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Intense Pain in Bottom Outside of foot
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Hello everyone first time poster here.. I found this place doing some searches on Peroneal Longus.

So I was hoping someone might have an Idea what I am going through and how to make it feel better, I don't have a regular podiatrist yet and really don't know when I can get in to be seen either..

So I have been working out since last march regularly to lose weight i am quite a large person, Down here in Tampa its getting nice again so I thought I might like to go running outside as my exercise as far as aerobics is concerned has been limited to Bike and Elliptical. So I went to a running store to get set up in a shoe. Turns out I have flat feet, The shoe I picked to go with is the Brooks "Beast"

On Friday we had casual day at work so I wore them all day to break them in, these shoes feel amazing very comfortable, and I noticed when I went to do my workout that day (10 min elliptical 5 for cool up and 5 for cool down) I was mush more stable on the elliptical, in my old shoes Id have to grab the bars fro time to time to keep from falling these I felt very stabilized and I don't think I grabbed the bars once.

So I wore them like a regular shoe all day, feeling great and no discomfort. I woke up yesterday and the bottom outside of my right foot is killing me, I can not put any weight on it whatsoever, so I laid in bed all day resting it alternating heat and ice. every time I had to get up just to walk to the bathroom was like some of the worst pain I have ever experiienced


The pain is centered right where the peroneus longus meets the bone on the end kind of in the center of the foot, the foot is a bit tender the more I move up it but not unbearable only in that area. It only hurt to put weight on it yesterday, and didn't get much better if at all yesterday, and now it hurts to even lift it to try to take a step.

If anyone has any suggestion what this may be please help me out here, I cant deal with this pain, and Im very discouraged, I was doing so well, I am trying to lose weight to join the military, and I am 80 pounds from my goal at this point, I have lost a good 40 pounds so far. Thanks for any ideas or tips you may have, feel free to ask me anything as well. And also to note I did stretch before and after the workout, my feeling is that it is connected to the support the Motion control shoes game me, and perhaps this tendon was over worked because it had never been in that position, but odd thing is its only the right foot.
Last edited by: Timber82: Jan 18, 09 6:56
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Re: Intense Pain in Bottom Outside of foot [Timber82] [ In reply to ]
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i have just gone through foot pain myself just weeks ago. i'm no expert, but here's my experience...

i had extreme arch pain...heel pain...and what was thought to be plantar fasciitis...and what was thought to be quadricep tendonitis. i went to a well respected running shop. they said i had flat feet...and extreme over pronation. they put me in a very stiff shoe...the saucony stabil 6. my arch pain did not go away. my heel pain did not go away. they suggested insoles...i got them...SLIGHTLY helpful but still not right.

i finally sought out professional help. i went to see a guy that turned out to be the pedorthic consultant for the detroit pistons, detroit shock, and the michigan state spartan mens and womens basketball team. he did a digital scan of my feet...examined my feet by hand...did a interview...took a look at my barefoot walk from the knees down...did a digital gait/biomechanical analysis.

verdict? i have a very prominent post tib tendon that masks what is actually a very normal to prominent arch (he said this is actually quite common in fast twitch, explosive athletes which is what i used to be but he didn't know that from my interview!!!)...i'm a very very mild pronator (but he says just about every human on the planet is a mild pronator)...and i probably never even had plantar fasciitis, instead it was most likely a problem with my post tib tendon.

he went on to say most running stores have very rudimentary ability to analyze gait or even understand what they're seeing. and he also said the most common thing he see's is WAY over correction for minor gait issues.

he made me some custom insoles...and suggest i get in a MUCH more neutral shoes and put in the inserts he made me.

what i suspect is...your arch has been misdiagnosed...then the non-existant problem was WAY overcorrected...and now you're in pain. return the shoes and try a stability control or neutral shoe. the brooks beast is their very stiff motion control shoe.

i could be DEAD wrong...but from what my pedorthist said, i wouldn't be surprise if i was right...

GOOD LUCK!!!!!!!!!!!!!!!!!!!!!!!! my foot issues are gone forever!!!!!!!!!!!!!!!!!! hopefully you'll also find foot bliss!!!!!!!!!!!
Last edited by: celerystalksme: Jan 18, 09 8:08
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Re: Intense Pain in Bottom Outside of foot [celerystalksme] [ In reply to ]
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Thanks for the input, you mention your pain on the inside and the heel for the most part, I have no pain there, howevr I am gonna have to hold off on the podiatrist with the small amount of funds I currently have. where the shoes comfortable while you were wearing them at least?

