I developed a pretty bad case of Metatarsalgia after a really hard effort at Gulf Coast in mid-May. Prior to this I’ve been averaging 30-35 miles/week of running for at least the last 3 years w/ no problems.
I have orthotics and my podiatrist, who specializes in runners, added a met pad to help with this. He also gave me a cortizone shot. This was 3 weeks after the race. I’ve reduced the mileage to 10-15 miles/week but the problem seems to be getting worse. Icing helps some.
I’ve taken 5 consecutive days off running twice so far, the pain is gone by the 5th day, but returns at the end of the next run. It doesn’t hurt at all to run (which is odd) but the pain is at about a 7 out of 10 when I walk on it for 24 hours after the run. I feel like since I’m able to run on it I should train through it but I’m not sure what the consequences will be.
I’m doing IMFL in November so I need to get this thing sorted out.
I had a foot problem last year that was diagnosed as metatarsalgia. My foot would hurt WHEN I ran and when I was just sitting around with shoes on at work. I used to have to un-lace or take off my shoe at work it hurt so bad.
I took a few weeks off completely, got a 1/2 size bigger shoe, and mine went away. No problems since. I also wore my flip-flops as much as possible instead of regular, restrictive shoes.
I would just take time off. November is a long time away. Enjoy the weather and go riding!
I struggled with that one for a year. (I’ve tried most orthopedic problems at this point) I think I just didn’t find good help, which is why it took so long to fix.
I hear your frustration. To have all your systems on “go”, and yet have debilitating foot pain (in my case, I couldn’t go for a walk), is enough to drive a person mad.
I started with the steroid shot, then added a met pad, and then my pedorthist had me walk across a pad with graphite (I guess) underneath a protective sheet, and it showed my metatarsal head hitting the ground hard. So he cut a circular area out from underneath my orthotic (leaving the top surface intact), directly under the metatarsal head that was hitting the ground. It was instant relief.
Anyway, after all of the above, I got relief, and eventually I didn’t use the cutout anymore. I’m a mid-fore-foot striker, so now I make sure I use shoes with plenty of forefoot padding, but they still must have lots of flexibility in the forefoot, to prevent it from coming back. Oh, and I still use metatarsal pads on my orthotics.
I struggled with this same issue in 2004. As a matter of fact, it flared up after the Gulf Coast and I dealt with it as I prepared for IMFL.
Anyway, I really agree with the previous poster about cut-outs in insoles/orthotics. That one helped me a lot. You can circle the painful area on the bottom of your foot with lipstick or marker, then step on the insole and then cut out the mark that you made.
Also, have you changed your running shoes recently? How about your everyday shoes (I kept buying different running shoes and then realized that my everyday walking shoes were a problem)? Is it bothering you at all on the bike?
It seems like time off alone won’t fix this for you if it flares up again as soon as you resume running. Hopefully rroof will reply to your post. He is a podiatrist and has helped a bunch of people here on the forum.
Most of all, take heart, I know this is frustrating, but stick with it. You still have time to prepare for IMFL and have a great race.
Thanks for the encouragement. I’ve got a solid running base so I’m not too worried about having to take time off if it comes to that.
I’ve got full length orthotics so I’m hesitant to cut them out if the condition will resolve itself.
Funny thing about the shoes. I’ve run in Kayano’s for years, I replace them every 300 miles. I bought a new pair after Gulf Coast and they are the new version of the Kayano’s which are a lot lighter. Not sure if this had any impact or not but the problem started after about a week in the new shoes. Again, that was also right after a hard effort so it’s tough to say.
No pain on the bike, thankfully. I’ve been putting in lots of extra miles there.
Icing hasn’t done as much for this as it has for other lower leg/foot issues I’ve had.
However, I did the cutout thing with a pair of insoles and Sweet Maria what a difference! My primary complaint was pain while walking and this has greatly reduced that. I can still run in the orthotics and then switch to the cutout insoles. Sweet.
I’ve got a wider pair of Kayano’s coming in the mail so maybe the combination will payoff.
I took me a year to find that answer. I’m glad you got it sooner and I hope it gets you back on the road.
I did Gulf Coast this year, too - with a brand new pair of orthotics which created huge blisters by mile 4 - I just told myself to run faster and it would be over sooner, so I did. I knew that would happen, but I had some knee problems that the new orthotics were for, and I decided that it was easier to heal blisters than knees. I took my shoes off in the med tent, b/c I didn’t know what was left in there. I’ve had the orthotics redone and fixed the blister problem now. I have an orthotic/shoe/sock collection.
I plan on being at IM FL too. Maybe we can meet and compare feet…
You may also want to double check your foot/cleat position on the bike. I had metatarsalgia recently during a half IM run. Even took my shoe off at an aid station to see if I had a rock problem. Turns out my the flesh under the meta head (big toe) was being repeatedly compressed during 56 miles of cycling. My meta head was directly over the pedal axle (using Sidi shoes and Speedplay pedals). I have since gone to a smaller shoe with a larger toe box (Shimano) and moved the cleat center further back. Compression now occurs slightly behind meta head and life on the run is good. Good luck.
I’ve been considering sliding the cleats back a bit. I’ve heard from several people now who echo that suggestion. I’ve had PF sporadically also which I’ve suspected may be coming from the cleat position.
Did you have any problems adjusting to the new position on the bike? Anything in the knees?
No knee issues. Had to adjust seat height a very small amount. You may find you are applying force more evenly through the downstroke of the pedal. Nice little bonus!
I have a flat foot and mortons toe but it never bothered me in my 24 years of triathlon, with the exception of some hammer toe (42 now), then I ran in Neutons for ten minutes fast on a treadmill and the next day I had a lot of pain in both feet around the ball of my feet. The pain was really bad and I went to a podiatrist who said I had metatarsalgia. Its been 2 years since that treadmill run and I still can’t run without the use of custom full length orthotics with a metatarsal pad and a forfoot cut out. When I wear the orthotics I am able to walk and run for a few miles but the area can still be sensitive at times. I must have injured my foot running fast for ten minutes on the treadmill with the Neutons. A did get a cortisone injection and it provided some temporary relief. I do not recommend a wiel osteotomy or any surgery for this problem because there are too many complications associated with surgery. I agree that this is a very frustrating problem because it can keep you from participating in running pain free.