I’m nearing the end of training for my first marathon (Phoenix on January 17). Obviously, with this has come an increase in my weekly mileage, to more than I’ve done before. Though, I feel I’ve maintained my week-to-week increase to a modest pace. I’m up to about 45 mpw right now.
The issue I’m having is pain in the innermost tendon on the top of my foot. I believe it’s the tendon that controls movement of the big toes.
For the past 6 months, I had been training and racing in Asics DS Trainers, which I really loved. My problem was, with the longer mileage I seemed to tire out and start to over-pronate a little too much. So, as I was ramping up my weekly mileage, I though I should go with a little more stability, especially for the longer training runs, and bought Mizuno Wave Inspires. After doing one 17- and one 18-miler in them, I was getting this pain in that tendon on the top of both feet. It didn’t stop me from running, but was pretty painful after I finished my runs. So, I figured that the Inspires weren’t for me, and took them back to the running store to exchanger for the DS Trainers. I figured this would solve my problem. But, now after about a week in the DS Trainers, I’m still getting this foot pain. So, maybe it isn’t the shoes.
No guru here, but I know one - I call Rick Wetherald (catchy ST screen name), elite racer, elite coach, degree in excercise phys, and currently in PT school.
This is kind of a stupid question, but, your shoes aren’t tied too tight are they? I’ve ran before with my shoes too tight, and that spot hurt on my foot for over a month.
No, I had thought about that and have experimented with different lace-tightnesses (I can’t think of a better way to word that). But, it did just occur to me that over the summer, during tri season, I was using elastic laces in the shoes, whereas I’ve just been using the stock laces in the new ones. It seems that the elastics would be a bit more forgiving in this regard. I’ll try putting the elastics in the new ones when I get home and see if that helps at all.
I had a similar problem several years ago. I was actively pulling my big toe up towards the sky with each step. I had to learn to keep my toes relaxed and not actively move them up just before landing. I couldn’t figure out why I was having the pain and it just finally hit me one day that I was basically overusing that muscle. anyways, that’s my story.
It is very reasonable to think that you are overusing the extensor muscles and tendons that cross the top of the foot to help control the pronatory motion you describe. As described in the last post, you may need to let the toes remain more relaxed. Do you eat holes through the top of your shoes toe box? Otherwise, I hope you aren’t thinking too much about actively trying to maintain an arch because gravity will eventually win with all that run volume and you will have a nasty tendinitis. Was there a problem like knee pain or something else that you felt necessary to combat by concerning yourself with the amount of pronation you were experiencing during these longer runs?
Your shoes may be too tight. I know from first hand experience that this can bruise the top of you feet; although you will not see any visible discoloration. I have bruised the tops of my feet several times as a result of over-tightening snowshoes with softer running shoes (which is the reason that I train with trail running shoes with snowshoes). It is very painful when you put the shoes back on and continue to irriatate the area. If this is the case, make sure that you give it time to heal by wearing your shoes very loose, and possibly adding some padding on the top; or give them some time to rest. Im not sure if this is the case, but the symptoms that you describe match this problem. Hope this helps.
Dorsal foot extensor tendonopathies (i.e. EHL, EDL or TA) as you described are generally caused from direct shoegear irritation as was mentioned and not biomechanical overuse.
I had a pain there a couple of times. The first time, yes, my shoe was too tight and the pain went away with ice. The second time, the shoe was ok, but I did increase my mileage (not gradually) and when I went to the chiropractor and he gave me a 1cc cortizone shot and the pain went away shortly thereafter (but I decreased my mileage as well).
But I’m not advising to get a shot in the foot by any means. That’s just what I did. Hope that helps.
Ice and time do work well most of the time. A local corticosteroid injection also works great and I’ve done plenty (and would have it done to myself assuming I knew the cause was mechanical irritation rather than just waiting and icing). But, are you sure your chiro did this? They are not supposed to do this (no drug license, etc.). No big deal (since it was likely a correct option and obviously helpful), just curious.
I always use elastic laces, and I haven’t had foot pain since. One of my feet hurt so bad before that I thought I might have a stress fracture. Maybe try the looser laces and see if it helps?
It looks like the main consensus here is that I might have my laces too tight. Even though it surely doesn’t feel like it, and I had them loose enough earlier this week that I was getting some extra heel movement, I guess it might make sense. The only difference between my previous DS Trainers and the ones I’m wearing now is the elastic laces (they are both the same model). So, I’m thinking swapping in the elastic laces should help solve the problem. Thanks for the help all!
If that doesn’t work, you can try skip lacing the shoes due to the irritation. If it is centrally located in a particular area on the top of your foot, don’t cross the laces there, just skip that hole and run the laces parallel to each other (staying on the same side, just the next hole up) and then cross over and continue to lace after you have skipped the problem area.
It may be a tendon problem as you suspect, but metatarsal stress fracture also hurts there and can also be discolored. I would suggest you see a podiatrist or orthopod who treats runners. I had a similar pain last summer from old shoes, I suspect mine was a stress fracture, but in any event 4 weeks off and new orthotics cured the problem.
I’ll add my anecdote as well. Probably laces or stiff uppers. One pair of old trail runners had really stiff uppers, and even though my laces weren’t super tight, I do remember getting similar discomforts to what you describe. Mine pain was much worse on downhills (which makes sense, since stride length increases you bend your pushoff foot more)
I have had a similar problem that was not the result of laces that were too tight. My Anterior Tibialis Tendon became irritated (as another poster mentioned) by overstriding and pointing my toes skyward. Try to slightly shorten your stride and relax your toes.
In the interim, do not run until the pain goes away. An irritated tendon sheath can take months to heal (as I found out).