Skip navigation
Community: Exchange advice in the forums and read running commentary Resources: Personal running log, calculators, links and other tools for runners News: Running news from around the world Training: Articles and advice about fitness, race training and injury prevention Races/Results: Find upcoming races and past results Home: The Cool Running homepage
Cool Running homepage  Search Cool Running Community

1558 Views 8 Replies Latest reply: Jun 9, 2013 10:32 AM by lenzlaw
LeannBeckman Rookie 1 posts since
Jun 1, 2013
Currently Being Moderated

Jun 1, 2013 7:52 PM

Pain on the top of my foot...not sure what it is??

I've been running cross country and track for 6 years and my body seems to be freakily resilient since I've never gotten injured except for shin splints once.  Recently, however, I've had this pain on the top of my foot, just where the 3rd metatarsal is.  I'm not sure what it is exactly...stress fracture, tendon strain, or something else.  My foot doesn't hurt when there's no pressure on it, but when I'm walking or running it hurts.  Usually its a sharp pain (it hurts especially if I've been sitting for a long time and suddenly start walking, like when I wake up in the morning); but after I've been walking for a while it dies down a bit.  The pain started mid-April, so it's been a month and a half.  It started not that bad, only an ache, then it went away for a couple days, then it came back again, and it's been on and off for the whole time.  Just a week ago it came back again but this time it was a worse and sharper pain than before and it hurts to even walk, not just when I'm running like before.  The pain is centered in that one area (middle of the top of my foot, an inch away from my toes), and it hurts when I press on that spot but not when I press around it.  It's not from overtraining because track just ended and we've been winding down, not increasing mileage or intensity.

 

I don't think the pain is bad enough for it to be a stress fracture yet, but I fear it could be the beginnings of one and that if I don't take enough time off to let it heal it will only get worse and I'll end up not running for even longer. I've already taken almost 2 weeks off and the pain is still there.

 

If you have any experience with this, do you know what it could be?  Is it a stress fracture?  And if I should take more time off (I probably should) how much?  And are there any foot exercises or things to do (besides icing) to make it get better faster?

 

I hope you can help and thank you so much.

  • ultimatehlth Pro 118 posts since
    Jul 13, 2009

    It's hard to say exactly with your description, but it could be one of three things: 1) tendinitis - does this area of your foot look more puffy than the other? Also when you wiggle your toes does it cause discomfort? 2) A neuroma (pinched nerve) though pain usually radiates to the ball of foot. When you squeeze the ball of the foot causing the metatarsals together the pain should be intense. Both are caused by ill fitting shoes. Best bet is rest, ice several times per day, NSAIDS, and lacing your shoes in a step ladder rather than crisscross. 3) Stress fracture - there likely would be a small pecan size bump at the pain site.

     

    I would recommend following the advice for #'s 1 and 2 if it doesn't resolve in 2 weeks you will need X-rays. By then if its a crack it will show up on X-rays as a crack or calcium deposit. Stress fractures can take 8 weeks or more to heal completely.

    Best,

     

    Hollywood Personal Trainer Los Angeles

  • Volcanogod Amateur 11 posts since
    Jun 7, 2013
    Currently Being Moderated
    2. Jun 7, 2013 10:48 AM (in response to LeannBeckman)
    Pain on the top of my foot...not sure what it is??

    I am training for a marathon at the end of August.  After last Sunday's 20 mile run I too noticed the top of my right foot was bruised.  it is slightly swollen.  I ran all week and during my runs the pain goes away.  Right after the run it comes back.  The only suggestion I have found is 'your shoes laces are too tight' .  That sounds silly to me.  The  more I consider this problem, the more I think that I need to replace my shoes.  They are at the end of their mileage.  I have sketchers go run and have put about 150-200 miles on them.  

  • JamesJohnsonLMT Legend 1,163 posts since
    Aug 23, 2009
    Currently Being Moderated
    3. Jun 8, 2013 5:52 PM (in response to Volcanogod)
    Pain on the top of my foot...not sure what it is??

    With apologies to Skechers, I would not train for a marathon in them.

  • lenzlaw Community Moderator 10,422 posts since
    Jan 18, 2008

    But Meb wears them!





    Len

  • JamesJohnsonLMT Legend 1,163 posts since
    Aug 23, 2009

    Well, you need to approach this scientifically if you want to know the answer. I will assume from your identification with track and cross country that you are fairly young, perhaps still growing, and some of the explanations for this type of pain may not apply. While the pain coming and going may not be consistent with a lot of stress fractures, the fact that you experience pain when pressing on a specific spot is. If you feel it is not due to overtraining, well that could be determined after the fact. A true stress fracture could result from overtraining, and simply become evident after season as it attempts to heal.

