Metatarsalgia and Podiatrist

[AJF]

I have something wrong with my feet that according to Dr Google the internet diagnosis is it could be Metatarsalgia. Ball of foot very very tender, painful if touched in wrong place. Ball of foot still swollen 9 days since I have last been running. Got blood formed round ball of foot in an arc and a build up of blood on side of foot (big toe side) although this is now dry and not growing. Toes sometimes quite tingly and stiff.

Now that does not sound good to me? Off to a podiatrist for a more formal conclusion as although I think I know the problem I am unsure on cause (think it may not help that I have double jointed big toes?) and the cure? Anyone else had this? What was recommended to you? Was it just some more shoes? Most importantly, when can I start running again?

Now I have never been to a podiatrist before but feel it may be a useful investment in my future. I am consious that I am gonna go to a podiatrist, they are gonna go through all the tests and then try to get me to wear custom orthotics just because it is good for them. Do they do that? Will they recommend off the shelfs if that is what I need?

What should I look out for in a good podiatrist? What is first assesement for? What warning signs should there be? Should I take the culprit shoes in question?

Any help or advice on podiatrist or metatarsalgia much appreciated.

[Mrs Rice Pudding]

I haven't had exactly what you have described but I will share with you my experience.

Over 9 months ago I had a feeling in my foot that came on suddenly, it was like I had a stone in my shoe. It was one very small spot around one of the sesamoid bones. Fearing it was a stress fracture I stopped running and got referred to a specialist at the local hospital, the pain increased and the consultant suspected metatarsalgia and/or inflammation around the sesamoid bones. I was given a cortisone injection and a week later my foot felt ok again. I began some easy running but after a few days I started to get a very intense pain in my big toe, then it would go numb and when the numbness went I was in agony. During the next couple of months I was diagnosed with many different injuries but eventually I was passed onto another consultant who diagnosed a crushed nerve caused by fat pad atrophy on my forefoot. I still get a lot of stiffness in my foot and big toe. I was getting a lot of numbness from any impact, driving etc seemed to bring it on.

I saw a pod. in May and had the same reservations that you have. To be honest the orthotics I was given were a life saver, I had spent weeks on crutches but a couple of days in my orthotics i was able to get about again. There are probably many podiatrists that will prescribe orthotics for no reason, get a recommendation if possible.

Keep icing and I found wearing my trainers looser helps with the numbness. Consider very lightly massaging in an ibuprofen gel into the affected area.

Good luck with your foot and don't rush into any injections/return to running. I always wonder if I had more patience I wouldn't of ended up being told to 'change sport because you won't be running for years'!

[AJF]

Hope you are properly on the mend now?

Well I have to admit I was not so forthcoming to the idea of rest, podiatrist etc and it has gradually got worse. Main pain and tingley toes are after road running so I just did less road running, no great hardship there but its getting worse not better?

Done the ibuprofen, done arnica gel, can't do shoes not as tight in fell shoes as I will just twist my ankle although I tried that in road shoes with a bit of light relief. Now into week 2 of rest with no real signs of improvement but have got myself a podiatrist appointment for Thursday. He does the Leeds Rhinos and Tykes so should be good?

[Penguin]

injured again blasted foot pain!! can't run at all at the moment, it hurts after 3 miles.. that's me goossed for a couple of weeks!! yes i know rest and ice..

[Mrs Rice Pudding]

Hope you are properly on the mend now?

Not really no but hopefully I'll be able to get running again one day.

Something else that has been invaluable for me is a good metatarsal pad, I've experimented with loads but have found the one they do at boots is a massive help. This is the one I use

http://www.boots.com/shop/product_de...7319&slmRefer=

It takes a bit of getting used to but is worth it. The big toe separator initially rubbed but without it the pad moves all over the place. I replace mine every 3 weeks or so otherwise I notice less cushioning from it (but probably due to no fat pad on forefoot)

From my experience a good podiatrist will fill you with confidence, I have full length orthotics with addition cushioning in the forefoot. Maybe be useful for you? Let me know how your appointment goes, after 9 months of feet problems and being diagnosed with so many different injuries I am quite interested in foot and all their problems!

[AJF]

Well went this morning and told all sorts of things.

• My sesimoids take a hammering because I have a high arch therefore do not absorb shock as well as other style feet.
  
• Too much lateral movement from the heel, with a lot of supination.
  
• Don't push off on my big toes as the toes (due to arch) are not flexible when pressure is applied to bottom of feet. Otherwise they are virtually double jointed. I therefore twist foot and push off my smaller toes.
  
• I have achillies tendinitus from hill running and Inov8 heels.

Result is Orthotics for £150.

Advised to not run, although also said he knew that I would and if I did it would not cause any long term damage although my feet also would not heal.

They are gonna have to wait till after Christmas but I will get some especailly for my road shoes. Reckon I will try some padded insoles in the mean time, especially in my fell shoes.

He also showed me how to tape my foot to mimic the insole to see if it helps a bit? Give me an idea of what it would be like with them on.

Not the result I wanted but the podiatrist explained a lot about the process and his evaluation (and why) so I felt confident of his diagnosis.

[Mrs Rice Pudding]

From what you've said it does sound like the pod knows what he's talking about. It seems we have a few things i common, I have very high arches, severely pronate and have a very flexible first metatarsal so my sesamoids took a hammering. My original injury was inflammation around the sesamoids, I got it whilst running leg 2 of pennine bridleway. It's a stubborn injury but with the right care I would have been running months ago, unfortunately I went for the quick option of a cortisone which led to numerous complications.

If your orthotics wont be ready for a while I would definitely try the metatarsal pad from boots.