There is a lot of experience here and even some doctors, so I will see what people have to say about a foot injury that has been bugging me for about a week. I am trying to figure out how best to manage it. It does not seem worthy of a doctor visit at this point in time as I have yet to actually even miss a workout. That being said, it appears to be trending worse. Here is what I’ve got:
Late last week I started getting light pain on top of right foot. Have had similar pain because of shoes being too tight in the past. Loosened my shoes, but no improvement.
Pain exhibits when I flex my big toe upwards, but the pain is located at the top of my foot near the base (so relatively far away from the actual toe). It is barely noticeable if I flex all toes at once (while not running, that is).
Pain seems to subside relatively quickly after running.
Worst the pain has gotten during any run is maybe 5 on a scale of 1-10.
So far I’ve managed with ice and ibuprofen (ice doesn’t seem to make it feel better, at least in the short term). I’ve been able to run 21 on Sunday, took Monday off to try to heal (felt great by Monday night, was bounding stairs without pain and didn’t even bother to ice it before bed), ran 10 each on Tuesday and Wednesday, and 9 this AM. The 9 this AM seems to have really aggravated it.
Now that I write this out I recall that the two runs that most aggravated it (Sunday and this morning) were on my Nike Lunar Racers, which are very tight in the forefoot.
There is some tenderness in the area of the foot that hurts, running along the big toe metatarsal.
No pain from pressing on the top of the toe towards the foot and I can jump on the foot without pain (understand these may be symptoms of a stress fx).
So what do you recommend? Rest it until I can complete a full run without pain? Keep icing it and just managing it since it really hasn’t caused a big problem so far? Try padding the tender region before a run? Go to a doctor?
I’m going through a couple of foot pains as I build up for the marathon. I had the same pain on the top of my foot (along the ligament that runs from my big toe to top of my ankle). I tweaked the way I tied my shoes and just ran through it. The pain went away in a week or so.
I’m now working through some really tight achilles right now. I’ve toned down my intesity so far this week and hope to feel better for my 10k on Saturday and HM next Saturday.
First - take the laces out of that shoe, and then re-insert them skipping the holes right over the instep - that should take the pressure off the ligament/nerves
Second - do these e-cises, they work for just about everything imaginable, but for achilles, PF, etc they are a dream:
… Late last week I started getting light pain on top of right foot. Have had similar pain because of shoes being too tight in the past. Loosened my shoes, but no improvement.
Pain exhibits when I flex my big toe upwards, but the pain is located at the top of my foot near the base (so relatively far away from the actual toe). It is barely noticeable if I flex all toes at once (while not running, that is).
Pain seems to subside relatively quickly after running.
Your description is pretty consistent with tenosynovitis of the EHL (extensor hallucis longus) tendon. This large tendon that dorsiflexes your big up up runs over the 1st metatarsal and up the front of your ankle under a dense band (retinaculum) there. It is commonly irritated by shoes with running (too tight, flexible, etc.). Since it resolves quickly after running, one can assume running shoe gear irritation.
Pain for me is on the top of my foot (big toe area) as well as on the inside (in the arch area). Both hurt to the touch. Thought it was feeling better yesterday but ran 10 and had to stop due to pain.
Will try those exercises as well as am starting to use the TP roller while sitting at my desk.
I had the same issue with my Lunaracers, too tight in the forefoot and the overlays they used were very harsh on my feet.
Thanks for the responses all. As an experiment I took my work shoes off and walked around a bit, much less pain (not zero). So when I put them back on I left them untied and it is quite a bit better. I think I will shelve my LunarRacers for a while . . . In general I like these shoes, but I probably wore them too much last week. I did 89mi last week and wore them for all the road miles because they are the “cushiest” shoes I own. Probably what caused it. I’m going to let today’s flare up pass, change the lacing pattern as suggested, and hopefully continue on as normal either tomorrow or Friday.
Your description is pretty consistent with tenosynovitis of the EHL (extensor hallucis longus) tendon. This large tendon that dorsiflexes your big up up runs over the 1st metatarsal and up the front of your ankle under a dense band (retinaculum) there. It is commonly irritated by shoes with running (too tight, flexible, etc.). Since it resolves quickly after running, one can assume running shoe gear irritation.
I guess I do have one question. Let’s assume this is correct. Will I be able to run through it by swapping shoes/lacing patterns/etc or would you recommend resting until the pain is gone completely?
