Plantar fasciitis, or PF, is a common cause of heel and foot pain. The plantar fascia is a band of tissue — called a fascia — that runs under the foot from the heel bone (calcaneus) to the toes, supporting the arch of the foot. When the plantar fascia becomes irritated or swells, or becomes inflamed, it causes pain, usually in the bottom of the heel and the adjacent parts of the foot. Morning and after a long period of rest / inactivity are usually the worst. PF also typically causes foot pain after exercise, especially activities involving running, jumping or stair climbing, and may also cause pain after standing for long periods.
Foam rolling, also known as self-myofascial release, is a technique for releasing muscle tension and increasing movement. By rolling over various parts of the body with a foam roller, pressure is applied to soft tissues such as muscles, tendons and ligaments. Foam rolling is practiced by athletes and patients of physical therapists to reduce muscle pain and help the body recover from exercise. Many people also use foam rolling to alleviate pain from injuries and conditions, such as plantar fasciitis.
From the science behind the “why”, we know that the mechanisms of action of foam rolling could be vastly more complex than what we currently give it credit for. For one, we know that foam rolling can alleviate pain instantly for those suffering from plantar fasciitis. In a study titled, “Effect Of Foam Rolling On Pain And Ankle DorsiFlexion Range Of Motion In Individuals With Plantar Fasciitis: A Randomized Controlled Trial”, Ranbhor, Prabhakar, and Eapen (2021) found that applying foam rolling resulted in a decrease in pain and an increase in ankle ROM. This translates to immediate increased ability to perform functions such as lifting the toes up towards the knees and walking.
Muscle flexibility is another aspect that is addressed in the video. Just like stretching the muscles in your foot can help alleviate the painful symptoms of plantar fasciitis, applying myofascial release to muscles throughout the body (such as using a foam roller) can also increase muscle flexibility. As Cheatham and colleagues demonstrated in their 2015 study, applying foam rolling to the plantar fascia and surrounding muscles improved plantar flexor flexibility. Using muscle stretching techniques similar to those you can do for your foot to other parts of your body can promote greater overall mobility, especially for runners who have developed muscle imbalances due to overuse.
Another benefit of using a foam roller for foot care is that it can improve how you distribute your weight and manage pain. In a 2018 study, Rambhia and her team used a foam roller to see how it could help evenly distribute a person’s weight to alleviate pain. The results show that it is an effective tool in making sure that you are placing weight evenly on your feet, and can help alleviate the pain associated with conditions like plantar fasciitis. Using a foam roller also helps to release tension on specific areas, allowing you to walk comfortably all day long.
In relation to other forms of treatment for plantar fasciitis, foam rolling may have several advantages. For starters, it is likely to be as or more effective than conventional physical therapy according to research by Hameed and Srivastava (2020), which found that foam rolling could improve outcomes comparable to those of traditional physical therapy while being conducted independently by the individual. This make shift virtually at your fingertips a highly accessible and convenient recovery modality.
Review of the evidence confirms that mechanical treatments like foam rolling are effective for improving symptoms of pain due to myofascial tension. A systematic review by Schuitema et al. (2019) that included 18 scientific studies concluded that foam rolling is an effective approach for myofascial release and treating pain, and can be a useful self-care technique. Most treatments involving foam rolling include release of the plantar fascia and the gastrocnemius (one of the two major calf muscles), and there are several different approaches that can be taken. According to Mohamed et al. ( 2024), one to two minutes of gentle rolling of the plantar fascia is indicated. Starting at the heel and moving toward the toes is best. Release of tension in the calf muscles is also useful. To do this, sit on the floor and place the foam roller under your calf, starting at the knee. Roll toward your ankle slowly, and then roll back toward your knee slowly. Repeat for several sets to release tension in the gastrocnemius and increase its flexibility.
In addition to stretching and utilizing massage tools like a lacrosse ball to release tension in the foot, bodyweight exercises, taping, and compression bandages can all help to alleviate the pain associated with plantar fasciitis. The video demonstrates various methods that can help alleviate pain and allow for improved activity levels. Personal anecdotal evidence from others who suffer from PF shows similar results. Many experience a dramatic reduction in pain levels in as little as a few sessions of these simple exercises. Boob Jr. et al. ( 2023). One user noted that after using these exercises for a few days, he could now walk without a limp.
Additionally, incorporating foam rolling into existing treatment regimes has also shown benefits. Gala et al. ( 2021) reported improved outcomes in individuals who used foam rolling in conjunction with stretches and strengthening exercises.
One individual reported that incorporating foam rolling into her physical therapy resulted in her being able to once again partake in activities and hobbies she loves, such as running and hiking, without pain.
The many benefits of foam rolling for personal recovery have been discussed at length in Yoshimura et al. ( 2020). Many stories were shared on the numerous improvements that individuals experienced within a short period of time after incorporating foam rolling into their recovery. Two particularly notable examples include the relief experienced from severe pain when rolling the bottom of the foot and the large decrease in pain that some individuals experienced in as little as a few months with just a few sessions of foam rolling. These improvements are not only physical, but also emotional as individuals are able to regain function and face daily activities without pain.
