Heel Pain, where to start
If you’re waking up with heel pain that makes those first few steps in the morning extra rough, or if it hits later in the day after walking the kids to school or during your workout, you’re not alone. Heel pain is a common issues I treat in my in-home physical therapy practice. It can stem from several causes, including muscle tightness, poor mobility, or overuse.
As a physical therapist, my goal is to help you get to the root of your pain, not just mask it. While every case is unique and should be properly evaluated by a skilled physical therapist, I want to share a few simple exercises and tools you can start using right away to find relief, improve mobility, and begin your recovery process from the comfort of home.
Start with Mobility
The first thing I do every morning when I sit at the edge of my bed is get my foot/ankle moving. Nothing fancy, just a little movement, some ankle pumps and a gentle stretch.
Mobility of the foot and ankle complex are important for overall tissue health and freedom of movement during our daily tasks. The next 3 movements are to help with blood flow and tissue tension and ankle mobility.
Toe Yoga: Eventually you should have enough control to alternate big toe and little toes but until then feel free to use your hands to help stabilize the other toes. Start with 2 sets of 10 and work up to doing several sets throughout the day.
Toe Yoga
2. Soft tissue work with massage stick (percussion tool or foam roll). Again nothing crazy just a couple minutes of target soft tissue work to address tissue tension and dysfunction in the large gastroc and soleus muscles.
3. Ankle Dorsiflexion rocking. This can be done kneeling or standing (with your foot elevated) and is to help get the ankle moving to help improve your walking pattern and squat depth. As you will see in the video I am rocking forward at 3 different angles - over the big toe, middle toes and little toe. I like to do 1-2 sets of 10 on each side as part of my rehab and/or my warm up before squatting.
Simple Strength Exercises to Support Recovery
Now that we have addressed mobility lets talk briefly about strength. Pain is often a sign that we have hit the barrier or threshold of the tissue and it is letting us know it needs some attention. If we want to push the barrier/threshold back further we have to increase the tissues resiliency and strength. The next few videos are just the tip of the iceberg and will show an easy way to get started on building tissue tolerance back up while you look for a qualified Physical Therapist to help you further on your journey to recovery.
Isometric hold calf raise.
Isometric exercises have proven efficiency at reducing pain and allowing us to activate muscles that can not yet tolerate full load or movement. The goal is a 45 sec hold for 5 rounds 1-3 times per day. It is okay if this is a little bit uncomfortable as long as the pain stays below a 6/10 and subsides within a few minutes of finishing the movement. If you are unsure ask a professional for guidance and you can always start smaller (30s x3) and build up to the ideal sets. Start with both feet on the ground and as you feel confident and safe progress to single leg holds.
Isometric calf raise: double and single leg
2. Full range calf raise with slow eccentric (lowering) phase: This is a great movement to progress to when you can achieve the full isometric sets and do not have an increased pain response
I like to have patients start out with both feet on the ground and work on a 5 sec lowering phase. Reps vary on this movement and we are looking for fatigue. If you can do more than 15 reps we need to make it more challenging.
The next progression is a 2 up and 1 down movement, again with a 5 sec lowering phase.
Progression 3 is a single leg up and down, still with a 5 sec lowering phase.
Calf raise: double leg, 2up 1 down, single leg
Heel pain can take time and consistency to overcome, but it’s absolutely possible to heal with the right approach. You live with your feet full time, so take the time to invest in your recovery. The key is a mix of mobility, strength, and proper load management, and knowing when to get help.
If your heel pain isn’t improving, or you’d like a more personalized plan, I’d love to help. Through in-home physical therapy, I bring expert, one-on-one care directly to you so you can focus on recovery in a comfortable, supportive setting. You don’t have to just live with foot or heel pain, lasting relief and confident movement are possible with the right care.
