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2011-09-25 2:27 AM

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Subject: What is wrong with my foot?

I have a pain whose diagnosis is a mystery.  It is in the ball of my left fore foot right in the middle.  There is no numbness.  The heel is fine.  It is not reproducible to palpation.  Slightly worse with dorsiflexion.  It feels fine when I am riding and not too bad when running, but every morning it feels like I have a rock in there.

 

I had the same thing on the right side about 2 weeks ago.  Now that is gone.  I thought it might be from my crappy Crank Bros Candy pedals so I got some Shimano SPD LOOK style pedals with a much wider cleat.  The first day I thought it helped, but now it is back.

 

? Morton's Neuroma, but no numbness.

? Plantar Fasciitis, but very focal.

? Stress Fracture, but not worse with running and not reproducible.

? Sesamoiditis, but what the heck do I do about that.

 

I am an ER doc, but I am stumped.  Any Podiatrists/Foot docs/trainers/foot pain sufferers have any ideas?



Edited by leftrunner 2011-09-25 2:28 AM


2011-09-25 6:20 AM
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Subject: RE: What is wrong with my foot?

Not a podiatrist but I've been to one an awful lot. Could it be metarsalgia? I had that for a while. It was pain in the ball of my foot.

2011-09-25 6:30 AM
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Subject: RE: What is wrong with my foot?
I suppose I need to rest for that?
2011-09-25 6:31 AM
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Subject: RE: What is wrong with my foot?
I suppose I need to rest for that?
2011-09-25 6:41 AM
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Subject: RE: What is wrong with my foot?
Could it be coming from your back? Does flexion or extension of your lumbar spine change the pain at all? Does the pain go away if you lay on your stomach and prop on your elbows?
2011-09-25 6:47 AM
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Subject: RE: What is wrong with my foot?
I suppose I need to rest for that?


2011-09-25 6:49 AM
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Subject: RE: What is wrong with my foot?

leftrunner - 2011-09-25 6:31 AM I suppose I need to rest for that?

Let's see, what did we do.....

I wish I would have thought to ice it right away. I think that might of helped a lot. The podiatrist put some extra padding on the insoles of my cycling and running shoes to keep the pressure off of that spot. I think you can buy something from the drugstore that might help. I'm sure he probably prescribed an oral steroid. OH! Finally I read somewhere to loosen up the straps on my bike shoes and that really helped a lot. I ended up getting a new pair of prescription orthotics with the extra metarsal cushion already in them.

My pain was pretty far a long (hurt just walking around during the day) and I don't typical seem to shake off inflammation very easily so don't let me scare you. I took time off from running but not cycling because it took me a while to realize that the problem was probably from my cycling shoes. The pain started not long after I got clipless pedals.

Like I said though, I'm not a doctor. I know I always like to talk about my aches and pains with someone though .

Another OH! I almost forgot, ART. That is what finally eliminated the pain all together.

2011-09-25 8:06 AM
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Subject: RE: What is wrong with my foot?

Is it worse in the AM?  Could be Tarsal Tunnel...have/still have.  I use a roller on my foot (local running store) and massage often.  I did rest and tape, etc..but it would get better than come back again.  To me..it's managible.

2011-09-25 6:39 PM
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Subject: RE: What is wrong with my foot?
best guess would be mortons neuroma and you don't have to have pain for it to be that. Stress fx would be second guess.  Get a tech to shoot a film your next shift.  Hijack a pod to inject it.  OR even better go see a trusted colleague
2011-09-25 10:08 PM
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Subject: RE: What is wrong with my foot?
Just shot a 2 view foot and normal.  Probably going to get some orthotics this week and give that a try.  Thanks to all for the input/advice.
2011-09-26 7:29 AM
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Subject: RE: What is wrong with my foot?
leftrunner - 2011-09-25 10:08 PMJust shot a 2 view foot and normal.  Probably going to get some orthotics this week and give that a try.  Thanks to all for the input/advice.
A quick caution from a 2 1/2 year plantar f/ mortons owner. Orthotics of any sort will greatly reduce your shoe volume. Morton especially hates to be stuck in a narrow toe box. Sometimes toe separators are used but that didn't work for me, it caused other pain. Mortons is usually between the third and fourth metatarsals and toes. It makes this area feel fat and cramped as if your socks are wadded up udder your mets and toes in this area, with increasing pain as time goes by. My sports podiatrists first recommendation was wider toe box. Then we used various sticky pads under the metatarsals in cooperation with the orthotics supporting the plantar due to pf. I also have fractured sesmoids on right foot, that pain of course is very easily diag. It's very local.I had to inventory my sock drawer as well, many of my cycling socks are very tight and squeezing the toes.You should consider metatarsal bursitis as well.


