Feet and heels
Plantar fasciitis stretches, and the loading that belongs beside them
The stretching that carries the strongest evidence for plantar fasciitis is specific rather than general, and the current guideline puts foot and ankle strength work alongside it rather than after it.
Clinically reviewed by Lee Albert, NMT · 8 August 2026
Two stretches, and most routines only do one of them
The plantar fascia is a thick band running along the sole of the foot, from the heel bone forward to the base of the toes. It is not a muscle, so it does not lengthen the way a hamstring does. What a stretch changes is how much tension the tissue and the toe joints will accept, and there are two separate places to change it.
The reference guideline names both, and treats them as one recommendation. The first is a calf stretch, which reaches the gastrocnemius and soleus and the Achilles behind them. The second is a plantar-fascia-specific stretch, defined in the guideline as pulling the toes back into extension while pressure sits across the ball of the foot. Almost every routine has the calf stretch in it. The toe-extension one is the half that gets left out, and it is the half that is specific to this problem.
Why it is loudest first thing, and what that says about load
The guideline's own diagnostic description is precise: heel pain on the inside of the sole, most noticeable with the first steps after a period of inactivity, and also worse after long spells of weight-bearing. It is commonly precipitated by a recent increase in weight-bearing activity. Limited ankle bend, running, and work that involves a lot of standing are among the listed risk factors.
The name is misleading and the guideline says so. Despite the ending, the tissue change is understood to sit on a spectrum that includes both inflammatory and degenerative features rather than being a straightforward inflammation. That matters practically, because it is the difference between a problem you wait out and a problem you load carefully.
The half that is not stretching
The 2023 revision of the guideline added something the older versions did not have: a recommendation that clinicians prescribe therapeutic exercise including resistance training for the muscles of the foot and ankle. Strength moved from a may into a should.
Underneath that sits a set of trials worth reading honestly rather than selectively. In one randomised trial, high-load strength training using slow heel raises beat plantar-specific stretching on the Foot Function Index at three months by 29 points, and the two groups were no different at one, six or twelve months. In a separate trial, a strengthening programme and a stretching programme both reduced pain with no significant difference between them.
So the fair reading is not that strength replaces stretching. It is that both do something, they are not interchangeable, and a page offering only stretches is offering half of what the guideline now recommends.
The sequence
- 1
Lower body warm up, raised sitting · 3 to 4 minutes
Mobilises the ankle, knee and hip in sequence from a raised seat, with no weight through the heel. A foot that has been still since morning tolerates a stretch better than a cold one.
- 2
Downward dog, hands on the wall · 60 to 90 seconds
The calf half of the grade A stretching recommendation, at partial load. Hands on the wall keeps most of the body weight off the heel, which is the difference between stretching the calf and pressing on a sore spot.
- 3
Toe squat · Start at 30 seconds, build toward 2 minutes
The plantar-fascia-specific half, and the one most routines skip. Kneeling with the toes tucked puts the toes into extension with pressure across the ball of the foot, which is exactly how the guideline defines it. Build the hold gradually.
- 4
Short foot, arch lift · 30 to 60 seconds each foot
Draws the ball of the foot toward the heel to dome the arch, without curling the toes. This is the intrinsic foot work the resistance-training recommendation is built on. The library keeps it at gentle effort while the fascia is reactive, so treat effort as adjustable and sensation as the limit.
- 5
Posterior tibialis strengthening · 30 to 60 seconds each side
Tibialis posterior controls the mid-foot as weight lands, and supports the arch from the inside of the ankle rather than from under the sole.
- 6
Heel raise, block between the heels · 30 to 60 seconds of slow repetitions
The library's primary loading movement for this pattern. The block keeps the heels honest so the load goes through the calf and the arch rather than rolling to the outside of the foot.
- 7
Heel raise · 30 to 60 seconds of slow repetitions
The movement the high-load strength evidence is actually built on: a slow raise with the lowering taking about three seconds. The trial protocol used one leg with a towel under the toes, which is where this progresses to rather than where it starts.
- 8
Legs up the wall, knees bent · 5 minutes or longer
Takes every gram of load off the foot and asks nothing back. Not treatment, and not pretending to be: a place to finish on a day when the foot has already had enough.
About twenty minutes, and two stretches plus one strength item is a legitimate short version on a busy day. Protect the strength items rather than the stretches when time is short, because they are the part the 2023 guideline added and the part most home routines drop. One movement is deliberately absent: the step version of the heel raise, where the heel travels below the level of the toes, is marked as a caution for the plantar fascia in the Vinys library, because sustained loading of the forefoot in that position can stir up an active heel. It is a progression for a settled foot, not a starting point.
What the research says
The reference document is the American Physical Therapy Association's clinical practice guideline for heel pain and plantar fasciitis, revised in 2023. Its stretching recommendation carries grade A, the strongest grade it awards, and the wording is specific: clinicians should use plantar fascia-specific and gastrocnemius or soleus stretching to provide short and long term pain reduction, as well as to improve short and long term function and disability. The guideline defines the plantar-fascia-specific stretch as one that pulls the toes into extension with pressure applied across the ball of the foot, and the calf stretch as ankle bend with the knee straight for the gastrocnemius and bent for the soleus.
