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8869 Views 8 Replies Latest reply: Mar 13, 2009 8:18 PM by ShihTzuMommy
mikepreble Rookie 2 posts since
Jun 19, 2008
Currently Being Moderated

Jun 19, 2008 6:18 PM

What can I do about pain in the outstep of my foot?


I'll apologize in advance for the long post but I'm really concerned that my foot won't let me progress in my marathon training:



I've been running 3+ miles every day on a treadmil for 3 months and then started training for a marathon about a month ago.  This past saturday I did my long run, 9 miles, and then the next day the top of my foot hurt pretty bad (which has never happened before) and I had to loosen the laces on my shoes.  Later that day, the outstep on my left foot started to hurt.  I couldn't walk without feeling dull pain in the bottom of my foot, which progressed into more of a sharp pain at the end of the day.  The top of my foot no longer hurt, it was just in the bottom of my foot in the outstep.



I stayed off it Monday and Tuesday and was able to take my dog for a 2 mile walk on Wednesday.  Then about an hour later it started to hurt again, and it still hurts today (Thursday) when I'm on my feet. 



I always take extra time stretch my calves, but didn't take the time on Saturday when this all happened.   But I did cool down at the end of the run with a mile walk.



My foot's not swollen.  My arch doesn't have any pain, it's in my outstep.  My arches are normal height and I've been running in the same shoes for months.  If I put pressure on the area it doesn't hurt or feel sore, it only hurts when I stand on it.



I don't think it's Plantar Fasciitis because it's not in my arch, but it does seem similar.



Any help/recommendations are needed and greatly appreciated.  I want to get back out on the road and running A.S.A.P!!!



  • lenzlaw Community Moderator 10,539 posts since
    Jan 18, 2008


    What part of your foot do you consider the outstep?  I'm not familiar with the term.  PF usually hurts on the bottom of the foot, just in front of the heel, but it may extend toward the toes.  It is worst when you first get up in the morning, or when you get up after sitting, that is, when your foot has been in one position for a while.  It tends to ease as you walk around.  You also mention running in the same shoes "for months".  You may need new shoes.  You should keep track of the miles you run in each pair of shoes and replace them at least at 400 to 500 miles.










  • RunningPT Amateur 16 posts since
    Jul 19, 2007


    You have been running EVERYDAY??? for months and now you are bumping up your mileage? If this is your first marathon, I am assuming this is your first foray into this kind of distance. Pain as the day of weight bearing goes on sounds less like plantar fasciitis and more like a 5th metatarsal stress reaction/stress fracture. This depends on where the pain is. The cuboid bone is in the lateral aspect of the foot and sometimes "collapses" when too much stress is applied repetitively.



    I see a bunch of possible things at work here:



    1) not enough rest days. Strength can ONLY improve if muscles have time to recover. Doesn't matter if you are an olympic weight lifter, casual runner, or basketball player.



    2) significant mileage increase. The general rule of thumb is no more than 10% increase per week in the absense of any pre-existing pain/injury.



    3) too much treadmill running. If all your short runs have been on a treadmill and then you go outside for a 9 mile pavement pounding, your body says, "forget this stuff!"



    4) old shoes. As the other poster mentioned, 400-500 miles on a pair of shoes is about the limit.



    When is the marathon you are hoping to run in? Smarter, slower, less frequent running after 2-3 weeks of rest is a good place to start.









  • lenzlaw Community Moderator 10,539 posts since
    Jan 18, 2008


    That is an unusual spot to have a problem, and it doesn't sound like typical PF at all.  So a bruise is possible, or maybe you stepped wrong at some point and twisted and sprained the plantar fascia.  I don't think there's anything else down there but the fascia itself.  So I think the treatment would be similar to PF treatment.  Some rest, maybe ice it when it gets sore (not always easy or convenient), and ibuprofen.  When the pain is gone you might try some stretching.  Don't stretch to the point of pain.  This may help in that regard:



    Do both feet to keep them at the same level.










  • lenzlaw Community Moderator 10,539 posts since
    Jan 18, 2008


    I didn't see RunningPT's  post until after I replied.  A stress fracture is a possibility but I don't know if it would present as pain on the bottom of the foot.  Here is an overview:  



    Another possibility if the pain is more toward the toes is Morton's Neuroma:










  • acoll123 Rookie 3 posts since
    Jan 12, 2008


    I experienced the same condition while training for the Country Music Marathon (my 4th marathon) this year and I finally traced the cause to a new pair of shoes that were too narrow. I am 5'-10", weigh155 pounds and I have been wearing Asics for a few years now because they come in 2E and 4E widths. I usually alternate between two pairs of shoes and wear the Gel Cumulus in a 4E width. About a month before the CM Marathon, I found a pair of Nike Pegasus in a 2E that were just too good of a deal to pass up so I got them and ran a 7 mile run and then a 21 mile run. After the 21 mile run I experienced exactly the same pain you described. I went back to using the wide width Asics and have finally recovered (after about 2 months). I had a horrible time in time in the marathon because of this problem - it feels like a bruise. I think the narrow width caused my foot to "fold up" slightly along the long axis of the foot causing the outside "outstep" as you termed it, to absorb more of the impact when I ran. This is just my theory, but I feel pretty certain this is what happened in my case. If you haven't already, go somewhere like fleet feet where they can tell you what kind of shoe you need based on your gait and the shape of your foot. I track mileage on my shoes and generally replace them after 350 miles. It is a relatively inexpensive bit of insurance to insure pain free running. Unfortunately, the only thing that helped me was time . . . I gradually worked back to long mileage and cross trained on an ellipticycle.



  • trbrown Rookie 3 posts since
    Dec 14, 2007

    It sounds similar to what I experienced.  My doc said Peroneal Tendonitis.  I where a wedge in my shoe which really has helped.  And take rest days btwn each run.  Good Luck!

  • ShihTzuMommy Rookie 6 posts since
    Dec 27, 2007

    Sounds familiar. I just finished my first half marathon this past weekend and had pain just like you described. I went to my doc the other day and it turns out I have an avulsion fracture of the fifth metatarsal (the tendon pulled and broke a piece of bone off). I'm now "banned" from running for 8 wks. I'd definitely get that checked out so you don't make it worse.

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