I forgot to mention there is no swelling or visible bruising as well, still hurts bad can't even walk the dog.
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Re: Intense Pain in Bottom Outside of foot [Timber82] [ In reply to ]
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In Reply To:
Thanks for the input, you mention your pain on the inside and the heel for the most part, I have no pain there, howevr I am gonna have to hold off on the podiatrist with the small amount of funds I currently have. where the shoes comfortable while you were wearing them at least?

I forgot to mention there is no swelling or visible bruising as well, still hurts bad can't even walk the dog.

oh yes, the shoes were VERY comfy while at the store. and VERY comfy during the run. but the next day, i could barely stand on my stupid feet! but now that i got the custom inserts and more neutral shoes, i'm good to go.

the reason why i think you might benefit from a more neutral shoe is because the shoe they have you in are designed to combat substantial pronation (your feet collapsing towards in the inside edge). if you did not need that to begin with, what could happen is that the shoes are causing unwanted pressure on the outside edge.

again...TOTAL guessing. until you can see a proper doctor, what you could do is go to a different shoe shop and see if they also believe you need a motion control shoe. OR...just try out a stability control or neutral shoe and see if there's an improvement.
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Re: Intense Pain in Bottom Outside of foot [Timber82] [ In reply to ]
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First off - just how much DO you weigh (and how tall). Also, how old are you.

I'm not a huge fan of the Brooks Beast, but that shoe exists for a reason and might very well be in the "right" shoe (you mentioned you got it at a reputable running store).

It would be unlikely to develop peroneus longus tendonitis after just 1 10 min eliptical workout. You are describing cuboid syndrome (subluxing cuboid or cuboid tunnel syndrome for your googling searching - they are all similar, but slightly different). Other possibilities are a cuboid stress fracture, peroneal tubercle injury (on the lateral calceneus). Also, to be sure of your "photo" the peroneus BREVIS attaches to the base of the 5th metatarsal (the bone/bump you see) and not the longus. The longus runs under the foot. If your pain is at this "bump" (called the styoid process) then all of the above I mentioned do NOT apply - this is likely insertional tendonitis. This is why a hands on exam is always best :)

But, some more things to research/digest. Good luck!

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Intense Pain in Bottom Outside of foot [rroof] [ In reply to ]
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Thanks again for the feedback, So are you saying both feet hurt? or just one?

To answer the questions, I am 6'4 330 lb. I wasn't planning on any triathalons or anything just go jogging on my lunch break do some 30 min HIIT which is what I've been doing on the elliptical and the bike. I am 26

I will Google these terms when I get back on my computer (on a PDA) In the meantime should I do anything outside of ice and heat?

Also on Friday I didn't do much walking as I have an office job and so outside of the 10 min elliptical walking was at a minimum, I really hope this passes I'd hate to have to call in tomorrow as well

Note after looking more closely it does appear it might be the other one mentioned all I know is the pain runs along that bone but is concentrated in that area where the tendon attaches to that bone so I don't even know if it is the tendon for sure, in fact now that I am looking it might be the tibialis interior since the pain starts at that joint and I feel the tenderness all the way up to my toes I am having a friend loan me crutches so I can try to get into work
Last edited by: Timber82: Jan 18, 09 11:08
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Re: Intense Pain in Bottom Outside of foot [Timber82] [ In reply to ]
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http://forum.slowtwitch.com/...rch_string=;#2146369

Does this description of my pain make sense? Read rroof's post in this thread. It explains it. I was a heal stricker & over strided. I change my running and the pain went away.

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Re: Intense Pain in Bottom Outside of foot [Timber82] [ In reply to ]
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Can't give you any advice on the foot issue, but did want to say congrats on your progress so far. There is a "tipping point" at which weight makes it especially challenging to get enough physical activity to work your way back down, and it sounds as though you have been beyond that point. Working in a medical field, I hate to see how many people just give up.

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Over 4.5 years bike crash free.
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Re: Intense Pain in Bottom Outside of foot [rroof] [ In reply to ]
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I checked out the thread and while it looks like our injuries are centered around the same place, I am not sure the amount of pain you felt, like was it only when you wore shoes, or what? Like I can barely stand on mine, I have had my feet elevated all day alternating ice and heat, and I wince in pain just putting my feet on the ground to stand up out of bed, and its some of the worst pain just to walk to the bathroom. I wish I could just figure something out temporarily to relieve the pain for now. And now the more I read up and all with my medical knowledge that can be summed up into google searches, I have a feeling I was originally wrong in the idea that it was the Peroneous Longus, and I'm thinking more along the lines of the Tibialis Anterior I am kind of tossed up on either one now, form the picture I can tell if that is the one that continues down the foot or not, just because the pain runs along the bottom and while it is focused in the area I pointed out it does run up to the ball near the pinky toe. but the toe itself has no pain, nor does my calf like many sites have said will be tight as well with this injury

Fortunately, my largest concern was getting to work tomorrow, my friend loaned me his crutches so while its not a permanent solution It will make walking to the office at least semi bearable then Ill be off my foot most of the day, sadly no work out. Ironically it doesn't hurt that much to drive, so at least this wont cause me to lose money while injured, and tomorrow I suppose I will call a podiatrist tomorrow see first if my insurance covers it) my main worry now on top of falling "out of shape" is injuring this anymore whatever it is.

