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347 Views 1 Reply Latest reply: Apr 9, 2013 7:24 PM by JamesJohnsonLMT RSS
AndreaH1 Amateur 11 posts since
Apr 12, 2012
Currently Being Moderated

Apr 17, 2013 3:11 PM

Any ideas on this foot pain?

I am an overweight runner in the perpetual beginning stage.  I "ran" all last year, was able to sometimes do a mile without having to stop and walk.  Twice I managed to run an entire 3.1 miles with no walking.  Thru that whole time I usually had a foot pain and starting up again this year still have the same thing.  Wondering if anyone knows what it might be?  A note first, I AM going to a local sneaker store to be evaluated and by a new pair of sneaks that work for me.  The pain is almost always in my right foot (although does pop up in the left one occasionally)...it's in the top of my foot and the front of my ankle, the only way I can describe it is that it feels like the same thing as a shin splint only in the ankle and top of foot.  It worsens as I run or walk but as soon as I stop it's gone.  Once I start again I can take about 5 steps and it starts again. By the time I've gone a couple miles it's hard to distiguish where the pain is as it feels like my whole foot, top and bottom hurt.   It's very painful, I have to limp home and within a few minutes it's like nothing ever happened. 

Not sure if it matters or not but about 4 years ago I had surgery on that foot for a neuroma which was removed.  My mom says the top of my foot looks swollen although I can't really see it (but I look at my foot everyday, lol). 

Any ideas of what it might be?  I'm trying to avoid the foot dr.

UPDATE - I'm surprised that I haven't gotten much of a reply on my thread, but am slightly hurt that the only reply I did receive was "how to eat", is this because I honestly posted that I am overweight?  Other posts in this forum have similar pain, etc, don't post their weight whether it be over and under and they seem to get actual replies on what may be wrong.  I feel like because I said I was overweight I was automatically not taken seriously.  I thought this would be the one place I could come and get some great answers or idea on what it may be.  I'm not trying to point the finger and I do appreciate the reply but I really, really didn't need to hear how I should be eating, that's not what I was hoping to find answers on.  I was fitted for a new pair of sneakers, they told me I overpronate, my calves are extremely tight and it's most likely a tendon problem in my ankle from my description.  I'm now trying a higher heeled sneaker and getting used to them.  Have only used them twice, the first time was awful, felt like I had done 100 squats by the time I finished, could barely run at all, mostly walking.  Today was a little better so I'm hoping that the new sneaks will eventually do the trick. 

  • JamesJohnsonLMT Legend 1,160 posts since
    Aug 23, 2009
    Currently Being Moderated
    1. Apr 9, 2013 7:24 PM (in response to AndreaH1)
    Re: Any ideas on this foot pain?

    The first and most important advice I can give, is to recommend you look at dietary and sleep strategies for melting those pounds off. At this point in time, you can't expect to safely run your weight down, because of the potential damage it could cause. I know this is easier said than done, but the sooner the weight comes down, the less likely you are to find running so painful.

     

    Though research is ongoing, the general consensus among health (not necessarily fitness) professionals is that diet is far more important for controlling weight than exercise. Basically, it takes a lot more work to burn off 500 calories than it does to pass up 500 calories at the table. That is partly because of how efficient our bodies are at getting the most work out of each calorie, and partly because exercise gives us a bigger appetite.

     

    Lack of quality sleep also makes us hungrier. While it would seem we burn more calories by staying awake longer, we instead become less able to manage insulin, store more energy, burn less, and starve for the pleasant buzz we get from food. Another problem is that lack of sleep short-circuits the production of vital growth hormone that gives us the youthful energy we need to burn those calories. And, contrary to what some dieticians advise, eating late, though it can make us sleepy, does not increase the quality of sleep. Digestive activity may knock us out, but it preempts hormone production, providing the raw materials for important hormones, but removing the work time to produce them. Here's an entertaining and rather breathless ride through some of the science and a lot of whimsy...

     

    So diet and sleep are important to weight loss, and running, maybe not so much. Now that I have gotten my health under control in my later years, I have found that I weigh and look the same whether I run or not. The benefits of exercise are still there for me, but that would be very different if I was overweight. The potential damage of running is not always worth the risk.

