Plantar Fasciitis Rehab Workshop Recap - Why It Happens and Exercises That May Help

Sports Chiropractic Care · Long Beach, CA

We hosted our Plantar Fasciitis Rehab Workshop at Elite Motion Chiro in Long Beach, and it was a great turnout of people looking to finally understand, and fix their heel and arch pain. For those who couldn't make it (or want a refresher), here's a breakdown of everything we covered.

Dr. Andrew D.C., sports chiropractor in Long Beach, California

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Part 1

Plantar Fasciitis vs. Plantar Fasciosis: What's the Difference?

We started with something most people have never actually had explained to them: the difference between plantar fasciitis and plantar fasciosis. It comes down to the suffix.

"-itis" means inflammation. This is the acute, early-stage version of the condition, where the plantar fascia is actively inflamed.

"-osis" means a chronic, degenerative condition; one that is not primarily inflammatory. This is what's typically going on in cases that have lingered for months.

This distinction matters because treatment approaches differ depending on which one you're dealing with. Anti-inflammatory strategies make a lot more sense for true "-itis," while chronic "-osis" cases usually respond better to a rehab approach that emphasizes loading, tissue remodeling, and addressing the underlying mechanical factors driving the problem. Treating a chronic, degenerative case as if it were a simple inflammatory flare-up is a common reason people don't get better.

Part 2

The Three Arches of the Foot

Next, we talked about the foot's arch system, since the plantar fascia is directly tied to how these arches function. The foot actually has three arches, not just one:

1. The medial longitudinal arch: the one most people picture when they think of an "arch." It runs along the inside of the foot and plays a major role in shock absorption and energy return.

   
   

2. The lateral longitudinal arch: runs along the outside of the foot and helps with load distribution and stability, especially during weight shifts.

   
   

3. The transverse arch: runs across the midfoot and helps the foot maintain its structural integrity and rigidity, particularly during push-off.

Each arch has a slightly different job, but they all work together, and when one isn't functioning properly, it changes the load placed on the plantar fascia.

Part 3

Three Lower Body Factors That Make Plantar Fasciitis Worse

This was a big focus of the workshop: three specific factors in the lower body that, when outside of normal range, tend to aggravate or perpetuate plantar fasciitis.

1. Limited great toe (1st MTP) dorsiflexion. Normal range is roughly 65–75 degrees. When this is restricted, it limits something called the windlass mechanism: the mechanism that tightens the plantar fascia and helps stabilize the arch during push-off. Less big toe extension means more strain gets dumped onto the plantar fascia during gait.

   
   

2. Limited ankle dorsiflexion. Restricted ankle dorsiflexion, often caused by tight gastrocnemius or soleus muscles, is one of the strongest modifiable risk factors for plantar fasciitis. If the ankle can't bend forward properly, the body compensates elsewhere, and the plantar fascia often absorbs the difference.

   
   

3. Reduced calf strength and endurance. This is usually assessed with a single-leg heel raise test, looking at both the number of quality repetitions and how well the movement is performed. When the gastrocnemius-soleus complex is weak, the leg can't absorb and transmit force as efficiently, which increases the load placed on the plantar fascia with every step and stride.

The takeaway: plantar fasciitis is rarely just a "foot problem." It's usually a downstream result of restrictions and weaknesses further up the chain.

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Part 4

Exercises That May Help

We put these concepts into action with three exercises designed to directly target the areas above.

Great Toe Stretch: Using a small weight plate or a squat wedge, place the shoeless big toe on the wedge so that only the first joint of the toe is in contact. Keep the heel glued to the floor and press the knee forward, driving the great toe into extension. A few sessions per week, 5–10 minutes each, is a great starting point to help increase dorsiflexion of the big toes.

Cowboy Sit: This is a static, held position that drives the back foot into both great toe and ankle dorsiflexion at the same time. Hold this position for time a few times per week, alternating sides so the tissue gets adequate recovery between sessions.

Adductor Rock Back: While this is technically an adductor exercise, it also does a great job of driving dorsiflexion of the great toe and ankle on the side of the bent leg, making it a nice complementary movement to the other two.

Part 5

Why This Matters

Plantar fasciitis and plantar fasciosis are some of the conditions we treat most often at Elite Motion Chiro, and we see firsthand how much it can limit people, whether that's walking around the house, getting back to running, or simply standing at work without pain. Our goal is always the same: help patients regain their independence and get back to doing the activities they love, without relying on band-aid fixes that never address the real cause.

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Disclaimer: This blog post is intended for educational purposes only and is a recap of information shared at our workshop. It is not a substitute for a professional medical evaluation. If you're experiencing any of the red flag symptoms listed above, seek emergency medical care immediately.