Diagnosis anyone?

A podiatrist couldn’t diagnose my foot pain last year…maybe experienced runners can. 

Here is the background:  A year ago, I ran a twenty mile run (training for Surf City).  Later that day, I felt a sudden, excruciating pain on the top of my foot between my ankle and my toes.  It came on like a cramp.  I iced it and the pain eased but I felt the pain in my foot for a few days.  I took the next six days off, icing and wrapping my foot regularly.  It felt better by the end of the week and I ran my planned half marathon on Saturday with no pain (I even PR’d!)

The pain seemed to magically disappear.  My foot would mildly ache every now and then and I would ice it and that was the end of it.  It doesn’t hurt when I push my toes, but when I push where it hurts, I often get a shooting pain/tingle, like hitting your funny bone. I ran Surf City in February with no problems.  In fact, it was my best race ever.

I went to the podiatrist shortly after that.  I think subconsciously I waited until after the marathon, which wasn’t exactly a responsible thing to do.  I was afraid that he would tell me not to run.  He took x-rays of my foot and showed no stress fracture, which was my biggest fear.  He prescribed some custom orthotics and told me to get a bone density scan* since my x-rays showed some spots that looked somewhat weaker.  He never told me what was causing my pain.  Orthotics and calcium were the only take-away from the appointment.  I received my orthotics in March and have been running with them ever since.

A couple of weeks ago, the pain returned.  It was subtle at first.  I thought it might have been from running a couple of runs in my trail shoes without switching the orthotics into them.  But on Christmas Eve, we ran a long run and I could vaguely feel it when we started.  Around mile 7-8, it started to hurt.  It actually hurt worse if I stopped to walk. I focused on keeping my steps light and finished 12.5 miles with moderate pain.

The next morning I could barely walk.  My foot hurt worse than ever.  I was so scared that I had a stress fracture that somehow hid the x-ray last year.   I immediately iced and wrapped it and took Ibuprofen.  It hurt for a while and then as suddenly as it started hurting, it stopped.  The intense pain when I walked was gone, leaving only my normal ache.  I consoled myself saying that a fracture wouldn’t stop hurting so suddenly.  But what could it be??

Possibilities:
My Google search came up with limited answers.  The scary thing that comes up is metatarsal stress fracture.  My pain does not seem to be emanating from the metatarsal bones, it is closer to the ankle. 

 

The arrow points to the approximate area where I am feeling pain.

The other (and more likely) possibility is midtarsal fault and nerve entrapment, where “there ends up being a jamming of the bones on top of your foot that will lead to pain, with or without shoes.”  The nerve entrapment However, this is caused by over-pronation and/or flattening of the feet.  My orthotics should help prevent that, right?

The only suggestion for treatment was rest [check] and tying shoes looser [check].  I am going to try new shoes, but I have been going back and forth between two pairs of shoes that aren’t all that old.  Could my orthotics be worn out after nine months??  I hope not!

My friend Stacey suggested the pain was related to my Achilles.  She was looking through information on trigger and pressure points in the foot and found an area of the Achilles that causes pain in the top of the foot.  I suppose this could be it.  I tried to roll out some knots in my Achilles.  I am pretty sure I need a good massage, but not sure yet if the pain is related.

I would love to see a specialist who is an expert in running injuries.  Unfortunately, I am limited to doctors within the Kaiser network.  I can’t afford to go out of my network right now.

Any suggestions??  I hope that it just goes away like it did last year.  I need my running now more than ever.  As I say goodbye to one of the worst years in my history, I can safely say that my running was a huge positive in 2010.  I am hopeful that 2011 brings about positive changes in all aspects of my life, including my running.  An injury would really put a damper on my optimism.

Best wishes to all of you in the new year.   Oh…. and happy running.

*the results of my scan showed that my density is at the low end of normal.  A calcium supplement was indicated.  I was surprised that my density was so low, considering all the weight bearing exercise I do.  However, my mother has osteoporosis, as did my grandmother.  It is not something to be taken lightly.