\jeff{krimmel}

Metatarsal Bursitis and Orthotics

Last weekend, I wrote about my first six mile run. It went well, and I was feeling good after it. In fact, Ariele and I went up to the gym shortly after we finished the run, and I rode the stationary bike and did my weight lifting routine.

Later in the day that Saturday, I started to have a ton of right foot pain. It hurt to step down on my foot when I tried to walk. So, I hobbled around, alternately trying to walk on the ball of my foot or on the heel of my foot. The pain was on the bottom of my foot, along the outside about three inches or so away from my heel toward my toes.

Sunday didn’t bring much improvement. I again hobbled around when I was forced to walk, and I looked for excuses to just sit still as much as possible. On Monday, the pain was actually a little worse than it had been over the weekend. I had a nurse at the health center take a look at it so she could write me a referral to the podiatrist. I scheduled an appointment for Thursday morning.

The pain was bad enough over the course of the day on Monday that I decided to go to the urgent care facility that evening to get an X-ray taken. I thought it was possible I had broken a small bone or two in my foot. It turns out the X-ray showed nothing was broken, and the doctor at the facility diagnosed the condition as plantar fasciitis.

The pain decreased a bit on Tuesday, and more so on Wednesday and Thursday. When I visited the podiatrist, he recommended I get orthotics. He diagnosed the condition as bursitis of the fifth metatarsal, the bone that leads up to the small toe. I have a “functionally flat foot”, and given that I weigh nearly 200 lbs, I was putting a bit of undue stress on my feet and lower legs when I ran. The doctor surmised that the three and four mile runs I had been doing weren’t long enough to cause the serious pain I felt after the six mile run.

The doctor had some interesting advice regarding shoe selection. I told him that I struggled mightily trying to find shoes that wouldn’t hurt me. The people who helped me at the specialty running shops always told me I needed stability or motion control shoes because of my flat feet. I would buy such a shoe, take it home, run in it, get a bunch of lower leg pain while running, and then return the shoe. This pattern repeated itself half a dozen times or so.

I finally decided I needed a neutral cushioning shoe instead of the fancy support shoes. I figured that my feet might be flat, but I didn’t need all the correction built-in to the shoe that the specialty shops recommended. I went back and picked out the highest end cushioning shoe I could find, the Asics Gel Nimbus VIII. Sure enough, the Asics worked great, and I was on my way.

Now I’ll get back to what the doctor said about shoe selection. He said that a runner should pick a shoe solely with cushioning in mind. The doctor claims that it is much easier to add support to a shoe than to add cushioning. He recommends buying a shoe with great cushioning and then using a generic insert or a custom orthotic with this shoe to provide the needed support, if any additional support is in fact needed. It turns out the shoes with built-in support didn’t have enough cushioning for me, and the shoes with enough cushioning didn’t have enough support. The generic inserts I had tried didn’t have the right kind of support in the right places. I thus needed custom orthotics.

I’ve taken the last week completely off in terms of running, and yesterday was the first day I was able to walk without any pain since before the six mile run last weekend. I plan on taking another four or five days off, and then I might make a few two or three mile runs. The orthotics should be ready for me very early in January, so I hope to have those in place soon so I can continue training for the 10k on Super Bowl Sunday.