[Angelos]

Hello !

I was going downhill and suddenly, I got severe pain underfoot (in the middle of foot-ball area). I suppose that I stepped hard on a rock or something but I’m not sure.

After that, I couldn’t neither run nor even walk so I took a rest. I was using some ice every now and then too. It was feeling ok after a couple of days and tried to run again but, when the downhill came it hit me again. I walked home in pain.

Then, I rested for 2-3 weeks and tried again. This time the pain started when I was in the uphill. I stopped and went back walking in pain once again.

Had you ever had any experience with something similar ? How did you deal with it, any advice ?

Topic

[Angelos]

Angelos on June 9, 2020 at 12:25 am #42565

Sometimes, when I wake up in the morning, I can feel that something is going on down there. It isn’t pain, it isn’t annoying. I just can feel that there is something in there that shouldn’t be.

[rich.b]

rich.b on June 9, 2020 at 6:17 am #42569

This description would point to the possibility of plantar fasciitis. Your descriptions fit well with my 2 experiences with PF: first time was lateral towards the 5th metatarsal, the second time was more classic in the midfoot and toward the heel.

What to do is dependent on establishing if the problem is PF or something else, so it is helpful to get help to establish what is going on. If PF, my experience is that running through it does not work (I am slow to learn with injuries). Tackling the inflammation short term (NSAIDS and ice) is helpful, but not a solution.

For me – and I can only phrase it as my experience – it required that I switch from running to biking (not training was not an option). Well into the first round of PF (after x-rays excluded a stress fracture of the 5th metatarsal) I finally got some good help from a PT, mostly in the form of his recommendation to 1) use a supporting insole (not a custom orthotic) to provide some relief to the PF, and 2) tape-up the sole of my foot (plenty of demonstration videos are out there on YouTube) to support the PF. With these I could gradually shift back toward running. Because of my delay in dealing with it the first time, this wound up taking 6 months before getting back to my normal running volume (total volume was maintained with cycling, and in fact increased to compensate for cycling vs running). Second time around, I understood the problem and quickly mixed in cycling and strategic use of the insoles and/or tape when I did run, and PF was resolved within 3 months (with careful management since then anytime any related sensations pop up – but it has been a few years since last).

There are other helpful rehab measures, but the key is correctly identify what is the root of your issues.

[Pete Dickinson MS,PT]

Pete Dickinson MS,PT on June 9, 2020 at 9:25 am #42577

Angelos,
Middle of the arch pain could be several things. It could me a musculo/fascial strain, or a bone/joint injury. Your running history might give some indication, are you in some big miles, quick increase in volume or intensity? X-rays are helpful for obvious bone injury. Return to activity after a rest period should be very gradual with a walk/jog program alternating 1min of walking with 2 minutes of jogging on the flat (preferably trail). Your foot will like taping, new shoes, etc. The big question is what caused the injury: training error, predisposing structural issues, trauma event.
Cheers,
Pete

[Angelos]

Angelos on June 9, 2020 at 11:04 pm #42600

Thank you for your comments guys.

Firstly, I should say that it doesn’t feel like a bone injury, I suppose that this scenario could be rejected. Nevertheless, I feel pain only in specific cases/movements. Only when I’m stepping on small or big rocks. It’s something sensitive to high pressure, like my bodyweight. When I’m pressing with my fingers I don’t feel it at all, neither when I’m walking in the city or on the bike.

It happened in a period of relatively high volume (for me) and very low intensity. However, I felt pain very suddenly, is that how a chronic-fatigue pain would reveal ? Also, it is a spot-specific pain. I don’t have pain in any other area of the foot, toes or the rest of the leg. I’m also stretching but nothing has changed. Perhaps reject plantar fasciitis as well ?

Personally, I assume that it is something on soft tissue (muscles?, tendons?, nerves?) that happened after a trauma event (pushing on sharp rocks whilst running downhill).

I’ll try taping and see how it goes. I was afraid to run even on flats, I may try a little bit to test its reactions.

Cheers !

[rich.b]

rich.b on June 10, 2020 at 12:45 am #42602

Your descriptions are fairly parallel with my first bout of PF; I was ramping up on speedwork. It was rather focused on a particular area, but as you find, I could not identify the spot by pressing on it. Similarly it felt like I always had a lump in my sock at the point (whether I had shoes and socks on or not). It is quite a while ago, but I believe the onset was fairly quick (or at least my recognition of something going on).

Nonetheless, the ideal would be to get help identifying where the problem lies in order to target the best rehab/management strategy. This can prevent the possibility of winding up with a longer-term issue that impacts training. (I’m still a slow learner in this regard.)

[Pete Dickinson MS,PT]

Pete Dickinson MS,PT on June 10, 2020 at 4:12 pm #42638

Angelos,
I still wouldn’t rule out a stress bone injury, sometimes those don’t become painful until under some load. Irregardless, you would want to go through the steps of closed chain strengthening without dynamic movement first (deadlifts, squats, calf raises, step downs), then progress to some gentle heel bounces, then if that is all tolerated, a walk/jog program.
Cheers,
Pete

[Angelos]

Angelos on June 11, 2020 at 12:42 am #42651

Alright, your tips are very helpful. It will probably be a mountain-bike summer for me.

Thank you so much ! 🙂