Big Toe Extension Stretch
DiGiovanni and colleagues (2003) found in a randomised trial that plantar-fascia-specific stretching (using big toe extension as the lever) gave significantly better results for worst pain and first-step pain at 8 weeks than weight-bearing Achilles tendon stretching in chronic plantar fasciitis. At two years (DiGiovanni 2006), after the Achilles group had also moved to the fascia stretch, the groups no longer differed. The windlass mechanism, toe extension wraps the fascia under the metatarsal heads, is the proposed active principle.
How to do it
- 1
Sit comfortably and cross your right ankle over your left knee
Ankle over knee
- 2
Use your right hand to support the foot, your left hand to take hold of your big toe
Hold the big toe
- 3
Gently pull the big toe back toward your shin (extension)
Toe toward shin
- 4
Use your other hand to press lightly on the arch to feel the fascia engaging
Feel the fascia tighten
- 5
Hold 30 seconds. Then switch feet
Switch sides
The evidence
DiGiovanni and colleagues (2003) found in a randomised trial that plantar-fascia-specific stretching (using big toe extension as the lever) gave significantly better results for worst pain and first-step pain at 8 weeks than weight-bearing Achilles tendon stretching in chronic plantar fasciitis. At two years (DiGiovanni 2006), after the Achilles group had also moved to the fascia stretch, the groups no longer differed. The windlass mechanism, toe extension wraps the fascia under the metatarsal heads, is the proposed active principle.
Citation: DiGiovanni BF, Nawoczenski DA, et al. (2003). Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. Journal of Bone and Joint Surgery (American) · DOI: 10.2106/00004623-200307000-00013