I seem to have developed a very sharp pain around the proximal end of my 3rd metatarsal. I’ve been having this foot pain while running for several weeks, but it’s been more annoyance then anything else, and it would either go away during the run (after I warmed up) or would disappear a few hours after stopping.
Today I went out on an easy 4 mile run and it started to hurt about 1/2 mile. After I got home, it was REALLY hurting, making walking tough and is currently that way. Without pressure on it, it is a sharp ache, but putting pressure on it causes a sharp stabbing pain to radiate along the length of the bone. So far there hasn’t been any swelling.
Does this sound like a pissed off nerve or something more serious (stress fracture)?
Not sure what the “proximal” end is, but I had something similar two years ago and ended up with a metatarsal stress fracture. Do a search for posts under my screen name about stress fractures. I posted my experiences during that time here on ST. Good luck!
I’m going to do that tonight when I get home. This morning, it soak in an ice bath for 30 min (along with the rest of me) and it didn’t seem to do much. Sitting here at work, I loosened up my shoe a bunch and have been either on my feet standing around (not much walking), or sitting down, and the pain has subsided a bunch…but I can still irritate it if I start walking around.
I did notice that there is zero swelling and that if I can massage the entire top of my foot, pressing fairly hard with my fingers, and never find a really sore spot. There are a few areas that are sore in comparison to the other foot, but nothing that I would even consider to be tender.
I irritated a tendon in that area this fall - had a shoe tied too tightly. I had an allergic rxn to a cortisone shot, and ended up on prednisone and that took care of it.
“I did notice that there is zero swelling and that if I can massage the entire top of my foot, pressing fairly hard with my fingers, and never find a really sore spot. There are a few areas that are sore in comparison to the other foot, but nothing that I would even consider to be tender.”
then it’s probably not a sfx as those are point tenderness. And the pain wouldn’t go away running.
Proximal metatarsal stress fracture certainly do occur, but they are not the norm (usually at the neck).
You mentioned you can’t find a focal area of pain, but think it is the base of the 3rd metatarsal? WhyHow? With a looming marathon, you really need to rule out the most likely first (stress fracture) since that is treated a lot differently than other possibilities (Lisfranc’s sprain, intermediate dorsal cutaneous nerve issues, etc.)
With my foot flat on the floor, but not bearing weight, if I flex my toes upward and hold, the pain starts fairly localized up at the proximal end of the metatarsals. I’m guessing the 3rd, as it is about halfway down my foot…about where the edge of the tongue of your shoe would lie. If you place your hand on the side of your foot and start flexing your toes, there is a muscle or tendon below and forward of your ankle bone that you can feel tighten. This pain is inline and just slightly ahead of that.
Could be a subtle Lisfranc’s ligament sprain (good google material for 'ya). Occasionally, lateral column instability will produce similar symptoms (usually at the base of the 4th metatarsal-cuboid joint).
I just spent the last few hours with it elevated and iced. When I got up and walked a little (to the kitchen and upstairs), I really couldn’t feel anything. As it warms up, some of the discomfort is coming back, but no where near what it was.
So how should I go foreward? Obviously the ideal thing would be to see a specialist, but I have crappy student health insurence, so I don’t look foreward to 2+ office visits plus radiology. I’m going to continue to ice, but should I just give up on running for a few days? A week? Should I go easy and just cut it short if I feel it coming back?
I took it easy all day sat, icing it quite a bit. By sat night, it felt really good…almost pain free. When I woke up this morning, my whole foot felt tight. So I rolled out my arch with a tennis ball and did some child’s pose stretches to hit the front of my legs and the tops of my feet. This combo seemed to make it feel MUCH better.
Once I stretched it out really well, I had to run out with my wife. I noticed the pain coming back, but I noticed that the outside base of my arch was getting sore as well as my inner arch up towards my big toe.
I started digging around online and found some stuff indicating this is a symptom of weak arches and possibly PF starting. It also named a few other symptoms (like lower back pain) that I’ve been having but considered unrelated.
This is my firts marathon build in a light shoe and this really didn’t flair up until I hit my 20 mile long runs, so I’m beginning to lean away from stress fx and towards a soft tissue problem. There is a PT that is coming to my running store tomorrow for free evals, so I’m going to go talk to him.
Same thing happened to me in the Spring of 07. The good news is you’re going to live. It is the result of overuse. I stopped running for about a week, took some advil, iced and then got new shoes and I was fine. However, I should say I didn’t give in to the pain until it hurt to walk and the top of my foot was sensitive to wearing a shoe. Listen to your body! If your foot hurts, stop using it for a few days-week.
I talked to the PT today and it took him all of 5 minutes to diagnose it. Apparently my calves are ridiculously tight, which has started to limit the range of motion of my ankles. In my left foot, it was preventing it from pronating enough, so when I toe off, the force was concentrating on my outer foot, which was over-stressing my metatarsals. My right foot doesn’t have a problem because I naturally rotate it outward and toe off the inside of my foot slightly.
So he adjusted my ankles, which immediately felt great and gave me a list of stretches to do to loosen up my calves. He found that one of the muscles that supports my arch (runs down the inside/back of the ankle and across) is also weak, so I have some exercises to help with that too. I think I’m going to start incorporating some barefoot running as well to help that along. He also said that my light weight trainers might still be too much shoe for me and told me that I should be in the most neutral shoe I can get my hands on, which is the direction I had been moving, so it’s good to hear my own observations backed up by an expert.
So it looks like the marathon is still a go. I might have to pick up some insoles to help the arch out, as I’m not sure if I will be able to work out all of the kinks by race day, but I should be good to run.