While many swear by the benefits of foam rolling, it is no one-size fits all activity. According to Trojian and Tucker (2019), “the effectiveness of foam rolling is highly individualized,” meaning that the severity of symptoms, the physical status of the individual, and various other factors can play a role in tailoring the activity. As with any exercise or recovery modality, what works for one person may not be the same for another, which means it is up to the individual to listen to their body and fine tune the method to best suite their specific needs.
While foam rolling is not a panacea for plantar fasciitis, it can be a valuable modality when implemented as part of a broader treatment program. By choosing the most appropriate techniques for the given individual and pairing them with other interventions, people with plantar fasciitis can benefit from improved foot mobility and decreased pain.
Citations:
Ranbhor, A.R., Prabhakar, A.J. and Eapen, C., 2021. Immediate effect of foam roller on pain and ankle range of motion in patients with plantar fasciitis: A randomized controlled trial. Hong Kong Physiotherapy Journal, 41(01), pp.25-33. https://www.worldscientific.com/doi/abs/10.1142/S1013702521500025
Boob Jr, M.A., Phansopkar, P., Somaiya, K.J. and Boob, M.A., 2023. Physiotherapeutic interventions for individuals suffering from plantar fasciitis: a systematic review. Cureus, 15(7). https://www.cureus.com/articles/169471-physiotherapeutic-interventions-for-individuals-suffering-from-plantar-fasciitis-a-systematic-review.pdf
Mohamed, A.S., El Gendy, M.H. and Sedhom, M.G., 2024, July. COMBINED EFFECT OF FOAM ROLLER AND GASTROCNEMIUS RELEASE ON PLANTAR FASCIITIS. In International Physical Therapy Conference-Cairo University (Vol. 3, No. 1, pp. 86-99). Cairo University, Faculty of Physical Therapy. https://journals.ekb.eg/article_456814.html
Hameed, F.S. and Srivastava, S., 2020. Effect of Self Myofascial Release Using Foam Roller Versus Tennis Ball in Subjects with Plantar Fasciitis: A Comparative Study. Indian Journal of Public Health Research & Development, 11(2). https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=09760245&AN=145355833&h=IClCo%2FL90joU9%2FB9rhyE%2F8GML2SbCuCUTIZvoqcAir8PD5a0d%2BK9SVdt9hkievAFjSvR0WI4XetZzqBIm5Nk0g%3D%3D&crl=c
Rambhia, I., Athavale, N., Shyam, A. and Sancheti, P., 2018. Immediate effect of foam rolling on pain and weight distribution in patients with plantar fasciitis: A pilot study. Int J Physiother Res, 6(2), pp.2671-5. https://www.researchgate.net/profile/Parag-Sancheti-3/publication/324456086_IMMEDIATE_EFFECT_OF_FOAM_ROLLING_ON_PAIN_AND_WEIGHT_DISTRIBUTION_IN_PATIENTS_WITH_PLANTAR_FASCIITIS_A_PILOT_STUDY/links/5ff43530a6fdccdcb82ef32b/IMMEDIATE-EFFECT-OF-FOAM-ROLLING-ON-PAIN-AND-WEIGHT-DISTRIBUTION-IN-PATIENTS-WITH-PLANTAR-FASCIITIS-A-PILOT-STUDY.pdf
Trojian, T. and Tucker, A.K., 2019. Plantar fasciitis. American family physician, 99(12), pp.744-750. https://www.aafp.org/pubs/afp/issues/2019/0615/p744.html
Schuitema, D., Greve, C., Postema, K., Dekker, R. and Hijmans, J.M., 2019. Effectiveness of mechanical treatment for plantar fasciitis: a systematic review. Journal of sport rehabilitation, 29(5), pp.657-674. https://journals.humankinetics.com/view/journals/jsr/29/5/article-p657.xml
Gala, M., Kulkarni, P. and Kumar, A., 2021. Comparison of immediate effect of plantar fascia release by roller massager and transverse friction massage on hamstring flexibility in desk job workers. Int J Physiother Res, 9(4), pp.3954-59. https://pdfs.semanticscholar.org/c5ce/f336c5facb05cbdadfcc80450a5ef96e1d3e.pdf
Yoshimura, A., Schleip, R. and Hirose, N., 2020. Effects of self-massage using a foam roller on ankle range of motion and gastrocnemius fascicle length and muscle hardness: a pilot study. Journal of sport rehabilitation, 29(8), pp.1171-1178. https://journals.humankinetics.com/view/journals/jsr/29/8/article-p1171.xml
Cheatham, S.W., Kolber, M.J., Cain, M. and Lee, M., 2015. The effects of self‐myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and performance: a systematic review. International journal of sports physical therapy, 10(6), p.827. https://pmc.ncbi.nlm.nih.gov/articles/PMC4637917/
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