Thursday, May 26, 2011
Metatarsalgia--A Pain in the Foot
I ended the last post with the protocol for an 18-mile run. I hypothesized that...if I could run 18 miles 3 weeks without getting injured before Rock n' Roll marathon, I would be ready for the race. The results were exactly what I hypothesized. Right down the injury part.
The 18-mile run went swimmingly, actually. I finished the run without incident, ate, took an ice bath and requisite nap. Tuesday, however, I went for a "recovery" run in San Elijo Lagoon. 7 miles of hilly, sandy trail. Not really ideal for a recovery run but I couldn't resist. It's my favorite trail, and I was in the neighborhood. Unfortunately, I also brought the run pair of running shoes, the ones without my orthotics. Looking back, I'm not even really sure I know why. All that damn "barefoot runing" talk. The hype had leaked into my brain, causing me to wonder, "Hmmm. What would happen if I ran without my orthotics? Do I really need them?"
I didn't mean to run 7 miles. I was only going to do 3 or 4 max. Besides, my legs were still trashed from the 18-miler 2 days ago. But after 2 or 3 miles, I started to feel better. And better. I decided to just do the whole trail. I allowed myself to run slowly, enjoying the view. I glanced at the GPS. Oops. Almost immediately after I hit 6.5, the ball of my left hurt started to burn. The burning sensation increased. It felt like my foot was on fire. To be on the safe side, I walked the final 1/2 mile back to the car. I must have bruised my foot, I reasoned. I figured it just a few days of RICE (rest, ice, compression, elevation) max.
Despite 2 ibuprofen, ice and a good night's rest, I couldn't walk without limping the next morning. Walking hurt. I tried stretching my calves and plantar fascia. Nope. Wasn't that. The ball of my foot hurt, right under my toes. Great. I probably have a stress fracture. A few days later, when I was limping around the Atlanta airport on an emergency trip to visit my ailing grandmother like Frankenstein's assistant, I started freaking out. I made a trip to the podiatrist and sat and fretted for the next 10 days waiting for the appointment, wringing my hands with my foot in an ice bucket.
The doc poked, prodded and X-rayed. "Not a stress fracture," he told me. I wanted to kiss him. He informed me I had Capsulitis, gave me 2 cortisone shots between the first 4 metatarsals (toe bones), and assured me I'd be running safely again in 2 days. A little bit overconfident, but, nonetheless, I was relieved.
What is "capsulitis"? It's inflammation of the joint capsule, and can occur anywhere in the body. This was specifically "capsulitis of the metatarsals", better known as "Metatarsalgia". It can be caused by wearing the wrong shoes, running, high-impact sports, or any pounding activity of the feet can cause it. The pain is on the ball of the foot, near the toes and is aggravated by pushing on this region or moving the toes (specifically during the push-off). The pain is very sharp and burning.
My symptoms were textbook. The doc gave me the cortisone shots to shut off the inflammation and gave me some new orthotics. He said to continue the ice and ibuprofen. I guess metatarsal pads would be another thing I could try.
The final result? One week later, my foot is 60% improved. It no longer hurts when I walk, a huge relief. However, the ball under my pinky toe still hurts while I run, although on a scale of 1-10, the pain has been reduced from a 9.5 to a 5. But I don't want to run a marathon with that kind of pain, mainly because it means my foot is still injured. I see the doc for visit #2 Thursday but I will most likely have to sit this one out. Which is a real bummer. This race was critical in training for Cuyamaca 3 Peaks 50K in July. If I can't run San Diego Rock 'n Roll Marathon Sunday, there's no way I should run a 50K a month later.
I'm most likely going to have to be conservative and start over...again. Building the mileage up slowly brick by brick. Perhaps I can have a late season come-back (Noble Canyon 50K is in the fall). Needless to say, I've been biking, swimming and doing weights a ton. Thankfully, I still have 2 other sports! Gotta love triathlon!