Ok, about halfway through my training last season I was having some leg pain…saw my PT and we found a couple things.
First I had screwed up putting my cleats on my bike shoes…and that was the main cause. But he also found that with my newer orthotics I really didn’t need Kayano shoes, the Nimbus would be better.
Well I managed to screw the shoes up…I had previously been in a wide shoe…but purchased the normal size. Size-wise I am right on the edge of fitting in the normal vs. the wide. I figured it was just a comfort thing and wore the shoes for running. Well my leg pain essentially corrected itself and went away. But over time it was replaced with a pain in my big toes. (both feet) My left foot is worse, but I do feel it on my right foot now and then.
In certain positions when I put pressure on the ball of my feet and/or big toes it is a burning like pain. If I take the pressure off, it lingers a few seconds and then subsides. It hurts when I bike, it hurts when I run…and sometimes it hurts when I walk. The pain is focused mostly on the side of my foot near the base of the big toe. It does hurt to the touch. In fact I’ve tried to massage it a bit…that hurts like hell at first and then subsides.
Anyone have any thoughts on what this could be? How long it will take to get better? I have not trained since IM MOO (Sept 13). I was hoping to start some biking in early October…and I’d love to start running in mid November. But I want to make sure I heal properly before doing that. It sucks that this hurts when I bike. ugh.
I am not a doctor. But I had what sounds like your problem over the winter. I went to the doctor and he said it was from the bone on my big toe rubbing against my shoe. He thought it was from my dress shoes and recommended getting shoes with a wider toe box. After about two weeks, it got mostly better and now it is totally ok. However, I took a lot of time off from riding my road bike, and I rode for the first time Sunday and had the start of the pain later in the day and some swelling in the same area, so maybe it was not my dress shoes, but the narrow toe box on my bike shoes. The doctor also said it could be fixed surgically, but I should not do that, as it would require extensive recovery and changing my shoes when I have the problem will likely solve it.
Common issue, but you need to fully evaluate the joint/pathology for your long term prognosis. Obviously, changing to a wider shoe and avoiding what hurts is sound advice. If hallux rigidus or hallux valgus, both will progress in time (the bad news), but that time frame can be delayed and you might not need anything more than supportive therapy for 40 years. Or, it could halt your running in just a few years time …
My right foot did have a bunion. I had surgery to correct it. I expect problems from that foot.
My left foot is the one that should be fine. It doesn’t have a bunion that I can see or know of.
I would not be surprised if the toe box being too tight is the problem. I could have made it pretty bad with both bike and run shoes…as both may be tight. I will take a look at my bike shoes today…perhaps I need to get something that will stretch them out a bit.
I’m just surprised I still have pain after 2 full weeks off. It has been getting slowly better though.
I guess either is possible. Is it odd that the pain just seemed to start overnight?
In either case… I do have a form of rheumatoid arthritis…so this could be part of that. Although it has been controlled for years and typically the RA pain is in my back…not feet.
Another possibility is Goute. I had similar symptoms to you about a year ago, and it ended up being Goute. Although by the time I went to the Dr, got it tested to confirm Goute, and got the antibiotic, it had cured itself (about 12 days total i think).
I have an appt with my podiatrist tomorrow. Luckily he had a spot. Depending on how that goes I’ll make one with my rheumy doctor. I have one with my gastro in October already.
Yes I am on immunosuppressives. I have Crohns disease which also comes with the RA. Although RA isn’t the “official” diagnosis. I believe they call it Crohns induced arthritis…something like that. The symptoms are closely related to Spondilitus. (sp?)
I am currently on Imuran and Humira.
A few weeks ago I was on a low dosage - short duration burst of prednisone to control a little crohns episode prior to IM Moo.
I’m sure you’re right, not an antibiotic. To be honest I can’t remember what the treatmeant was suppose to be because by the time it was confirmed as Goute it had gone away on it’s own.
Ah, not true RA is correct. Known as “reactive arthritis”. Figured you were on Imuran or other immunosuppressives. Yes, the great toe joint would be an unusual area for that to occur, although I do have a recent case of this (after ‘debating’ with his gastroenterologist for a while)
Yeah…my PT took a look and thought there was a little swelling in the toe joints.
I am hoping it is just a shoe problem. If both bike shoes and running shoes were too tight in the toe box…well when you train for an IM you spend a lot of time in those shoes…and your feet take quite a pounding. So hopefully making that change is the problem. I am going to look at my bike shoes this evening. Perhaps I can stretch them a bit.
I can honestly say when I ran in a wider shoe…which I did towards the end of my training…my feet did feel a little better.
Saw the doctor. He thought the area was just a bit irritated. Changed my orthotic angle a little bit. Really a very minor change.
Now…for the last two days I’ve noticed my big toe is warm and tingling a bit. Today when I noticed it I took off my shoe and the tingling remained for quite some time. THe shoes I am wearing are big enough and have never given me a problem in the past. In fact these are the shoes that are most comfortable.
AND…the pain has diminished considerably.
I think this is a good thing…but is this tingling an issue or is there an increase in blood flow that is possibly helping? My toe may have been tingling prior to the change…but it also hurt so bad I didn’t notice it.
Is there a way I can tell? Im guessing the toe being hot is a good sign as I’d be going numb if it were a lack of blood flow.
It is highly unlikely to be a ‘lack of blood’ issue. If the joint is inflamed for whatever reason, there is a medial dorsal cutaneous that often can produce those symptoms if irritated. Should continue to improve with your orthotic adjustment (I’ll get a forefoot varus post).
