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I'm running my second marathon on Sunday. Tuesday (2 days ago) my big toe started hurting just out of the blue. The pain is in between the pad of my big toe and the ball of my foot (does this make sense?). It seems to be slightly swollen as well. I've been icing it and taking motrin. I don't know what else to do! Should I run on it?? Any advice would be appreciated!
You may have bruised the small bones under your big toe. The only way I'm aware of fixing it is to stop running - which of course is never an option. Your near term solution is to ice repeatedly (like several times a day) and to go buy or make a nice soft and comfy shoe insert that will provide some good padding for your forefoot. Perhaps one of those gel inserts will work with some modification. I'd stay off the pain relievers (motrin) until race day and then take as much as you need to run the event. After the event ice repeatedly and don't run for several weeks. Good luck!
Note that the article I cited assumes a heel strike, which you may not be doing. Nonetheless, taking the pressure off the ball of the foot and the big toe will help.
Ibuprofen and other NSAIDs are NOT recommend when racing. They have potential side effects including the kidneys failing to clear fluid from the body (sounds like a good thing but can lead to hypnoatremia) and possible muscular bleeding throughout the body. Really not worth the risk.
The question you asked is, "should I run on it?" The answer is "no."
It hurts. It's swollen. The injury occurred "out of the blue." All this, despite your efforts to control it with pain medicine and ice. Imagine how it will feel after 26.2 miles in competition. It will probably flare up before you make it to the starting line.
Second marathons are important.. It's the rematch, the one where you see what you can really do after the lesson your first one taught you, but could you really do your best on this toe?
I know how disappointing it is to sign up for a big expensive race and have to drop out due to a sudden or chronic pain problem. It's very depressing, but you could have a fractured toe. If so, there is nothing therapeutic about a Marathon for a fracture. There's really nothing therapeutic about a marathon for almost any condition, since they tend to create more problems and depress your immune system's ability to deal with even the common cold. I've been sick for months after marathons, and I don't think your toe is going to respond any better to your ambitions.
It's worth noting that I recently nursed a cat back to health after it was slammed by a car at high speed. Several bones were broken including the pelvis according to x-ray, blood was coming out of one eye and the rectum. When I took it to the emergency room, they didn't give the cat much chance, and wanted $1300 to start work. The other option was to just let it go, which we decided was probably more humane under the circumstances.
I paid the medical team for their work and brought the cat back home to say goodbye to the neighborhood. Long story short, the cat is doing fine today, can eat, sleep, play and run with the other cats. The only thing she can't do so far is climb trees, but give it time. During this process, I noticed a big difference between how animals react to injuries, and how people react. People have absolutely no patience with crippling injuries and expect to do something right away to solve the problem. Animals become lethargic, and crawl away to die. Sometimes they do, but almost any body can heal itself if given the time and appropriate care. This ability is built in.
The cat didn't have to go anywhere, had no work to return to, and wasn't planning any marathons. She had all the time in the world. That time, along with the ability to heal, was all that was really needed. People often undermine their own health by allowing expectations and goals to override their natural path to health. Too much, too soon, too fast, can't wait, and problems never get the chance to resolve themselves before being made worse by impatient interventions and my gosh, that schedule.
Is there something you can do? Yes!. Eat healthy, stay hydrated, sleep well, and don't go running any marathons until this thing heals. If you are really concerned, and you should be, see a doctor for peace of mind. There will be plenty more races where that one came from, and in most cases, the money you save on medical support will greatly exceed what you lost on registration fees and travel arrangements. Your health is the most valuable asset you have. It's the only thing that makes anything else enjoyable. Make it your number one priority. There's a purring cat in my lap that, if she could talk, would agree!
Expert advice from the others with good recommendations. If this race is important to you and you are feeling prepared otherwise, then try wrapping or a gel toe cap (something along those lines to get through along with compression socks). Try wrapping at night and evelevation. It may be a simple build-up of uric acid, which usually shows up in the toe, so drink natural cherry juice and plenty of other pure, clear fluids to see it that helps.
Make a last-minute choice, as necessary. If you feel there is a risk to future races or the potential for a major setback, then do bypass this particular event. If this specific marathon is deeply important to you, then, wrap, strap, pray and go. (Raise your hand and get on that golf-cart if you need to).
Wishing you all the best.