On the exercise side, the 2023 revision gives grade B to prescribing therapeutic exercise that includes resistance training for the musculature of the foot and ankle, an upgrade on the 2014 wording. The trial evidence behind it is mixed in an interesting way. Rathleff and colleagues randomised 48 people with ultrasound-confirmed plantar fasciitis to shoe inserts plus daily plantar-specific stretching, or inserts plus high-load strength training every second day using unilateral heel raises with a towel under the toes. At the three month primary endpoint the strength group's Foot Function Index was 29 points lower, a large effect, and at one, six and twelve months there was no difference between the groups. Thong-On and colleagues randomised 84 people to strengthening or stretching and found both improved worst pain, morning pain and walking speed, with no significant difference between them.
The guideline is also clear about what does not carry its own weight. Taping gets grade A, but explicitly in conjunction with other treatment. Orthoses get a negative grade B as an isolated treatment for short-term pain relief, and only a grade C may when combined with other treatment. Night splints get grade A as a one to three month programme, specifically for people who consistently have pain with the first step in the morning. None of this is about Vinys and none of it endorses it. What it describes is a plan with several parts, in which the stretching is the part you can do at home and the part that has to be specific to be worth doing.
Sources
- 1Koc et al., Heel Pain and Plantar Fasciitis: Revision 2023, APTA clinical practice guideline (Journal of Orthopaedic and Sports Physical Therapy, 2023)
Clinicians should use plantar fascia-specific and gastrocnemius/soleus stretching to provide short and long term pain reduction and to improve short and long term function and disability, a grade A recommendation.
- 2Koc et al., Heel Pain and Plantar Fasciitis: Revision 2023, therapeutic exercise recommendation
Clinicians should prescribe therapeutic exercise that includes resistance training for the musculature of the foot and ankle, a grade B recommendation new to the 2023 revision.
- 3Rathleff et al., high-load strength training improves outcome in patients with plantar fasciitis, randomised controlled trial with 12-month follow-up (Scandinavian Journal of Medicine and Science in Sports, 2015)
High-load strength training using slow unilateral heel raises produced a Foot Function Index 29 points lower than plantar-specific stretching at the three month endpoint, with no difference between the groups at one, six or twelve months.
- 4Thong-On et al., effects of strengthening and stretching exercises on temporospatial gait parameters in patients with plantar fasciitis, randomised controlled trial (Annals of Rehabilitation Medicine, 2019)
Both a strengthening programme and a stretching programme significantly reduced worst pain and morning pain and improved gait, with no significant difference between the two groups on any parameter.
Common questions
What is the best stretch for plantar fasciitis?
The guideline does not name one, it names two, and gives them a single grade A recommendation between them: a plantar-fascia-specific stretch, which pulls the toes back into extension with pressure across the ball of the foot, and a calf stretch through the gastrocnemius and soleus. The toe-extension one is the one most routines leave out.
Should I stretch the calf or the foot?
Both, and they are not substitutes. The calf matters because limited ankle bend is one of the listed risk factors, so a stiff calf changes how much load reaches the heel. The plantar-fascia-specific stretch is the one aimed at the tissue that is actually sore.
Why is it worst with the first steps in the morning?
That pattern is part of the formal diagnostic description: pain on the inside of the heel, most noticeable with the first steps after a period of inactivity, and also worse after long spells on the feet. It is common enough that the guideline gives a grade A recommendation for a one to three month night splint programme specifically for people who consistently get it.
Should I rest until it settles?
Nothing in the guideline recommends rest. The recommendations are stretching, manual therapy, taping alongside other treatment, and, since the 2023 revision, resistance training for the muscles of the foot and ankle. Complete rest leaves the tissue tolerating less when normal walking resumes.
Do insoles help?
The guideline is unusually blunt here. It recommends against using orthoses, prefabricated or custom, as an isolated treatment for short-term pain relief, and only says clinicians may use them when combined with other treatment. So insoles sit alongside the stretching and the loading rather than instead of them.
Can any of this be done sitting down?
Most of it. The warm up is built for a raised seat, the short foot and tibialis posterior work are seated by default, and the heel raises can be done seated or holding a counter. The toe squat needs the floor and the wall version of downward dog needs standing, so those two are the ones to swap.
Get heel pain assessed rather than stretched if it followed a specific injury or a fall, if the heel is hot and swollen, if there is numbness or pins and needles in the foot, or if both heels are involved alongside stiffness or swelling in other joints. Several other things cause pain in the same place. Stop any movement that produces sharp pain rather than a firm stretch, and see someone if the pain is not settling at all over time.
Also called plantar fasciitis stretches, stretches for plantar fasciitis, plantar fasciitis exercises, plantar fascia stretch, heel pain stretches, plantar fasciitis stretches for seniors. Movements are drawn from the clinically authored Vinys library. This page is general movement information, not medical advice, and it is not a diagnosis. How the method works.