would be the movie “Groundhog Day”. In other words, it is OK to play with pain that is within reason.
How did you miss calf stretching? This is what you do, period!
Plantar fasciitis is not some mystical, poof and now you got it- there is an underlying singular cause. However, most of my colleagues forgo the root cause thing and focus only on the end result. No wonder plantar fasciitis treatment fails so often. I’m just getting going and feeling better already and it is, after all, all about me.
Here’s a thought. Should one put their effort into eradicating the smoke, or would they fight the fire? Only a fool would fight the smoke and ignore the fire. This also goes for plantar fasciitis (smoke) and equinus (fire). I am OK for doing things to address the plantar fasciitism to make one feel better, but do not ignore the equinus.
You did not overdo it. This is a critical concept that everyone out there in the AO Nation must understand. This includes my halfwit colleagues. Take a look at my post on inflammation. While “doing too much” may have triggered your plantar fasciitis, it was only the straw that broke the camel’s back. Your plantar fasciitis was just waiting to get going because you have equinus (calves that are too tight) that developed over the past several years and your boost in activities took it over the edge, but DID NOT cause it. I am widely published in this area. This, my friend, is the root cause of plantar fasciitis and 21 other foot and ankle non-traumatic acquired foot and ankle pathologies. And the equinus will be there until you stretch it out.
One final point. Interestingly, plantar fasciitis can and often resolves without addressing the equinus. It is a mystery, but I have theories not to be addressed here. But know this, unresolved equinus, based on my 40 years of heuristic experience, can and will likely cause one of the other 21 foot and ankle non-traumatic acquired foot and ankle pathologies in time. 65% of my patients presenting with one of these other foot and ankle non-traumatic acquired foot and ankle pathologies had a clear cut history of plantar fasciitis in the past 5-10 year give or take. So, there are many reasons to stretch.
OK, I am now calm…..
Stay healthy, my friends,
AO
Karen on May 5, 2022 at 10:48 am (Edit)
Just a quick question on the calf stretch. How long do you hold the stretch? When I downloaded the guide and saw the typical pattern of recovery/advancement schedule it shows week 1 as 15 seconds 3 times a day, week 2 30 seconds 3 times a day, etc. just want to make sure I’m correctly assuming that I need to work up to 3 minutes a day by week 6 and that I will actually be holding that stretch for a full 3 minutes or is it a up and down motion?I’ve been suffering for 5 months and it’s just getting worse. New insoles superfeet orange hurt, bought some Softsoles which is more comfortable but I remembered somewhere in my research that tight calves can cause PF. I’m not a runner but I am a walker but I can’t even do that because of pain. I’ve always worn good quality athletic shoes. I don’t wear high heels and never have. Now my IT band hurts and I have lower back pain. Geez it’s frustrating. Anyway I’m starting the calf stretch today but just want to make sure I have the execution and length/ duration correct. Thanks so muc!
AngryOrthopod on May 19, 2022 at 8:35 am (Edit)
Hey Karen,
So sorry for the delayed response. I live on a small farm and spring gets quite busy and of course that makes me angry.
As to the protocol, most people start at 3 minutes 3 times a day. It all really depends on if you experience pain and how long you can last. More symptomatic people, or older, infirm folks and those with co-morbid conditions might consider the slower start. When stretching, it needs to be a consistent stretch that is held. Of course one can lift out of the stretch to take a break if needed.
Contrary to most of the information out there, shoes and orthotics (this also applies to most all the other goofy treatments) have nothing to do whatsoever with treatment or help with plantar fasciitis. The evidence supports this.
Finally, I have no doubts that your IT band and low back pain stem from equinus and/or your compensation to manage your gait with plantar fasciitis. Stretch you calves and all will fall in line.
Stay healthy, my friends,
AO
AngryOrthopod on May 19, 2022 at 11:30 am (Edit)
Hey Karen,
So sorry for the delayed response. I live on a small farm and spring gets quite busy and of course that makes me angry.
As to the protocol, most people start at 3 minutes 3 times a day. It all really depends on if you experience pain and how long you can last. More symptomatic people, or older, infirm folks and those with co-morbid conditions might consider the slower start. When stretching, it needs to be a consistent stretch that is held. Of course one can lift out of the stretch to take a break if needed.
Contrary to most of the information out there, shoes and orthotics (this also applies to most all the other goofy treatments) have nothing to do whatsoever with treatment or help with plantar fasciitis. The evidence supports this.
Finally, I have no doubts that your IT band and low back pain stem from equinus and/or your compensation to manage your gait with plantar fasciitis. Stretch your calves and all will fall in line.
Stay healthy, my friends,
AO
Evelyn on June 17, 2022 at 2:18 am (Edit)
Dear AO,
I am angry too! My feet are not cooperating. Last Thursday, I work up with a pain under my second toe. When I walked, it felt like there was a marble between the base of my toe and the floor. Whether I sit, stand or walk, it hurts. Didn’t do anything to cause it (except age). Any exercises that would help?
