3 weeks ago while running, I was forced to walk after experiencing shooting pain on the top of my foot right below the second toe (I was able to walk back home with no pain). I took a week off from running, and did not have pain when biking, swimming or walking (depending on the shoes I’m wearing). Right away, I decided a 2-week break from running was in order and wouldn’t hurt my training. Went to ortho, got X-rays (nothing broken), and got scanned for new running orthotics to include metatarsal pads, as I have Morton’s foot. I won’t have the new orthotics for about 2 more weeks.
Took another week off from running (biked and swam more is all). After 2 weeks from D-day, tried running again, and pain began almost immediately. Last week (week 3), I tried elliptical with no pain and began water running. Got a bone scan, and yesterday was back at ortho to review results and establish diagnosis.
No stress fracture. Doc says it’s capsulitis. Of course, I ask the question, how long does this take to resolve? He said 8-12 weeks. Ouch. I hope that clock started right after I quit running. He gave me some NSAID pads to wear 24x7, I’m icing 2-3x daily (ball of foot), and I was cleared for elliptical and biking (which I was doing anyway), and I am trying to stay off my feet as much as is practical (luckily I work at home). At home I’m wearing the stiffest soled shoes I own. Next visit to ortho (who treats many runners) is in 3 weeks. He said not to try running for another 2 weeks, and I am good with that.
Anyone else ever have this and have any tips? I’m a little freaked out right now after locating some forums where people say they’ve lived with this (and not run) for months and months. Did I catch it in time to resolve it quickly, or is it that it was on its way well before a few weeks ago and could take months to undo?
On the plus side, I never had any swelling that I know of, and there is no pain in flexing or extending the toes passively. I get weekly massage—is there anything special I should ask for there? Any specific stretching or strengthening? I am willing to do whatever it takes.
Thanks!
2nd MTP joint capsulitis is a very common issue in runners (esp with certain mechanical issues, like a Morton’s foot - short first ray, uncompensated forefoot varus, etc.)
Your tx and expectations sound about spot on to date. Other entities ruled out (i.e. Frieberg’s infraction, stress fx, etc.). Offloading the 2nd met head will be helpful. Occasionally, a corticosteroid injection is used to decrease inflammation in the joint as well (instead of oral NSAIDs).
As for how long? Can last months to years … ugh. There are surgical procedures for chronic cases (say, over 2 years of failing treatment).
Good luck!
I just went through this. Capsulitis in 2nd metatarsal on right foot started to bother me in November (late) and had the same impact to my running as it had for you. I got it diagnosed in December and tried cortisone, ice, NSAIDs, over the counter met pads, etc. That got me through a February marathon, but I was in serious pain and it was causing a change in my stride to compensate.
Finally, broke down and got orthotics for my running shoes and he also built up a met pad that fits into my biking shoes. I’ve been using them for a month now and all is good. I can still feel it, especially after a long run or if I walk around on tile floors, but it barely hurts anymore. These things are a godsend. I guess I’m a success story because I had read the same things you did about people just living with it. I don’t know how someone lives (and runs) with that.