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Proud member of Team Tooth Pick (TTP): like a leaf in the wind.

I can help!

I think I know. I have had the same problem for the last month. I went to a podiatrist who examined the toe and x-rayed it. He told me that my first metatarsal was too long and it was rubbing against the other bone and causing a spur. His suggestion was to quit running and I could get an operation to shorten the first metatarsal. I told him that I had an IM in April amd I would have to make due until then. As it worsened from running it became more inflexible and caused me to roll my foot out which then caused hip and knee soreness. So now I have started aqua jogging in the pool until I can find a solution. I posted this question on Gordo's site and most of the responses were to get a second opinion. I have used ice, rest, 3/4 orthotics and read everything I could find on the internet. Most of the symptoms appear under a condition called Hallux Rigidus. I am hoping some sort of change in my gait ( mid foot to heel ) and physical therapy can restore the flexibility. The toe does not hurt when I am running but the inflexibility is a problem with my hip and knees. I have not had any problems with it on the bike. I am currently trying to find a specialist to take a second look at it. Hope this helps.

Thanks bro. I'm slightly devastated right now, but at least I know where to start.

Cheers. Leo

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Proud member of Team Tooth Pick (TTP): like a leaf in the wind.

my first metatarsal was too long and it was rubbing against the other bone and causing a spur. His suggestion was to quit running and I could get an operation to shorten the first metatarsal.

Wow. That sounds a little far-fetched to me- he's telling you your toe bones are too long to allow you to run? Were you new to running when you discovered this condition?

I think I would be running right out to another doctor, if I was told that what I need was an operation to shorten my toes.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Maybe rroof will check in on this, but I think he will agree that the most obvious problem is that you only have four toes--this will put undue pressure on the affected joint, as you struggle to maintain balance. I am surprised that the Podiatrist did not notice this.

Are you really having an issue, or did you just want to get us all hot by posting a picture of your pretty foot?

And it's not like his toes are long to begin with.

Monk - I want the number of your hair stylist and make-up artist.

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A lie can travel half way around the world while the truth is just putting on its shoes.
- Mark Twain

ONe more thought is gout (build up of uric acid - most common exactly where you hurt). Consider seeing your doc and asking for a blood test and maybe an Xray.

Hah! Always funny Monk!

Hallux rigidus is a good first "search phrase" to look at. Basically comes in 3 flavors (via Regnauld Classification).

Send me a PM with some pertinent details and I'll try to help out w/ some options. For the rest: is the "bump" hard and bony or soft and along under the long tendon on the top of your toe? A ganglion can occur on the extensor hallucis tendon in that area, but these are usually not that painful.

The "bump" properly termed exostosis is usually from the joint jamming on the dorsal aspect over the course of many years. You may have joint pain with this or maybe not. You eventually will :( The exostosis is usually spot painful to touch or any pressure. Pushing up hard on the big toe will hurt at the end or motion as well. The bad news is that this is a progressive thing and eventually gets worse. Many PRO athletes (I'm talking MLB and NBA) have gone through similar surgeries for this (no, not the toe bone shortening thing - that was someones lame description to you).

This does respond well to oral anti-inflammatory meds (Motrin, Alleve, etc.), but these should be used with caution in endurance athletes (dehydration/kidney issues). This is also one place where a local corticosteroid injection works very well - doesn't cure/fix the condition, but a well placed (and timed) injection prior to a race might make a world of difference without any significant pathology. It also might not do much :(

Outside possibilities are chronic gout (unlikely from your photo and history) and more unusual tendon sheath/joint capsule lesions (ie synovial sarcoma).

Playing the odds game over the internet: stage I hallux rigidus cause a dorsal exostosis. Addressing the reason/biomechanics for your hallux rigidus (joint jamming) is a good first start to delay this from getting worse though. Let me know where you live (PM) and I may know a reputable fellow tri doc who can help.

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Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

What assumptions are you making from that?

Dude, put on your old (1/2 size larger) shoes! Then listen to rroof, and see a couple of good doctors - you know one, I have the contact info for another.

You might want to commute on the fixie for a while too, while you heal up.

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<If you're gonna be dumb, you gotta be tough>
Get Fitter!
Proud member of the Smartasscrew, MONSTER CLUB
Get your FIX today?

None. But you should see how long my toes are, and no one has told me (yet) that they need to be shorter. ;)

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A lie can travel half way around the world while the truth is just putting on its shoes.
- Mark Twain

After a long run last week, I recently sustained the exact same injury/symptoms + diagnosis (bone spur on 1st metatarsal).

Very interested to know how long was your recovery was and whether it eventually required surgery. Also, any advice for healing it most quickly (I have been icing it alot, have kept off running for a few days, etc)? I am seeing an excellent sports podiatrist who thinks I will likely be ok for IMFL if I am smart/cautious/careful but I'm super curious to hear firsthand from others how recovery has gone for this type of injury.

I had your EXACT problem. Mine was from running in shoes size 11-1/2 instead of 12 for many many years. My left foot is very slightly longer than my right and over a period of time (around 20yrs), I developed a Dorsal Bunion in that exact location. I slowly lost flexibilty in the big toe. Normal flexibility is 65-75 degrees. Mine went down to around 35 degrees. I was training for a marathon, running around 60-70miles a week and because of the inflexibilty of the big toe, the second toe started moving toward the big toe, to pick up the load. As my training continues, I developed a corn on my second toe which was now rubbing on the big toe. Well I did the marathon but had a very bad time of it. That was 2001. I decided to see several doctors and ultimately had the bunion removed. My toe was even WORSE after the operation and to make a long story short, took around 4 years for my toe flexibility to come back to where it didn't bother me running. I would say now it's back to about 45 degrees and enough so I can continue to race. What I'm telling you is an operation should be the very LAST choice. In the mean time, I searched the web extensively for help and also to educate myself on this problem. I found a relatively quick fix (non-operational) to your problem Look up "dancer pad". I know you'll get some weird sites, but the one you are looking for will show you orthodics that ballerina dancers eventually use as they get older because of problems to their big toes from dancing on them. You'll know the orthodic by the cut-out in it where the big toe is located. This cut-out effectively allows your big toe to NOT have to bend as much as normal. Using this will give you added years of use and in the mean time you can find out what is really causing the problem and fix it.
Good luck and think very serious before any operations.

Bump

Ah that big toe! Yeah the problem slowly went away after I did the following things (with advice from the fabulous Julie @ julsto.com):

1) Stop wearing shoes that are too bloody tight. I went back to my regular size 7.5 H-street's. I think the improperly fitting shoe was the main culprit.

2) For good measure, I relace my shoes so that I could skip the 1st set of eyelets.

3) Massage at and proximal to the affected area.

4) Ice and arnica gel.

5) Eased up on the training volume.

So at this point, I have no problems in that area anymore. Only thing is that I have it a bit in my other big toe, but that's a whole 'nother story.... (watch for a future post on lower leg nerve entrapment.)

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Proud member of Team Tooth Pick (TTP): like a leaf in the wind.