6

votes

Hacking Plantar Fasciitis

Answered on August 19, 2014
Created June 14, 2011 at 12:27 AM

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.

246ebf68e35743f62e5e187891b9cba0

(21420)

on January 05, 2012
at 07:09 PM

Funny you mention this Stephen, as a separate diet-related experiment I've been drinking a veggie smoothie with a half pound of kale and other fruits/veggies in the morning (with the goal of consuming at the bare minimum of a pound of raw vegetables daily) and my PF hasn't been present, despite about 3 miles of walks daily in various footwear, including my Docs and Vibrams, both of which seemed to trigger the PF worse than anything before. Kale is absolutely loaded with Vit K, although I'm not sure specifically which ones. I guess I'll find out the next time I end up walking 13mi or more.

Medium avatar

(10611)

on January 03, 2012
at 04:45 AM

I didn't get relief from stretching, shoe wedges, use of a roller or weight loss. Shoe changes to better support and softer soles helped some, as did walking on softer surfaces like sand or grass. But nothing has helped as much as the walking stick. I can't remember the last time I felt the stabbing pain, and I still walk a lot daily. The effect of the vitamins is interesting - glad to hear it's helped you.

Eecc48184707bc26bce631485b5b7e34

(4764)

on June 14, 2011
at 05:30 PM

How much vitamin A are you getting a day, Joshua? Sounds like it could potentially be too much...

Eecc48184707bc26bce631485b5b7e34

(4764)

on June 14, 2011
at 05:29 PM

Oooh! your golf ball comment reminded me: you know those small glass coke bottles? Keeping an empty one in a sock in the freezer, then using it a couple times a day to roll under the arch of my foot was incredibly helpful.

Eecc48184707bc26bce631485b5b7e34

(4764)

on June 14, 2011
at 05:28 PM

Better than 1:1 is not better... It appears that 1-4:1 is generally biologically appropriate.

04f2eae4450112cdedce7235923c646d

(1112)

on June 14, 2011
at 02:16 PM

I second the foam rolling. After having plantar fasciitis for more than a year, the foam rolling made my calves fine. I do not have a foam roller, but I just use a 1.5 liter or 0.5 liter water bottle. It is free, give it a try. Also check out the mobilitywod.com

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on June 14, 2011
at 01:38 PM

Same here, my symptoms resolved after going with Vibrams + Paleo. Joshua, it sounds like you are taking too much CLO. You don't want too much n3, either. Not that that will fix your feet, but just in general.

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on June 14, 2011
at 01:37 PM

Same here, my symptoms spontaneously resolved after switching to Vibrams. You are probably taking too much CLO.

246ebf68e35743f62e5e187891b9cba0

(21420)

on June 14, 2011
at 11:17 AM

All of my previous foot-related issues went away with minimalist shoes... the tightness came because I neglected my stretches (didn't really think stretching before/during walks was needed) For about a month now, I've had "better than" 1/1 o3/o6 ratios. Two shotglasses of CLO before bed, organ meat once/twice weekly, no birds, and sparing on the pork.

B3ea6447483d614acfc7cab288c6483e

(48)

on June 14, 2011
at 12:58 AM

The rolling with a golf or lacrosse ball is a great thing to do. It releases tension on the entire posterior chain if done when standing...

B3ea6447483d614acfc7cab288c6483e

(48)

on June 14, 2011
at 12:52 AM

you can also look up arch taping online and get some cheap athletic tape to perform it. This will alleviate pain in normal walking.

B3ea6447483d614acfc7cab288c6483e

(48)

on June 14, 2011
at 12:51 AM

Unfortunately a severe case as you describe can last as long as 12 weeks. Be aggressive with the stretching and ice and once you can walk without pain, switch to heat to increase blood flow and nutrient delivery to the Plantar Fascia for repair.

3f5bbb444498a24f1a9720d75fa7c903

(2369)

on June 14, 2011
at 12:51 AM

Same thing for me. Getting out of traditional athletic shoes and starting a paleo diet solved my PF. I hiked the Montana mountains last summer in my VFFS, up to about 10 miles per day, with no problems at all (except getting flowers stuck in my toes).

