Been dealing with this issue, hesitate to even call it an injury, since last summer training for Canada. Been willing to just train through it to get through the 2013 season, but wanted to do a running focus 2013-14, and have some good run centric races next year. So now is the time to try to jump on it.
The pain is in a spot right between the first and second metatarsal when I push off, usually most pronounced when getting up in the a.m. or after sitting for a while. Goes away for the most part after walking for a while, and does not always occur every time I get up. The pain is most pronounced on the pushoff. I can also trigger it by turning my foot inward and pressing the bottom of the big toe into the ground
With one exception, it never hurts when I run. The one exception is if I start a run on a shallow upslope, requiring more flexing for a few steps, and then it goes away. Other than that, nothing, and that includes an IM, HIM and 18K trail run with steep climbs and descents. Just ran 8 hilly miles yesterday and didn’t feel it at all.
At first I was afraid it was a stress fx, but I can jump up and down on it all day and it does not hurt to land on it, and since it doesn’t hurt while running, it does not present as what I know of stress fxs. Took a week off after Miami 70.3, and felt like it went away, but once I started running again, it returned. It does not seem to get worse, it’s just present.
Anyone else had something similar? Standard issue tendonitis?
Research Morton’s neuroma. It’s a fairly common running injury where an inflamed nerve gets pinched between metatarsals. One way to diagnose it is to squeeze your metatarsals together (across the width of your foot) and pinch the soft tissue between metatarsals with your other hand. See if this causes pain. Don’t be gentle! It can also feel like you have a rock or a marble in your shoe that you can’t get rid of.
I had an injury VERY similar to what you describe. After periods of non-use(hours) I would feel the need to squeeze my toe and it would pop back into place. It would wake me in the middle of the night. I could run just fine until I tried to push a little harder or was on an incline and pain would shoot through my toe into my foot. It was always worse after I had ridden that day…but it took an hour or so to really get aggravated. My massage therapist could feel the swelling and tightness in my toe…she would work on it and it would be better for a day. What I realized is that I had just started Mountian Biking when this all started…I was using some cheap cycling shoes because I had yet to buy some good mtb cycling shoes to lock into. These shoes had some flex in them(hard plastic)…not carbon. Long story short…I got some nice carbon mtb shoes and that helped…I quit riding and ran only…that helped a little more. Its been a week since I have ran…a month since Ive ridden(im on swim focus now)…and my toe/foot is getting much better.
So…to speculate…I believe I was putting some undue pressure on my toe with the cheap cycling shoes…I didnt notice until I was running…and when it had down time…one side of my toe would swell up and “pull” my toe out of alignment. I would have to pop it back but it was still irritated.
Likely fibular sesamoid issue (esp with your description of hills/increased symptoms with turning foot in and pushing). Tibial sesamoid more commonly injured and usually more symptomatic though.
Likely fibular sesamoid issue (esp with your description of hills/increased symptoms with turning foot in and pushing). Tibial sesamoid more commonly injured and usually more symptomatic though.
Thanks doc, does it make sense biomechanically that it hurts when walking, but not running?
Likely fibular sesamoid issue (esp with your description of hills/increased symptoms with turning foot in and pushing). Tibial sesamoid more commonly injured and usually more symptomatic though.
Thanks doc, does it make sense biomechanically that it hurts when walking, but not running?
Not really … though shoegear and how a person runs, etc. makes a huge difference with these. Should hurt some with running, especially up hills.
Forgot that sometimes when wearing cycling shoes, either when on the bike or walking around, the presssure of the foot “falling around” the cleat (if that makes sense) can trigger discomfort. I also have very high arches.
Also pain doesn’t really come at the ball of the foot, in or out. I’d say it’s closer to the extensor hallucis tendon.
I had somewhat similar pain, but between 3/4 metatarsals. I wasn’t willing to stop running, pain wasn’t bad enough. I bought these, wore them everyday, all day, for ~2 weeks, then only when running for another 1-2 weeks. Pain has gone away completely… YMMV but it worked for me. http://www.amazon.com/gp/product/B000KPMGZM/ref=oh_details_o03_s00_i00?ie=UTF8&psc=1
Luckily got into both PT and podiatrist for an xray today. No stress fx, both came up with metatarsalgia, which I gather is like “shin splints.” More of a “it just hurts” rather than a diagnosis of a specific cause
Xray did apparently show the second metatarsal and MT head are slightly larger than the others, indicating greater pressure there. Very high arches
i have what my doc calls a “loose foot” with pain similar to yours. i found that if i pad my shoes to take the pressure off of that area, i can run pretty normally. i also don’t lace my shoes all the way down- i leave 2 eyelets free on both sides. also, i find that hokas or brooks pure cadence feel pretty good. best of luck to you!