2011-09-29 3:22 PM
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Subject: RE: What is wrong with my foot?

mortons or whatever, it is an inflamation. the above post says that the mortons hates a tight toe box, this is the key.

I have turned mine from a monster to a minor pest.

1)go buy some gummy toe shims at cvs or wall greens. at night shim  bitween  2nd and 3rd toe(from big toe) with one shim no more. wank around like this in flip flops.

2) realize and accept that it is not just your bike, run , work or diet it is all of them adding to the inflamation.

3) go up a size in your running shoes or use supper thin socks.

4) alternate to another brand of cycle shoes. example: specialized to shimanno. my shimmanos  have a larger toe box and are a half size bigger.

5) dump cotton socks they bunch up and are thick. cotton kills. go to Ip.

6) buy a reusable ice pack and use it after every run or bike for 10 minutes.

7)do not use drugs to mask it.

it took about 30 days to turn it around.

good luck.

2011-09-29 3:32 PM
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Subject: RE: What is wrong with my foot?
I have the same problem, lots of things to try in this thread....
2011-09-29 3:36 PM
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Subject: RE: What is wrong with my foot?

I had mortons on both feet.  The BEST thing I did for it was change the rest of my shoes, not my running shoes.  We tend to think all of our foot problems have to do with our running shoes. Not necessarily.  I have to wear "dress shoes" for work.  I started to realize that all of them were much narrower in the toes then my running shoes.  I changed them all, mortons were gone within a month.  Just something to think about.

P.S. - mine presented themselves just like the OP, mostly in the morning.

2011-10-01 9:44 PM
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Subject: RE: What is wrong with my foot?
dietcoke - 2011-09-29 4:22 PM

mortons or whatever, it is an inflamation. the above post says that the mortons hates a tight toe box, this is the key.

I have turned mine from a monster to a minor pest.

1)go buy some gummy toe shims at cvs or wall greens. at night shim  bitween  2nd and 3rd toe(from big toe) with one shim no more. wank around like this in flip flops.

2) realize and accept that it is not just your bike, run , work or diet it is all of them adding to the inflamation.

3) go up a size in your running shoes or use supper thin socks.

4) alternate to another brand of cycle shoes. example: specialized to shimanno. my shimmanos  have a larger toe box and are a half size bigger.

5) dump cotton socks they bunch up and are thick. cotton kills. go to Ip.

6) buy a reusable ice pack and use it after every run or bike for 10 minutes.

7)do not use drugs to mask it.

it took about 30 days to turn it around.

good luck.

I will try these.  Thanks!

2011-10-01 10:19 PM
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Subject: RE: What is wrong with my foot?

Hi Doc, (I kinda wondered when you used "palpation").  Lots of good advice already written here but I wanted to suggest you have someone squeeze your forefoot at the transverse arch (medial to lateral).  If it hurts I'd think more like a neuroma and if not the above advice should help. It's certainly not scientific but a neuroma shouldn't like it.

Mxr mentions orthotics take up a lot of space which is true so you might need new shoes if you will wear them in your bike shoes.  If you'll just wear them for your normal walking/running try not to get a rigid pair but preferably a pair that will flex somewhat with walking.  I've personally had good results from Footlevellers, superfeet and Footmaxx - not necessarily a recommendation just something you can check into.

It is also possible that along with loosening off your bike shoes you could try metatarsal arches located under the location of your pain.  They're usually low cost pads with sticky tape to hold them in place.  I used to find them at shoe repair places but I believe anywhere that sells orthotics should have them.

One last thing - you could try a series of electrotherapy treatments on your foot using 2 electrodes - one above and one below your pain area. 

Good Luck



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