X-rays showed I have arthritis in my feet but now they get stiff. I tried on my old Earth shoes (with the negative heel) and they felt good. Don’t want to make my feet worse. What do you think are the pros and cons of negative heels?
Lastly, I had a great doctor who had a recipe for “secret sauce” that was a great treatment for toenail fungus. He left private practice (boo hoo) to pursue a new career. I have misplaced the recipe. Do you happen to have one? Thank you! Evelyn
aoeditor on June 17, 2022 at 3:53 pm (Edit)
Greetings Evelyn,
I am going out on a limb here and guess the arthritis is in your midfoot (arch joints). Even creeping farther out on that limb, I would guess you have had plantar fasciitis in the past. Couple that with the “marble” under your second metatarsal head and you have the common denominator I continue to talk about- equinus. Yes, calves that are silently too tight can cause all that and they do. So, the exercise is stretch your calves. Believe it and be patient and you will not be disappointed.
To be honest, I do not quite understand mechanically how the earth shoe might help anyone, at least in the short run, but I know it has helped some of my patients. I could see that in the long term a negative heel shoe might stretch the calf, but minimally. Having said that, keep wearing them for short term help.
Fungal nails is another mystery, which of course makes me angry. I do not have a secret sauce.
Stretch, stretch stretch!
Stay healthy, my friends,
AO
Eric on August 22, 2022 at 9:48 pm (Edit)
I have plantar fasciitis and have been seeing a PT. He’s been having me do some calf stretching (not your kind, against a wall – a straight leg calf stretch and a bent leg calf stretch), calf raises, and balancing on one leg. The balancing is because he suspects the PF has something to do with over-pronation while running, so the balancing is to have me focus on standing on one leg without my ankle rolling in.
These things have been helping but I’ve also started your stretching protocol in addition to these things. My question had to do with the over-pronation I mentioned. When I do your stretch, with the arch on the stair, it feels like I can get a deeper stretch if I let my foot pronate but my instincts tell me I should keep my foot in a more neutral position. Any thoughts on this?
Eric on August 30, 2022 at 2:02 pm (Edit)
I have plantar fasciitis which a PT suggested may have been caused by over-pronation while running. He prescribed calf stretching against the wall (both straight leg and bent knee stretching) as well as calf raises. He also has me practicing balancing on one foot, focusing on not letting my ankle roll in.
I’ve recently started your trying your stretching method as well and I was wondering if it matters whether I let my feet pronate while I stretch. It feels like I can get a better stretch if I pronate a bit while stretching but if my problem does have something to do with over-pronation then I’m wondering if I want to do this stretch with my feet in a more neutral position?
aoeditor on August 31, 2022 at 7:37 am (Edit)
Hi Eric,
Podiatrist and PTs are fixated on pronation, and I do not know why. Generally speaking, flexible flatfeet or pronation is part of our anatomy, some more, some less and some not at all and that can’t be recouped except with surgery, which is silly and dangerous, unless there are significant symptoms (entirely different subject and discussion). Here is the thing, equinus or calves too tight is the primary driver increasing pronation or the forces of pronation. So, definitely stretch those calves, my way. I would focus on just the stair stretch. The soleus, bent knee stretch is a wast eof time and will not address your problem.
So, don’t be concerned with pronation while stretching, just let it happen. Furthermore, attempts to force a normal arch, reduce pronation with the balancing or intrinsic strengthening, or other maneuvers is just busy work and will not be of benefit. Keep your eye on just one ball- equinus. You are feeling the stretch and that is where the money is Eric.
Keep it simple my friend.
Stay healthy, my friends,
AO
Eric on September 1, 2022 at 10:32 am (Edit)
Thanks for the reply. One more question … my plantar fasciitis showed up after an injury while back squatting. I went down on a back squat and I felt a pain on the outside of my leg a little bit below the knee cap (near the head of the fibula). For a few weeks I couldn’t squat (bodyweight or otherwise) … any time I went below parallel I had pain in that same area on the outside of the knee.
Squatting down hurt. Getting up out of chairs hurt. That took about 3 weeks of rest (no squatting, no running) to get better. After that I started running again … my knee was fine but my foot started hurting after running. The pain wasn’t bad at first but it gradually got worse and worse until I decided I needed to go see the PT.
Knowing that background info, does that change anything? Would you still point to equinus as my main issue?
aoeditor on September 1, 2022 at 12:30 pm (Edit)
Eric,
First of all, the diagnosis of plantar fasciitis is all that is needed to know that equinus is the root cause. Equinus is the only cause, in my opinion. For some reason my colleagues love to make things way more complicated. Pity.
That story only makes one more sure that equinus is the problem and calf stretching the solution.
Please have a look as to why your “down time” accelerated your equinus and thus your plantar fasciitis.
The Gastrocnemius : A New Paradigm for the Human Foot and Ankle
Now you got work to do!