     

    Based on what we know now, and continue to study, I would recommend for the time being that you look into cross-training activities that focus on the core and upper body. The part of the body above the belt is less mechanically efficient during energy expenditure than the legs, and can yield more calories burned, and more cardio effect, for the amount of actual work done, without any damage to your ankles and feet. It isn't just about the amount of calories each exercise burns while you are doing it, but how many calories you will continue to burn throughout the day after you are done.

     

    It may take longer to put a diverse workout together, but you will have the added benefit of overall fitness. The effects of exercise Intensity are more important than endurance. Endurance exercise like running is sustainable because the efficiency asks much less of us per hour, though the increased need for oxygen may obscure this. Our bodies adapt and become very efficient at energy expenditure and storage. Asking more of the entire body in less time forces more dramatic changes that will have a better effect on fat loss than simple aerobics. That's why it is harder to endure. Ask any triathlete if they would rather run a marathon, or swim it. Sure, it can be tough, but swimming is usually much easier on the ankles.

     

    In your case, you have even more compelling reasons to adopt a broader exercise profile. After neuroma surgery, you have an increased risk of more neuromas and other foot damage than the general population, when all other circumstances are equal. That is because of genetic predisposition, and whatever biomechanical or anatomical problems led to the neuroma in the first place. It's not like catching a cold and developing immunity, it's about the way your foot works. If your feet continue to take a hit, it will limit your general mobility and all your activities, which would have a net effect that is negative. Be what you are. Continuing to run may prove too costly.

     

    Besides neuromas (in this case, perineural fibrosis), there are other possibilities in how the tarsal (ankle) bones stack up that may be coming into play. If during your surgical experience, any x-rays were taken of your ankle, it would be worth having your podiatrist take a second look at them for alignment issues that could predispose you to other foot/ankle damage, in addition to neuroma. It would have been easy for a professional to skip past this part when focusing on what was hurting you at the time.

     

    The fact that one foot has the problem more than the other, suggests a structural/biomechanical difference between that foot and/or leg, and the other. I went through a similar period in my running when neuroma symptoms during training and competition had sidelined me for a few years (I likened the pain to crucifixion), and found that the ailing foot was slightly different in metatarsal configuration, and the leg was shorter than the other. Only after compensating for both these factors was I able to return to competition at a higher level without pain. Maybe similar problems can be solved for you, too.

     

    Back to diet, there are so many winning and losing strategies out there, and overlap between them, that it is impossible to predict what is right for you, especially since "right" may change over time. Professional guidance may be helpful, but it is even more helpful to recognize a few basic principles, and to develop an iron will for informed action.

     

    Content of meals is important, but timing may be more so. Your body shifts gears between digestion, assimilation, storage, and expenditure of basic nutrients like fat, protein, and carbs. It tends to specialize in these tasks at different times, and may have to perform one operation at the expense of another. Production of important hormones and enzymes are synchronized in a beneficial way with these processes, if we time them correctly, but not so much if we don't.

     

    Moreover, there are many subdivisions within these three main nutritional groups that are critically important. Focusing too closely on one specific group may starve you for vital nutrition and increase your hunger and propensity for storage, which is exactly what you don't want.

     

    Nutrition isn't everything. For example, many people do not know that the many benefits of fiber can be offset when it absorbs nutrients from your food and eliminates them as waste. Yes, technically, it's still good for you, but you can see the irony. Focus less on the intrinsic worth of individual dietary components, and more on finding a diet your slimmer ancestors may have been familiar with. Sometimes supplements act as detriments, depending on unnatural combinations. Timing needs to resemble some natural rhythm your body can understand and cope with.

     

    Your immediate concern is your foot, and I've tried to give you some suggestions for keeping it healthy in the future. Right now, the foot doctor you are trying to avoid is your best friend. Even when pain subsides, you've got swelling to contend with, which is not a very good sign. Please take my advice to stay off it for now, so you can remain mobile later. Internet research can help in many ways, but it can't look inside your foot. We are always here for support, though, so please let us know how things turn out.

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