Your description is pretty consistent with tenosynovitis of the EHL (extensor hallucis longus) tendon. This large tendon that dorsiflexes your big up up runs over the 1st metatarsal and up the front of your ankle under a dense band (retinaculum) there. It is commonly irritated by shoes with running (too tight, flexible, etc.). Since it resolves quickly after running, one can assume running shoe gear irritation.
I guess I do have one question. Let’s assume this is correct. Will I be able to run through it by swapping shoes/lacing patterns/etc or would you recommend resting until the pain is gone completely?
Tough call -** let pain be your guide**. Continuing to irritate the tendon/sheath is not good of course. If you have an A race looming and it isn’t bad, I’d push it (you mentioned an 89 mile week so I’m assuming something coming up). If not, better to let it calm down more before running. Goes without saying to eliminate what causes it (or what you think is causing it).
Tough call -** let pain be your guide**. Continuing to irritate the tendon/sheath is not good of course. If you have an A race looming and it isn’t bad, I’d push it (you mentioned an 89 mile week so I’m assuming something coming up). If not, better to let it calm down more before running. Goes without saying to eliminate what causes it (or what you think is causing it).
Will do. My A race (Phili marathon) is 7 weeks away, so I can probably afford to be a bit cautious. Thanks again for the reply, I think you are a great asset to the forum.
Tough call -** let pain be your guide**. Continuing to irritate the tendon/sheath is not good of course. If you have an A race looming and it isn’t bad, I’d push it (you mentioned an 89 mile week so I’m assuming something coming up). If not, better to let it calm down more before running. Goes without saying to eliminate what causes it (or what you think is causing it).
Will do. My A race (Phili marathon) is 7 weeks away, so I can probably afford to be a bit cautious. Thanks again for the reply, I think you are a great asset to the forum.
Just to update this thread in case anyone cares or finds it in the future, my foot was feeling good the day after I wrote this, so I ran 12 in the morning last Friday. Foot was fine so I ran another 7 that evening. The pain became very sharp after that 7, so I took Saturday off. Sunday felt better, but I wanted to be cautious so I ran 6 very easy, and then 8 easy on Monday. Tuesday was off for life reasons. After those four days with two off and two easy pain was light but my foot was not healed, so I made a podiatrist appt. I am hoping he agrees with the extensor tendinitis and can resolve it with a cortisone shot. Still, all accounts of this I find from googling everyone seems able to train through it, so I did my normal Wednesday training, which totaled 15 miles. The foot pain became very sharp again after the second run and hasn’t gotten much better overnight, so I’ll probably be off today. After today, assuming it feels better, I’ll just run 6-8mi per day until the appt (Tues). A little bummed about this because I only want to run Phili if I can have very good fitness, and I will have lost 2-3 weeks to this fiasco. The thing that bugs me is if I had just called it a day early when the pain started on the long run that caused all this, I would have missed 8 miles of a long run instead of ~60+ miles spread over 2 or 3 weeks. Managing running injuries is very tricky . . . if you stop running every time something hurts, you won’t be running very often. But running through injuries can occasionally lead to very bad outcomes.
Edit: One thing I am considering is cutting the top off my Vibrams (which I never wear) and trying to run in them (on the treadmill or track) with only the toes and the velcro strap holding my foot in place. I think that would help my situation considerably as walking around barefoot has generally been pain free since the injury (except when I overdo it like right now). I did try running in them once since the injury, but that stretchy sheath over the top of the foot was no better than a regular shoe.
Sorry to update my own thread again, but I do like it when injury threads have a conclusion (most don’t). Went to the podiatrist yesterday, I have a Rx for Meloxicam and an appointment for an MRI. He thinks the EHL tendonitis is most likely (I did not bring it up), but was concerned that some nearby part of my foot was also sore and shouldn’t necessarily be with the tendonitis. In any case, foot seems to be getting better at a slow pace. The week after the injury I ran 50-some miles and had some pretty painful days, last week was 60-some. This week I am up to 34 and will probably run another 7 tonight. Pain is not gone, but much better right now.
New diagnosis after MRI: I have an “impending stress reaction” and “so far, the bone is not involved”. The former sounds bad, but the latter maybe means its okay. I ran 87 miles last week and it didn’t really get any worse. The news about a stress reaction came from the podiatrist over voicemail along with instructions not to run until my follow-up appointment on Thursday. Anyone ever had a stress reaction before? I’m five weeks out from Phili and wondering if this means I am toast.