I have been struggling with some foot pain the entire season. I think it was a result of my introduction to trail running last off season. I had x rays on three different locations all negative for the possibility of a stress fracture. An MRI was completed to rule out a Neuroma. The podiatrist is recommending orthotics to reduce the pain. My orthopedic is convinced I have metatarsalgia.
Is this an injury that can be cured with orthotics? What are the other options to eliminate the pain and allow the foot to heal permanently. I have been trying short periods of rest all to no avail. Is this an injury that can be completely resolved over time?
Any experience with this problem would be greatly appreciated. I am extremely frustrated and losing hope since this problem does not want to go away.
“metatarsalgia” is just a junk term/catch all phrase for generalized forefoot pain (absent a specific pathology, like a lesser met stress fracture, Morton’s neuroma, Frieberg’s infraction, capsulitis, etc.) It is primarily an overuse injury and rest (whether absolute or relative - more on that in a moment) is all that is needed to resolve … in time.
Absolute rest is ideal (i.e. crutches, no weight, cast), but not really practical. Relative rest (behavior modification of not running, CAM boot, orthotics) is generally employed to decrease forefoot stress. Shoegear changes, posterior calf stretches, ice after activity, “orthotics” all will eventually help. Best of luck!
I have a bad case of stone bruise (aka metatarsalgia) and I two six weeks off with no running (recommended by my doctor) and that didn’t work for me. I went out and bought superfeet insoles (green) and that didn’t help. I finally went out and bought $5.00 spenco rx metatarsal arch cushions from a running store and that helped significantly. Upon initial use of the pads the pain went away completely but after some long runs it came back. But with that said the pain intensity went down significantly and is now tolerable. Also, when it does come back it’s at the very end of my long run, so the majority of the run is pain free. The only thing I don’t like about the pads is that they are not fixed in the shoe but to me it’s worth the hassle of avoiding really nasty foot pain. The pads float around in the shoe and are kept in place by your weight in the shoe. So you have to make sure they are well placed everytime you go out for a run.
Thanks for the responses. I read some of the previous posts on this type of injury, and several people recommended the Aetrex L405 inserts. I am going to initially shut down my running for a month, I hope this is long enough? I will try to use the inserts upon resuming my runs to see if that will eliminate some of the pain.
I was also experiencing similar issue on longer runs, after an hour it becomes a walk/run scenario.
I was really dissappointed that the rest didn’t help me. If I had to do it over again I would have tried the inserts first. I would have been a lot happier because I wouldn’t have missed runs. But given that I said that “rest” may be enough for you and exactly what you need.
Will it be enough rest? I don’t think there’s a right answer to this question. I think it’s nature’s decision.
I have had this problem, it developed right after running on the treadmill in a new pair of Neutons. I ran for ten minutes and the next day I couldn’t put either foot on the ground. I have been running my whole life and never could have even imagined that such a disorder existed. I have a mortons toe and a flat foot, that never bothered me before. I tried a cortisone shot and it helped cool down the inflammation temporarily, but short of having surgery to correct the problem the best bet is a pair of custom orthotics with a huge metatarsal pad built into it to off load the stress on the joint in pain. These pads will help heal the problem but you will probably always need them and will be unable to walk barefoot again. Incidentally if the issue that your having is a neuroma than you might benefit from a cortisone shot. There is a surgery for neuroma’s but there’s no guarantee that it wont grow back. The surgery for Morton toe called a Weil Osteotomy also has it’s risks because you can end up you second to sticking up.
I have been struggling with Metatarsalgia for some time too (2d digit on L foot). My issues were driven by lower back. When I get the back right, I don’t have the issue. I see a PT who specialized in biomechanics.
The Metatarsalgia was also exacerbated by curved shoes (i.e., Sidi). Rroof steered me towards Specialized shoes and that helped. I would think that Shimano and Bont would do the same (but maybe with a shim).
As to the person who had a prob with Newtons, although I do not exclusively train in such shoes, nor do I do a lot of long training runs in them, I find the pads on the bottom of the Newtons move the digits and help with mobility.
I have also found that the socks with toes and “yoga toes” (when not running) help treat the symptom. Interestingly enough, I moved my computer monitor from the left side of my desk (I have a job where I sit a lot) to right in front of me and it helped my back issues; I tended to sit on my left cheek and rotate that way.