     

    Healing hurts, and there is a lot of stress from tendons attaching to your feet down there. a slight separation over time, and bingo - stress fracture. Most cross country runners will eventually meet some surface irregularity that results in a seemingly temporary trauma, like stubbing a toe, when in fact the injury process has just begun, and will degress as the injured site is repeatedly used.

     

    Before jumping to that conclusion with both feet, consider maintaining manual pressure on that spot long enough to rule out a spasm in any interosseous muscle in that location. They hurt where they are, if it's between the bone. Sustained pressure can release a spasm that otherwise may not go away quickly.

     

    BTW, have you recently changed shoes? Some of these flats could cause a problem down there. On neuromas, I would doubt that at your age, at least of the wear-and-tear type, but it's interesting to note, along with Ultimate's input, that shoes are not the only source for neuromas. They have occurred in people who wear no shoes, and can be congenital. Have either of your parents had similar problems resulting from athletics or other foot-related activity? Bear in mind that biomechanics (such as excess pronation) can force the metatarsals together in such a way as to irritate tissues in between, including nerve tissue, which in advanced cases often results in what is correctly called a perineural fibrosis, but frequently referred to as a "neuroma," though incorrectly. Pain in the Metatarsal-Phalangeal Joint (MTP) can produce similar symptoms, but steroid treatment for neuroma actually exacerbates MTP problems, so be advised.

  • JamesJohnsonLMT Legend 1,163 posts since
    Aug 23, 2009
    Currently Being Moderated
    6. Jun 8, 2013 6:30 PM (in response to lenzlaw)
    Pain on the top of my foot...not sure what it is??

    Lol Meb could probably dust most of us in wooden shoes!

  • JamesJohnsonLMT Legend 1,163 posts since
    Aug 23, 2009
    Currently Being Moderated
    7. Jun 8, 2013 7:31 PM (in response to lenzlaw)
    Re: Pain on the top of my foot...not sure what it is??

    You know, I just researched Meb and the GoRuns, and while I wish him well, I'm not too sure about what the folks at Skechers are trying to do here. It's true that many (not all) efficient runners have a mid-foot strike, and it is all the rage to fit that procrustean bed. Notable is Meb's mention of using these for his tempo run, and that he intends to compete in them. Well, I run marathons in flats, but heck if I will train in them. Way too much mileage for so little shoe.

     

    In the case of the GoRun, it looks like an adaptation of the MBT (Masai Barefoot Technology) that Skechers and others adopted for casual shoes, similar to the women's fitness sandals (forget the name) and other stuff that supposedly promotes fat-burning by preventing a firm footplant with a rocker sole that keeps us moving . The problem I have is that during a run, the force applied to the arch is orders of magnitude above anything "natural." Just mashing up a bunch of stuff under the midfoot, and saying "there, you have a mid-foot strike" stretches credulity. I need more science than that, and I really couldn't find any in a search. If they are really on to something, why did the GR2 reduce the midfoot bump from the GR1? Why throw out something that is working, unless it really isn't that important, and sales are the real goal?

     

    The whole idea behind MBT was a way to force shifting movements to simulate standing on soft ground, as a means to induce exercise when normally there would be none. For runners, the pitch is that the midfoot bump reduces heel strike. Fair enough, but whether we believe in evolution or intelligent design, we have to face the fact that the human foot is designed in a shape that is just the opposite of this shoe. It is heel rolling to forefoot, with a concave, not convex, arch. At the very least, folks with flat feet can expect problems down the line from the biomechanics that result. I would not wish this on every runner in the form of a trendy running shoe.

     

    Back to Volcanogod's experience, biomechanically speaking, what happens when we remove stability from the footplant with a rocker sole, resulting in a breaking action from none other than the dorsiflexing tendons on the top of the foot and associated musculature? I suppose if used correctly, the midsole should absorb and distribute this impact without damage, at least from anything other than concentrating so much pressure under the arch, where it arguably does not belong. Some runners, like the indefatigable Meb, may emerge from such training unscathed, but eventually, I will expect anything from bouts of plantar fasciitis, tendinitis, and worse from this gimmick adaptation of MBT, which was never targeted at runners before. Caveat Emptor.

  • lenzlaw Community Moderator 10,422 posts since
    Jan 18, 2008

    You make some interesting points about load distribution on footplant.  I haven't seen anything more than opinion.  They have been reviewed and wear-tested by a couple of the popular magazines and the testers seem to think they were OK but required some adaptation.  Of course there have been lawsuits over the claims made for the walking shoes (not sure if it was Skechers though).    I tried on a pair in the store once, version 1 which had more of a rocker than version 2, and it definitely was a different feel.  But after watching some of the running styles that I see in races I don't doubt that they will work for some people.





    Len

More Like This

  • Retrieving data ...

Legend

  • Correct Answers - 10 points
  • Helpful Answers - 7 points