Stay healthy, my friends,
AO
Rosie on May 1, 2023 at 2:02 am (Edit)
April 2021 I developed PF in my left foot. I had never ever had pain like it. I immediately sought advice from a sports massage therapist and she indeed said I had tight calf’s and worked on them for the entire session . She gave me some stretches to do using the stairs , but nothing like the 3 minute stretches .The following week , whilst walking my dogs I fell down a rut in the grass and I felt a pop. The pain was like nothing else. I was in tears. How I got home I don’t know. I was taken to hospital for an X-ray fortunately nothing broken despite huge swelling , I was given crutches and told to ice and rest etc.A couple of weeks later the swelling had subsided and some of the pain , so I started to do little stretches again and went back to my sprouts massage lady.I have no idea what I did , but guessed maybe tore the plantar ???This is when I discovered your blog.I tried to do the stairs , but found it so hard so after more research I found calf rockers. I bought two and also a night splint. Oh my goodness how the rockers made the stretching job easier. I set my timer and religiously did the three minute stretches x 3. Within a few weeks the pain lessoned and I was able to walk the dogs ok. Three months later my pain had dropped from 10 to about 2-3. Each month got easier and apart from odd twinges I felt cured.This is when I became lazy. As the pain was virtually gone I stopped my stretches. I did them occasionally when I thought about it , but not how I should.Fast forward to November 2021. The pain returned to about a 7-8 . Out came the rockers and I resumed the three minute stretches. This time the pain went much quicker.Into 2022. I was moving house and had loads going on and I stupidly stopped the stretches again.I had a whole year with virtually no pain unless I did excess walking etc.Strangely the pain I had was on the top of my foot not the heel or plantar. It felt like I had tightened my laces too much.
So Fast forward to April 2023. The plantar fasciitis came back with a vengeance in BOTH feet this time the right foot more than the left. . I was in tears again. Barely able to walk. My rockers had been put in the garage when I moved house. I unearthed them and restarted the stretches. It was so hard this time. It felt like there was no looseness as at. !!So the moral of this story is NEVER EVER stop stretching your calf’s once you’ve had PF.I will never ever stop.I was stupid and admit that. But the stretches do work and I wouldn’t be in this pain and state now if only I had listened more to you.
Angry Orthopod on January 18, 2024 at 1:42 pm (Edit)
Hi Rosie,
Big apologies for such a late response. WordPress decided to stop sending me alerts on comments, and for me , out of sight, out of mind. Needless to say, it made me angry. Better late than never.
Just a bit of very important info. I am a Bart’s man. I was a Sr. Registrar orthopaedic surgeon at St. Bart’s in London for 6 months in 1984. Great time, great training. I just hated that folks had to wait so long.
I LOVE YOUR STORY!!! Especially your conclusion. You are not alone and definitely not stupid. I am stupid because my wife says I am- she’s always right. The stupid folks are the ones out there searching for every solution, quick and too often costly, that doesn’t work. Why do they not work??? Because these treatments do not address the root cause, equinus. You know that.
I hate to be “that guy”, but TOLD Y’ALL so. Rosie, your story is classic. I can’t tell you how many patients over 35 years practicing who recurred many times and finally figured that calf stretching was a life long endeavor for them.
Let me finish by giving you and everyone else out there in the AO Nation two more reasons to continue to stretch. First, you are in a category of about 20% who just get tight time after time and in an ideal world require stretching routinely. You found this out thru the school of hard knocks. I do not have a reason for this except that I have seen it too many times and everything seems to lie on a spectrum. My smart wife is in this group. Second, equinus causes 21 other things, so it is a possibility the next time it might be insertional Achilles tendinosis, midfoot arthritis, or posterior tibialis tendon dysfunction or any one of the 22 pathologies attributed to equinus. Rosie, I don’t need to tell you this, but everyone else- pay attention.
I have one request, Rosie. If you frequent Facebook, could you get on the Plantar Fasciitis Help and Support group and set those folks straight.
I hope you are well and active, if not, well…….I will be angry.
Stay healthy, my friends,
AO
Heidi on March 7, 2024 at 3:44 pm (Edit)
So I started your stretching protocol and ended up with wicked hamstring cramps the night after. Did the stretch in the evening. I think it over stretches the sciatic nerve causing problems if a person like me has issues with sciatica and neural tension. Any thoughts on that?
AngryOrthopod on March 25, 2024 at 9:43 pm (Edit)
Hi Heidi,
Now you have made me angry, at least your sciatic nerve has. While I have not encountered this issue, I have no doubts it is likely related to the stretching. No doubt it stretches the hamstrings to some degree, and thus the sciatic nerve could be receiving some friendly fire. I would say slow down on the intensity and the duration to let the sciatic nerve catch up so to speak. One additional thought is a lot of sciatic nerve issues are actually piriformis syndrome. I would encourage you to read up on that and look to YouTube for stretches for piriformis syndrome. I hope this helps.
Stay healthy, my friends,
AO
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