B3ea6447483d614acfc7cab288c6483e

(48)

on June 14, 2011
at 12:48 AM

I am currently in school for sports med. I have seen many of these issues resolved by freezing a water bottle and rolling each foot back and forth with a good amount of pressure to break up the scar tissue. Hard to explain in text but attempt to also stretch your soleus, the muscle under the Gastrocs. You could prob find a youtube video to show you how

246ebf68e35743f62e5e187891b9cba0

(21420)

on June 14, 2011
at 12:44 AM

Stretchin: towel pulling, toe raises on curbs, anything to increase my poor ankle flexiblity. Icing: I have a cloth-exterior gel coldpack that lasts approximately 30 min. I use this, cupped around my heel, refreeze, and use it again in about an hour. So I'm icing for two, 30min sessions per evening with my ankle elevated. It's also wrapped up tightly for compression

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15 Answers

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1
246ebf68e35743f62e5e187891b9cba0

(21420)

on July 02, 2011
at 01:51 PM

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.

7
Bd142c32b4055224d3191461f1f57520

on June 14, 2011
at 12:49 AM

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.

6
77732bf6bf2b8a360f523ef87c3b7523

(6157)

on June 14, 2011
at 01:43 PM

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.

Also, if you're not doing this already, you should be doing a PNF protocol for your calves. Check out MobilityWod.com for everything they have on calves and hips.

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.

04f2eae4450112cdedce7235923c646d

(1112)

on June 14, 2011
at 02:16 PM

I second the foam rolling. After having plantar fasciitis for more than a year, the foam rolling made my calves fine. I do not have a foam roller, but I just use a 1.5 liter or 0.5 liter water bottle. It is free, give it a try. Also check out the mobilitywod.com

3
E7be2ce38158357f5dacae07b43d1b29

on June 14, 2011
at 03:56 AM

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.

2
C221a8c9efba0c80d03b9f84a2b3b3f9

on June 14, 2011
at 12:53 AM

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.

2
Eecc48184707bc26bce631485b5b7e34

on June 14, 2011
at 12:45 AM

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.

3f5bbb444498a24f1a9720d75fa7c903

(2369)

on June 14, 2011
at 12:51 AM

Same thing for me. Getting out of traditional athletic shoes and starting a paleo diet solved my PF. I hiked the Montana mountains last summer in my VFFS, up to about 10 miles per day, with no problems at all (except getting flowers stuck in my toes).

246ebf68e35743f62e5e187891b9cba0

(21420)

on June 14, 2011
at 11:17 AM

All of my previous foot-related issues went away with minimalist shoes... the tightness came because I neglected my stretches (didn't really think stretching before/during walks was needed) For about a month now, I've had "better than" 1/1 o3/o6 ratios. Two shotglasses of CLO before bed, organ meat once/twice weekly, no birds, and sparing on the pork.

Eecc48184707bc26bce631485b5b7e34

(4764)

on June 14, 2011
at 05:28 PM

Better than 1:1 is not better... It appears that 1-4:1 is generally biologically appropriate.

Eecc48184707bc26bce631485b5b7e34

(4764)

on June 14, 2011
at 05:30 PM

How much vitamin A are you getting a day, Joshua? Sounds like it could potentially be too much...

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on June 14, 2011
at 01:38 PM

Same here, my symptoms resolved after going with Vibrams + Paleo. Joshua, it sounds like you are taking too much CLO. You don't want too much n3, either. Not that that will fix your feet, but just in general.

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on June 14, 2011
at 01:37 PM

Same here, my symptoms spontaneously resolved after switching to Vibrams. You are probably taking too much CLO.

2
34a367e60db77270bd7096dc04270fdc

(4171)

on June 14, 2011
at 12:44 AM

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.

B3ea6447483d614acfc7cab288c6483e

(48)

on June 14, 2011
at 12:58 AM

The rolling with a golf or lacrosse ball is a great thing to do. It releases tension on the entire posterior chain if done when standing...

1
A3414e929f7c39da2fb07ef3b973bc25

on January 03, 2012
at 03:06 AM

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.

Medium avatar

(10611)

on January 03, 2012
at 04:45 AM

I didn't get relief from stretching, shoe wedges, use of a roller or weight loss. Shoe changes to better support and softer soles helped some, as did walking on softer surfaces like sand or grass. But nothing has helped as much as the walking stick. I can't remember the last time I felt the stabbing pain, and I still walk a lot daily. The effect of the vitamins is interesting - glad to hear it's helped you.

246ebf68e35743f62e5e187891b9cba0

(21420)

on January 05, 2012
at 07:09 PM

Funny you mention this Stephen, as a separate diet-related experiment I've been drinking a veggie smoothie with a half pound of kale and other fruits/veggies in the morning (with the goal of consuming at the bare minimum of a pound of raw vegetables daily) and my PF hasn't been present, despite about 3 miles of walks daily in various footwear, including my Docs and Vibrams, both of which seemed to trigger the PF worse than anything before. Kale is absolutely loaded with Vit K, although I'm not sure specifically which ones. I guess I'll find out the next time I end up walking 13mi or more.

