Member Case Study: Pain in Foot

author : AMSSM
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I have a pain on the far left side of my left foot, all the way to the left and a little in front of the heel. It hurts after I run for 45 minutes or so. It hurts pretty badly for the next 48 hours.

Member Question from ballyard7
I have a foot injury question. I have been reading everything there is to read about the different foot injuries and can't figure out what is wrong.

I have a pain on the far left side of my left foot, all the way to the left and a little in front of the heel. It hurts after I run for 45 minutes or so. It hurts pretty badly for the next 48 hours and then it goes away. It doesn't hurt when I push on my heel or if I push up and back (which would indicate a bone spur). And it's not my arch.

Some background....I hurt my left hip about a month ago. When I ran on it, I got an uncomfortable feeling in my hip. It would get worse the longer the run went until it made me limp on my left side. I ran a 1/2 marathon instead of the full I was going to do. My hip hurt for the first six miles and then felt great for the last seven.

I did notice the foot pain in the last mile of the 1/2 marathon, and it hurt for 48 hours like it does now. Prior to this race I didn't have any foot pain. I also got a blister from this race and I haven't gotten a blister in years. Maybe my gait was off because of my hip, and it hurt my foot.

My hip is almost better now. I've been taking lots of time off. I only ran twice in one month. But my foot pain is still there. Any insight into what it is?

Answer from Grant Morrison MD

Member AMSSM


I completely agree with you that your hip injury could have created the foot pain. In fact, I am very concerned about that as well! The risk for a stress fracture in marathoners is substantial, and there are potentially very serious implications for stress fractures in the hip especially! Don't ignore this one!

Regarding your foot, however, there are a number of possibilities. It does not sound like it is a stress fracture of your fifth metatarsal from the location you describe, but if it hurts on the bone that sticks out like a little bump on the outside of your foot, get that checked out ASAP too! If it is closer to your heel from that area, you could have twisted or "subluxed" another bone called the cuboid. Often, that can be treated with treated with an adjustment or a manipulation from an experienced osteopathic physician, physical therapist, sports physician, or chiropractor. Sometimes a particular taping technique can be used; for that you will need to see an experienced provider as well.

Alternatively, you may have put an excessive strain on the tendons that come down from the outside of you lower leg, go behind your ankle, and wrap under your foot, especially if your gait has changed. Try running on a treadmill in front of a mirror, and see if your foot and arm swing look symmetric, and if not then seek some help from someone experienced in running gait analysis.

You didn't mention where the blister was; that may be a clue. If the blister is at the site of the pain, I would blame the hip for messing up your gait again, but also look inside your shoe for a rough surface that could be causing a friction point. However, any change in your gait could be altering the friction points virtually anywhere in the foot as well.

Less likely and more difficult to detect are some nerve entrapment syndromes and something called "fat pad syndromes", both of which can be treated with modification of your shoes and/or orthotics.

Get your foot and your hip looked at by a sports medicine physician, and good luck!

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Grant Morrison MD
UMPhysicians
Fairview Maple Grove Medical Center
14500 99th Ave N
Maple Grove, MN 55369
763-898-1000

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date: February 11, 2009

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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