'I am limited in my activities due to chronic plantar fasciitis but need to do weight-bearing activities. Is the elliptical machine considered weight-bearing? How about walking with Nordic walking poles?"

— Lisa Clement, Oakland

You are on the right track regarding weight-bearing activities. Resistance training (the use of free weights, resistance bands, and weight-lifting machines) is usually the first activity that springs to mind. But activities such as dancing, aerobics, jogging, walking, push-ups, and hiking — where our feet and legs (and bones) work against gravity to carry our weight — are also considered weight-bearing.

Since the elliptical machine is utilized from a standing position, it is definitely considered "weight bearing." Walking with poles is an excellent activity on many levels, including strength and cardiovascular.

The larger situation for you is plantar fasciitis, which is a painful inflammation of the connective tissue (fascia) that runs along the bottom of the foot from the heel bone to the base of each toe. The plantar fascia is critical for stabilizing the foot when walking and running and also absorbs some of the shock created when the foot strikes the ground. Every time the foot moves, the fascia stretches and contracts.

PF has a number of causes such as arthritis, a sudden increase in time spent on your feet, an increase in intensity of activity, using

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shoes that are worn out and/or ill fitting, and weight gain. Other causes are more related to general foot mechanics that are particular to each person, such as pronation, tight Achilles tendons and calf muscles, natural arches that are low or high, or an abnormal gait in the way the feet strike the ground.

Relieving the pain of PF usually requires a combination of anti-inflammatory drugs, massage, and stretching techniques. Rather than wasting time experimenting, it is best to first consult a medical professional who can provide an accurate diagnosis and a referral to either a physical therapist or other professional who can teach the appropriate exercises for your situation.

According to a study published in the Journal of Bone and Joint Surgery in 2003, a new stretching technique has been very helpful in reducing pain in the heel. This should be done first thing in the morning, after sitting for 30 or more minutes, and an additional three times per day:

1. Cross one leg over the other.

2. With your hand, gently pull the toes toward the shin for a count of 10.

3. Repeat 10 times.

Strengthening exercises to improve the resilience of the plantar fascia and strengthen the muscles of the foot and leg are also called for as a way to prevent reoccurrence. Two exercises recommended by sports injury specialists Owen Anderson, Ph.D.; and Walt Reynolds, Certified Strength and Conditioning Specialist (www.SportsInjuryBulletin.com) are:

1. Walking barefoot on your toes.

2. Toe grasping, where you stand barefoot and alternately curl the toes under as if you are trying to grab something and pull it under your foot.

Resources:

"The 5-Minute Plantar Fasciitis Solution," Jim Johnson, P.T., Dog Ear Publishing, 2008, $29.95.

"21st Century Complete Medical Guide to Plantar Fasciitis and Related Heel Disorders and Injuries," Progressive Management, 2004, $25.

Linda Buch is a certified personal trainer. E-mail her at Linda@LJBalance.com.