1
001cd8e3885a870edc0ea8323ad9c719

(260)

on June 14, 2011
at 01:18 PM

There is some good info here:

https://docs.google.com/document/pub?id=1ZxoXjPvKvW8rl8zsPgFzCjy1GV5zK9ZlA3OasL5prME

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...

1
E588852ed669a6bb5ddb2f8b7e4c8023

on June 14, 2011
at 12:46 AM

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.

Eecc48184707bc26bce631485b5b7e34

(4764)

on June 14, 2011
at 05:29 PM

Oooh! your golf ball comment reminded me: you know those small glass coke bottles? Keeping an empty one in a sock in the freezer, then using it a couple times a day to roll under the arch of my foot was incredibly helpful.

0
B3ea6447483d614acfc7cab288c6483e

on September 07, 2013
at 12:44 AM

What stretching, icing (duration and form) are you doing?

B3ea6447483d614acfc7cab288c6483e

(48)

on June 14, 2011
at 12:51 AM

Unfortunately a severe case as you describe can last as long as 12 weeks. Be aggressive with the stretching and ice and once you can walk without pain, switch to heat to increase blood flow and nutrient delivery to the Plantar Fascia for repair.

246ebf68e35743f62e5e187891b9cba0

(21420)

on June 14, 2011
at 12:44 AM

Stretchin: towel pulling, toe raises on curbs, anything to increase my poor ankle flexiblity. Icing: I have a cloth-exterior gel coldpack that lasts approximately 30 min. I use this, cupped around my heel, refreeze, and use it again in about an hour. So I'm icing for two, 30min sessions per evening with my ankle elevated. It's also wrapped up tightly for compression

B3ea6447483d614acfc7cab288c6483e

(48)

on June 14, 2011
at 12:52 AM

you can also look up arch taping online and get some cheap athletic tape to perform it. This will alleviate pain in normal walking.

B3ea6447483d614acfc7cab288c6483e

(48)

on June 14, 2011
at 12:48 AM

I am currently in school for sports med. I have seen many of these issues resolved by freezing a water bottle and rolling each foot back and forth with a good amount of pressure to break up the scar tissue. Hard to explain in text but attempt to also stretch your soleus, the muscle under the Gastrocs. You could prob find a youtube video to show you how

0
Medium avatar

(10611)

on July 02, 2011
at 03:10 PM

I walk a lot for transportation and leisure, and have had problems with Achilles tendon stiffness and pain for the last 5 years. Hard soled heavy shoes on pavement aggravates the problem - just stepping off the sidewalk and walking on grass often alleviates the pain. I've had limited success with heel wedges or stretching. For the last 4 months I've been using a walking stick and have had nearly complete alleviation of pain. I use a lot of force - like poling a boat - which takes stress off the ankles. Swelling and bossing at the tendon bases have gone down a lot.

0
C1a9731f404b68be8f7e6a032b3395dd

(105)

on June 14, 2011
at 03:19 AM

My husband is a nurse and a runner who is also in the military - so, for work - he is always either walking or standing on his feet - then he goes running at night - and then in his free time he wears awful military boots. He got some orthotic insoles which helped a little bit, but, after I bought him every PF device known to man (and Amazon) - this thing was what helped him the very most: http://www.amazon.com/PRO-STRETCH-FLEXIBILITY-EXERCISER-MEDIDYNE/dp/B0015RUVCE/ref=pd_sim_sg_65 It took a while, but after weeks of faithfully stretching on that device morning, noon, and night - it finally got better.

0
Bb1ba0d71083ceaecd3a3b405a977454

on June 14, 2011
at 02:02 AM

I had PF for about 7 yrs that persisted even after I dropped 50+ lbs. It didn't full go away until I ditched the orthotics and overly supportive shoes. A frozen 500 ml H2O bottle works wonders. I would try curcumin too. Like a previous poster, I am not an MD, just giving you my take.

0
Aaf41dd75cc92e2921d0dbdb15bb100a

on June 14, 2011
at 12:47 AM

Disclaimer: I'm not a doctor. If indeed your new developed muscle is contributing to your pain, let the muscle relax and the pain will go by itself (better take a miorelaxant as a last resource), forget any additional measure. I find it hard to believe that while walking (or resting) the muscle rebuilded so hard that it's severily constraining the foot, even in that case let the muscle loss some mass then.

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