Member Case Study: Foot Falling Asleep During a Run

author : AMSSM

comments : 0

What would cause my foot to fall asleep after running about 3 miles and then have a numb spot on the top of my instep?

Member Questions from BillMacnuda:

What would cause my foot to fall asleep after running about 3 miles and then have a numb spot on the top of my instep? This is not causing any noticeable pain, just a spot that has no feeling when I touch it even after a recovery period.

I have checked to see that I have the right shoes. I was told by Road Runner Sports after an in-person visit, that I have a "full volume foot" that requires wide shoes. After they analyzed my feet/gait, they okay'd the pair of Asics that I currently have. I have also loosened the shoelaces as much as possible while still keeping my shoe on my foot while running. If I run/walk, I can go further before my foot falls asleep. This is only happening on my right foot.
 

Answer from John Martinez, M.D.
Member AMSSM

There could be several reasons for the numbness that you are experiencing, so the typical disclaimer of seeking medical advice over the internet means we can only provide general information, and the best course is to have an evaluation by a qualified sports
medicine professional.

One likely cause of numbness to the inside of the foot would be tarsal tunnel syndrome, or compression of the tibial nerve - think of it as the foot's version of carpal tunnel syndrome. The symptoms can range from numbness to tingling, burning, or pain in the foot. The symptoms typically worsen with activity or throughout the day, and will usually be relieved by rest or decreased activity.

Flat arches may be one reason for the development of tarsal tunnel syndrome. Diabetes and trauma may be two other causes.

Typical treatment of tarsal tunnel syndrome such as wider shoes or arch supports relieve pressure on the tibial nerve. Anti-inflammatory medications such as ibuprofen (Motrin or Advil) or naproxen (Naprosyn or Aleve) may be used to decrease inflammation of tissue around the tibial nerve. If symptoms do not improve, your sports medicine physician may recommend orthotics (if you have significant flat feet) or a steroid injection to decrease swelling. In more difficult cases that do not respond to these treatments, surgery may be necessary to relieve pressure on the nerve.

John Martinez, M.D.
Coastal Sports and Wellness Medical Center
San Diego, CA

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date: August 7, 2007