Xray charliey thank you for the congratulations, I know I have just started my journey, but I can't beat that feeling when I step on that scale and see the number is smaller.


EDIT


OK now I retract my statement about the Tibialis Anterior, my eyes were playing tricks on me, this is definitley the Peronius Longus or as mentioned earlier possibly the Brevis, here is the picture that made me realize I was ay on on the Tibialis Idea, and this is all considering if the problem is even centered around a tendon, I would love to hear that its just a bit sore and will be fine in a day or so. "Note: fille is a .png if its a red X I got it form the wikipedia site"

Last edited by: Timber82: Jan 18, 09 14:26
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Re: Intense Pain in Bottom Outside of foot [Timber82] [ In reply to ]
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If you are not sure if your pain is located at the anterior tibial insertion (on top of the foot) or the peroneals (outside, lateral aspect), you most definitely need to pick up the phone tomorrow first thing! These are completely different areas and you are likely confusing yourself further with google/images, etc. as things are NOT what they seem on static images of tendon anatomy across the ankle/foot (i.e. many take 90 degree turns if you turn the page and look at the next picture) ;)

Good luck!

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Intense Pain in Bottom Outside of foot [rroof] [ In reply to ]
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Yes, what confused me was the bottom part of the first picture I posted, it appeared as though the anterior tendon comes down and then runs along what is really the Peroneal longus, that is why I got confused, I think Im gonna edit that part out lol

RRoof in Googleing the cuboid syndrome you mentioned it seems that its typically offset by a twist or something like that, like I went to bed Friday night perfectly fine and woke up Saturday unable to move, I dont know if this make a difference or not but alot of the references dealt with "landing incorrectly". I of course as have proven in just this thread can be very off, just a thought thouhg :)
Last edited by: Timber82: Jan 18, 09 14:50
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Re: Intense Pain in Bottom Outside of foot [Timber82] [ In reply to ]
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So, little update, went to a podiatrist, I was off on the tendons.. I never found a diagram of the bottom of the foot, turns out it was my flexor tendons on the side of my little toe. I do have Flat feet, and he loves the brooks shoes I have. It was caused form what I assumed, but I felt better paying someone $40 to tell me, that I overworked the muscles by wearing those shoes at once all day, think about over training and so sore the next day you cant walk.

Choices...
Keep Brooks beast shoes ($120) and use them till next pair is needed

Return Brooks shoes (only wore them once) and purchase custom made heat molded orthotic insert that I can use in any shoe (put them in my tennis shoes for same amount of support take them out and put them back in my work shoes, and is used by many runners, and is said to last supposedly forever... what would you all do? The Orthotics will run me about $195
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Re: Intense Pain in Bottom Outside of foot [Timber82] [ In reply to ]
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You paid the guy for his advice ... follow it!

If given a choice between running in Brooks Beasts or a neutral shoe with an orthotic - I'd almost always pick the later.

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Intense Pain in Bottom Outside of foot [Timber82] [ In reply to ]
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Can you give an update on how long this took to fully heal along with any other helpful information? I too have pain in the same area but it has been 1.5 weeks since. Days 1,2 were almost unbearable while the rest of the time hasn't been too bad as long as I'm not on my feet too long.

I am exactly where every decision that I've made and every action that I've taken has put me.
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Re: Intense Pain in Bottom Outside of foot [Cummins] [ In reply to ]
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Wow! blast from the past! I wore the orthotics for a brief period the pain subsided not sure if this is attributable to time or the orthotics. Long story short I lost my orthotics about 6 weeks afterward. Took shoes back and just continued with normal shoes. I have not felt pain there since the time period of this post longer experience pain there. I mhighly active now workput 6 days a week (hogh impact insanity) run 5k's etc no issues. I cant say if this helped or not but i did look into pose running when I run.

I cant say my issue was typical Id highly recommended a specialist if not anything for peace of mind Good Luck!
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Re: Intense Pain in Bottom Outside of foot [Cummins] [ In reply to ]
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I had similar sounding pain about a year ago and the thing that really seemed to help me (along with a short break from running, of course) was seeing a chiropractor to get some ART (active release technique) done on the area. Very painful, but really helped to loosen up my foot muscles. Two sessions about a week apart and I felt much, much better.

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