When and How to Stretch
For many if not all of the conditions in this manual, calf stretching is one of the cornerstones of treatment. Mann asserts that wedged heels, arch supports, or heel cups are ineffective in the face of a tight heel cord unless the calf is assiduously stretched. Patients need to be taught repeatedly how to stretch.
All patients in my practice who are taught how to stretch are followed up in 1 month to check their progress. At that visit, they are asked to demonstrate proper calf stretching technique. One hundred percent of patients demonstrate improper technique and have to be retaught.
Even when patients are told beforehand that they will be asked to demonstrate proper stretching, 100% will still not stretch their calves correctly. Calf stretching, if done for less than 30 seconds, actually tightens the calf muscle, making the problem being treated worse. Only the muscle stretches, not the tendon. If a person feels the stretch in the heel or in the Achilles tendon, he or she is pushing too hard.
Calf stretching should be done with the toes pointing toward the wall and not externally rotated. Otherwise, the foot bends at the talonavicular and calcaneocuboid joints and the calf muscle is not stretched. Also, it is best if the patient wears his or her orthotic while stretching. Calf stretching should be performed five times per day.