Member Case Study: Top of Foot Pain

author : AMSSM

comments : 0

Yesterday I ran 10 miles. At mile 7 it started feeling sore. At mile 9.5 I got a shooting pain and walked the last 1/2 mile. I have a half Ironman to do in a week and a half. What are my chances?

Member Questions from Jungle Jim:

Last year the top of my left foot started hurting towards the end of my first 1/2 marathon. This year, no problems until I ran about 9 miles in different sneakers. The pain went away soon. A couple of days later I did 56 miles on the bike and a 5 mile run, no pain. Yesterday I ran 10 miles. At mile 7 it started feeling sore. At mile 9.5 I got a shooting pain and walked the last 1/2 mile. Last night I swam 1.3 miles and it was a little sore.

Today, Fourth of July, I've been babying it with slippers on. I have a 15k to do on Sunday (4 days away) but more importantly, a half Ironman to do in a week and a half. My question is should I see a doctor tomorrow? Should I skip the 15k (even if it feels ok) to maximize the chances for the all important HIM?
 

Answer from Mark Alexander, MD
Member AMSSM

I wouldn’t shut you down completely just yet, but I would suggest you see a good sports medicine provider. I would like more information regarding your problem. The “top of the foot” is fairly vague. The lateral portion of the dorsal foot could suggest cuboid syndrome, which can be corrected with some manipulation and taping and still allow you to train and compete.
 

More general pain over the top of the foot could suggest lace bite or an irritation of the tendons across the top of the foot. Pinpoint tenderness over any of the bones in the foot would be more indicative of a stress fracture. Needless to say, a stress fracture in the foot would keep you from running for at least a period of time. The transient nature of your discomfort would make this less likely.

An x-ray may help identify a stress fracture, early arthritis, or bone spurs that could be running into each other, a condition called impingement. Through a thorough history, exam, and possibly imaging, you and your physician can come up with both a definitive diagnosis and a treatment plan. Assessment of your running style, wear on your running shoes, and the cause your symptoms by an experienced sports medicine physician would be helpful for you.

Depending on the outcome of that visit, you may be able to continue training while doing your rehabilitation. In summary, foot pain in triathletes is a common complaint with a number of potential causes. Before having you “rest” your foot and not run, I would have you visit your nearest sports medicine provider.

Mark Alexander, MD

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date: August 7, 2007