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Foot Ligament Injury

Plantar Fasciitis Physical Therapy: Rathleff Protocol

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Posted 2 years ago


Last updated: 07/11/2023


by James McCormack

James McCormack
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Plantar Fasciitis Physical Therapy

Plantar Fasciitis is a painful condition defined by pain under the heel, on the inner side, and along the medial arch of the foot. It is made worse by impact activities, and over time, there is a physical change in the structure of the Plantar Fascia connective tissue that decreases its loading capacity.

To address these changes, strengthening exercises are the most effective treatment for Plantar Fasciitis. In particular, an evidence-based rehabilitation protocol by Rathleff et al. (2014) has been demonstrated to be the most effective Physical Therapy Protocol for Plantar Fasciitis.

Our aim in this article is to show you the protocol, but please keep in mind that this is only one form of treatment for Plantar Fasciitis. It is a complex condition, and various treatment methods are often combined to resolve the symptoms of Plantar Fasciitis.

Rathleff Protocol: Heavy Load Strength Training for Plantar Fasciitis

The Rathleff Protocol is a set list of modified calf raises using a rolled towel under the big toe. The function of the towel is to place a stretch on the Plantar Fascia, which bias the heel raise towards the Plantar Fascia rather than the calf muscle, although both work in tandem.

Rathleff Protocol:

Below you will see each week the repetition count will decrease per set while the sets increase.

  • Sets: 3-5
  • Repetitions: 8-12
  • Frequency: Every 48 hours
  • Length: 8-12 weeks



Week 1-2

Repetitions: 12

Sets: 3

Week 3-4

Repetitions: 10

Sets: 4

Week 5-12

Repetitions: 8

Sets: 5

How to Perform a Repetition:

  • Roll up a towel and place it on a step
  • Place your toes on the towel so they are extended with your heels over the edge of the step
  • Slowly raise your heels as high as possible
  • Slowly lower your heels below the height of the step to complete one repetition
  • This can be carried out on one leg if possible or two if it is too painful to do on one.

Physiotherapy with James McCormack

This article is written by James McCormack, a Lower Limb Specialist who is an expert in treating Plantar Fasciitis.

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack if you are experiencing any of the symptoms discussed in this article. James offers Online Physiotherapy Appointments weekly and face-to-face appointments in his London clinic.

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