Ball of foot pain/sesamoiditis?
I have dealt with this a couple times over the past year or so, but never before in my years of running so not sure what's causing it.
Both feet, but left worse than right, have been getting VERY sore under the medial ball of my foot, pretty much right under my sesamoid bones, when I run. It doesn't seem as bad on trails as on asphalt/sidewalk. My shoes are a little on the older side but not worn out. The pain, about halfway through my long run today, was almost debilitating. This is really frustrating considering I'm just barely able to run after fixing my hip/IT issues.
Anyone have any experience with this or brilliant suggestions?
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shannon:
what side were the hip/IT issues?
do you have point tenderness on both feet at the same spot (i.e. sesamoid bones or MTP joint)? since you didn't mention it, i assume no bunions or hammer toe?
always good to get to a diagnosis, but assuming you don't have bunion at 1st MTP or hammer toe issues, then the acute treatment for stress fracture or metatarsalgia is, as always, rest, ice, elevation, NSAIDs. you might even try the dreaded mtp inserts to provide more cushion for acute relief.
once the pain is more tolerable, i always suggest to friends and colleagues...barefoot running! yeah!
actually, no need to go that far. minimalist, no support, racing flats, will also work or the vibram 5 finger, or the merril barefoot line or even the New balance minimus line.
sounds like your issue is that you are slamming that region of your foot, one side more than the other. the natural running foot strike is to hit the ground first with the lateral part of your foot, toes spread wide to sense the ground, and then upon imapct a roll to the medial side or ball of your foot. you are probably just slamming down on the ball and skipping the lateral side landing. barefoot or minimalist show running will force you to run properly.
it takes time to get your foot structures back into shape after atrophying in big cushy shoes, but this will clear up all your running problems.
the trail running has you being more mindful of where you set your foot, so you can't just zone out and slam the ball of your foot each time.
by the way, go minimal even during your normal day. once you return to surgical life, you should be walking around all day in minimalist shoes. when i walk the hospital and see clogs or big cushy shoes on the surgeons, i know i can smoke them on the run
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good luck!
gh
No bunions, no hammertoes. I do have point tenderness at the same spot on both feet but it is BARELY noticeable on the right, and pretty bad on the left. The IT issue was on the same side.
I don't know how much this confuses the issue but I do remember, from xrays that I don't have and don't remember the side of (left vs right..) that I have a bipartite sesamoid. I'm assuming that that is on both feet.
I knew I would somehow get sucked into barefoot running!
OK, I will try the rest, etc, etc and try to get through this.
In the hospital I spend all day in crocs... I feel like that's as minimalist as it gets, yeah?
Thanks for the help.
Bipartite sesamoid is not a issue. If you have one side like that there is >80% chance you have it in the other.
You aren't getting sucked into barefoot running, you were made for barefoot running or minimal shoe running.
Not familiar with crocs, but if you tell me the model, I can give u a thumbs up or down, if you care to know. The general desire in a shoe is to have no lift at the heel and neutral(I.e. No stability or thingys that prevent normal foot movement), and no excess cushion that completely overrides proprioception of the foot structures.
Wishing you a speedy recovery.
Gh
The minimalist approach will also help with the IT, by the way.
Gh
So this am when I went on a run, there was no pain for a couple miles, then it was REALLY BAD and the pain, instead of localizing just to the ball of the foot spread up the big toe too on the left. Obviously I need to stay off of it while this is going on, but do you think that changes anything? This is killing me.
S
Inflammatory response kicked in s/p 2miles. Likely will respond to more rest. Fhb tendon inserts at great toe and traverses sesamoids, so not surprising to have toe pain.
Assuming all is normal in terms of foot structures and no anomalous bone formations in the area, or occult neuroma, then likely just basic inflammation.
An ultra sound for fluid pockets and weighted imaging or MRI could bring peace of mind.
Accurate leg length measure from a pro is more academic than anything, since you can move as if you had a discrepancy due to tightness even with even legs.
Try 1.5 mile runs with perfect form, maybe even on treadmill for controlled environment. Incline at 1.5%. Run easy and light.
Try walking in minimal shoes and, only in the short term, ok to use mtp pad, but trim it and only when walking.
You have a couple of weeks until the 12 week CdA prep so use the time to get pain free.
I'll keep thinking a out this and if i come up with snything i'll let you know.
Gh
Stay warm and dry out there,
Shannon
I had a similar problem a few years ago and went to a local sports doctor who also does ART. He noticed I was trying to “protect” the ball of my foot which caused the muscles/tendons to strain even more which made it hurt even worse. The more it hurt, the more I protected it which caused it to hurt more, etc. The sesamoid bones were close in proximity to but were not a problem.
He did some ART focusing on the tendons under the foot while pulling the big toe towards my shin. It hurt but it felt much better. I saw him 2-3 times for this until it did not hurt and have learned to manage the pain by replicating what he was doing. Today, no pain and running fine. I do pay attention to run volume and try not to pound out huge volume on back to back days. Whatever he did, it worked.
Hope this helps.
I've been running for almost 10 years and this past year is the only year that i've had this many injuries. Don't really know what to make of it.
So, I guess I will rest it this week, ice, wear the right shoes, etc (but today I'm in heels at another stupid conference!!!) but is there anything else anyone has to offer that would get me to the point that I can run my ironman?!!! This sucks.
The pain is not in a position where a neuroma would be; this is pretty much either an inflammation or a fracture of a sesamoid as far as I can tell.
May try some of the padding, though, so thanks for the help!
did you get the wt101's! the plate is better than padding.
the other quick fix is high rpm midfoot strike with very little toe off. you can run like this and still go fast and not strain the mtp joint.
don't get anyhting removed or shots in the foot until you do the above. i think the above will work along with ice, etc.
after cour d'alene, rest and then make the high rpm minmal toe of style of running permanently your style of running. i kind of run like that and i am pretty fast, not elite or anything, but you get the picture.
GH
After CDA I am thinking I am going to quit running, period. Heck, I may be quitting before then. I can barely walk so I have no idea how I'm getting through this race.
Rest until kind of goes away, then wt101, run with us Pasadena can get then in 4 days. Then think Benny hill when u run, not Mirinda carfrae!!!
Just kidding, more like chrissie Wellington run style vs. Carfrae.
Gh
Picked up the wt 101's at runner's circle--let's hope these things work!
Avoid toeing off, run with high rpm short strides.
Instead of the 2.5hr run this week, do a shorter high rpm short stride run at a good clip without toeing off.
Avoid trails with rocks big enough that could hit the plate and zing the inflamed area. For now, that plate is for road impact protection and to prevent too much flexion at the mtp joint. After cda, once all inflammation goes away, you can use the 101s on rocky trails as rock protection.
You'll be ready for CdA and never stop running!!!!!!
Gh
See u then or around town training.
Gh