Mystery foot injury - ball of foot

Triathlon Forum
1

I’m posting this in hopes of getting clarity of what this could be, as the symptoms don’t seem to completely line up with things I’ve researched. I’ve been dealing with pain in the ball of my foot for about 6 months now, which originated during marathon training. I’m going to lay out the timeline in bullet form to better organize -

November 2021

  • started feeling a little bit of discomfort in the ball of my foot after runs, but never hurt during runs and I didn’t think much about it; kept running and training for a February marathon
  • developed a callous between my big toe and 2nd metatarsal that was causing a lot of pain (or so I thought this was the cause of the pain); filed it down and it seemed to help for a run or two, but the pain came back eventually

December 2021

  • pain got worrisome enough for me to completely stop running and forget about the marathon; the pain was never terribly painful, but bad enough to make me nervous about it
  • during this time, the main symptoms were: pain when palpitating the base of the 2nd metatarsal, and pain when bending the 2nd metatarsal down (it felt like a very sharp pinching under that toe joint), and it felt like there was a small pebble under the ball of my foot. Definitely couldn’t stand on my tiptoes, or walk barefoot, and my foot was pretty inflamed.

January 2022

  • went to doctor, got an x-ray that showed thickening of my 2nd metatarsal bone, which could be indicative of a stress fracture, but also could happen in conjunction with something else that is putting a lot of stress on that bone and my doctor actually said he didn’t think it was a stress fracture.
  • still wasn’t running, but was occasionally biking (which bothers it a bit), and still walking without a boot, so wasn’t completely resting the foot

April 2022

  • started introducing runs again after several months off (and my foot had gotten a lot better to the point of no pain while walking) - at most I did 3 30 minute runs/week, and it felt fine during the first week or so, but the pain came back after a few weeks of this. Not as bad as before, but symptoms are now a bit different
  • main symptoms are: redness in ball of foot/toes, along with throbbing sensation and the foot gets warm to touch, a tiny pinching sensation when i bend my 2nd metatarsal down (but only the tiniest pinch - nothing like how it had been previously), weird small twitches in my toes. The ball of my foot also gets pretty puffy and inflamed.

May 2022

  • finally getting an MRI at the end of the month, but wanted to post this in the meantime to get some ideas, since I am stumped as to what this could be.

Also relevant, I have a bunion on the foot that I’ve had for about 15 years that has never given me any trouble. That could definitely be contributing though.

Appreciate any thoughts!

2

Guesses might be metatarsalgia or bone spur.
If it’s metatarsalgia you can try a met pad on your insole of the shoe. see if that helps. the pad is placed just behind the ball of the foot, centered. You don’t want the pad under the ball of your foot. The idea is putting the support there will offload the area that’s the issue.

3

Has your doc considered the possibility of it being Morton’s Neuroma?

4

He didn’t - he thought it was just capsulitis, possibly a stress fracture. The more I read about neuromas, the more I think that could be it. Though I’ve been reading that they are tough to capture on MRIs without contrast, which is what I’m scheduled to get at the end of the month. Might look into seeing if I can get it with contrast…

Though I don’t get the nerve-y feeling that I would expect with a neuroma, there is sometimes a burning sensation in my foot. The thing that confuses me is the redness and warmth… though that could just be inflammation associated with a possible neuroma.

5

My friend had similiar symptoms. He was misdiagnosed with sesamoiditis and ended up having surgery to remove the sesamoid because nothing worked. It didn’t solve it and actually started having issues with the other foot as well. After a couple of years he was finally correctly diagnosed with psoriatic arthritis. He’s doing better now that he’s taking the right medication.

6

I can’t add to the suggestions of neuroma and metatarsalgia, but if you’re in New England, the people at Portland Foot and Ankle (Maine) are great. I’m sorry to hear you’re dealing with this. Keep us updated.

7

How old are you? I have had similar problems and it was determined to be arthritis in my right foot, specifically in my index toe. I have a slight hammer toe which probably contributed to the issue. I am 63 years old. Run mainly in Bondis now which also helps.