I've had a pair of Vibrams for quite awhile, but never expected my good friend and longtime sports doc to tell me they are responsible for my current (and quite severe) case of Plantar Fasciitis...
He tells me the increased musculature of my calves has contributed to the tightness in my achilles tendon and in my plantar fascia... and this is why I am currently waking up every morning in pain for the first 2-3 hours of the day. This would coincide with the symptoms, which started to occur about a week after a family theme park trip where we walked up to 14 miles a day... and I was in VFF's every day.
So after 1 1/2 months of self-treatment via stretching, icing, and massage... I have reluctantly filled my scripts for a topical anti-inflammatory, an oral anti-inflammatory, in addition have been instructed in some aggressive stretches, and a Strassberg SocK (which thusfar has proven useless as it stretches mid-foot but not ankle where my flexibility is lacking). I'm wondering how far I should take the treatment, as I am normally quite opposed to pretty much any "painkilling" drug, but am very close to making this exception.
At this time... I've yet to take the anti-inflammatory. It is apparently very aggressive (indomethicin (sp)) and a stomach irritant.
I finally got it under control.
Stretching the calf and ankle by placing my toe on a curb or step, then leaning forward with a locked knee. Also looping a belt around the balls of my feet and knee to stretch the begeezus out of the ankle and achilles.
Asian Squats, as often as possible (I work on computers for a living so when going to someone's desk I'd push their chair out of the way and squat).
Rolling a frozen waterbottle on the floor similar to a foam roller but much more aggressively.
And actually taking my doc's advice and using the anti-inflams when the pain was on the more severe side. Don't take them now, but since posting this question I've probably taken them 5-6 times.
As a licensed massage therapist, when people see more for plantar fasciitis, I generally have to beat the living crud out of their calves, hammies and glutes. The stretches you have been instructed to do I'm sure are great but if the soft and connective tissue are extremely tight, stretching could potentially cause more micro-tears.
I suggest receiving therapeutic massage (Waslaski Orthopedic style, for example) which sounds like you have a script for. I also advise my folks to use anti-inflamms if tolerated and prescribed by a doc. I like the topical anti-inflamm, but you can also explore Tiger Balm and arnica. Oral anti-inflamms need to be taken with care.
Can you estimate your ankle dorsiflexion past 90 degrees? Are both feet affected, or just one? Is there a side-to-side difference in the amount of dorsiflexion you have?
Do you have any hip tightness? External/internal rotation deficits? Any asymmetries?
Are you doing any foam rolling or self-myofascial release on your calves?
Do you lift any weights? My own PF seemed to resolve more quickly once I started squatting and deadlifting. In my case, I think I had some severe strength deficits that were contributing to excess strain on the structure of the foot.
For your achilles tendon: are you doing any eccentric calf raises? Those seemed to help me when I had an AT problem.
Finally: my own ankle dorsiflexion issues did not improve at all until I started these two protocols as explained by Bill Hartman: mobilization with strap (KStar has a similar one on mobilitywod but with a band -- I prefer the strap), and miscellaneous soft tissue and mobilizations. The one with the strap was especially helpful for me -- may not be the case with you, depending on the source of your dorsiflexion issues. But it's worth a shot.
Best of luck. PF is a bitch.
Despite the accolades for barefoot, flat shoes or heel-down foot posture often advocated in paleo, I've learned (the hard way) that I NEED a bit of a heel, at least 1/2" to 1" or I have awful pains shoot through my arches. I do better walking with more pressure on the ball of my foot rather than the heel, and I'm talking about better for my feet as well as my legs and back and all over posture.
I also do better while hiking/etc. on uneven ground with ankle support, meaning high laced, sturdy boots. So maybe our very, very distant ancestors needed nothing, but maybe we've buggered the matrix since then. It sounds like you need genuine support, designed to work for YOUR system, not something that might have worked 10,000 years ago.
I had plantar fasciitis a couple of years ago. It seemed to develop pretty quickly after starting CrossFit. I never have owned any Vibrams, I ran in Nikes with all kinds of cushioning in them. What helped my pain was my husband taping up my feet with Kinesio Tape and rolling my feet around on a golf ball when I sat at my desk. It eventually went away as mysteriously as it started.
I treat this condition in my practice all the time. I suggest you find a good treatment oriented massage therapist that can deeply work your posterior calf muscles as well as your foot.Stretching alone is not sufficient.Icing for 15 min 2-3 times a day can help as well as a topical anti-inflammatory such as Inflamyar or traumeel (homeopathic). If the ankle restriction is due to misalignment a chiropractic adjustment may be in order. Heel cups and arch supports can be helpful during the acute phase as well.
Hmmm. My plantar fascitis and and achilles tendonitis resolved after getting my vibrams.
Either way though, I suspect there is something else inflammatory going on in your system - the two biggest culprits could be 1)n6 oils (nuts, veg oils, poultry, pork, eggs) and 2)excessive reliance on muscle meat to the exclusion of an apropriate amount of organ meat, seafood etc.
Have an honest look at your diet to see if it could be leaning too heavily toward the n6 with insufficient n3. That's the most likely scenario but it's worth assessing protein (methionine/tryptophan) intake as well and perhaps reducing it while increasing glycine intake (broths from bones/connective tissue).
Does motrin work? It's a pretty powerful anti-inflammatory and is fairly harmless if taken with sufficient phospholipids to insure substrate for the mechanism of the drug so it doesn't strip phospholipids from the gut wall.
I went to talk to Lee Saxby (friend of Christopher McDougall of Born to Run fame) at an event here in NY not too long ago because of the pain I was experiencing in my left foot.
He diagnosed me with Plantar Fascilitis and said McDougall had the same problem for awhile.
What Saxby told me was to get a golf ball and roll it around with my foot. I have no specifics on length of time to do this, or how hard to push, but I bought one and it helped a lot. I still have some pain but not nearly as much as I did before. It's been about a month, I probably don't use the golf ball as much as I should--whenever I think of it, really.
I also sometimes apply some topical pain-relieving cream from Gold Bond, usually before I go to bed. I'm not sure that's really doing anything for me though.
I talked with a guy from Movnat (they did a weekend course up here I attended) and he said to freeze a cup of water and then roll my foot on the ice cylinder. That helps too.
Saxby also said to keep walking/running in barefoot shoes.
There is some good info here:
Scroll down a bit to get to the PF section, but the exercises before hand are good for overall lower leg and foot strength which is important to barefoot/minimalist running.
I especially like the sock doc's video...
I'm in PT for plantar fasciitis and have had some soft tissue calcification in the heel area, verified by x-ray. For me, vitamin K-2 has been an important part of my treatment. I've taken 1000 mcg of K2-MK7 and 5 mg of K2-MK4, with good results for pain management.
I've also found that very deep massage of the calves and fascia to be very helpful (via the Graston technique). My thought is that, as the malformed collagen and the trigger points are straightened out, the K2 helps prevent excess calcium from getting in the tissues as they heal.
Neuromas vs. VFF's ? 4 Answers
Vibram toe pain 5 Answers
Help my painful arms out? 3 Answers