Metatarsalgia and Other Foot Swelling Issues

Alix J. Shutello  

It is safe to say that for the last two months I have not been training. I have been dealing with the heat and cross training by cycling, swimming, tennis, and yoga.  Randomly, when I wake up in the morning it feels like there is a bubble in my right foot. I’ve been ignoring of course, because it doesn’ t hurt….or at least it didn’t until this morning.  

When I got out of be this morning my foot hurt and the “bubble” on the bottom of my foot was more like a balloon.  

My right foot

 

Comparison of my left vs. right foot

 

As you can see, my right foot is looking a little funky.  So, like any athlete, I chose to try to diagnose myself first before going to the doctor….because I’ll need to before I start training for my next half marathon next week.  

So you go online and type in “pain in ball of foot.” You get a lot of things, including the site, wrongdiagnosis.com, and you’ll see that there 422 causes of foot swelling…great.   

I decided not to stay on wrongdiagnosis but concentrated on looking at metatarsalgia, or 2^nd metatarsal pre-dislocation syndrome. After reading about the condition this “appeared” right.  In reading about a condition on another site about a person with seemingly the same problem, this person, Pete, had pain and swelling under the second toe of one of his feet.   

Technically, according to http://www.zfootdoc.com/newpage16.htm, Pete  “is bearing more weight on the second joint that it was mechanically designed to handle. In his case he has a small bunion. It was just big enough that the first joint (behind the big toe) was bearing less weight than it was designed for. It is a side effect of bunions and a few other conditions. The joint capsule responded by blowing up like a little water balloon. In this case a painful water balloon that hurts from the inside.”  

And of course, there are videos galore on how to treat metatarsalgia.  I took a look at http://www.ehow.com/video_6561849_treat-metatarsalgia.html to decrease some pain. However, but I need to go see my podiatrist or physcial therapist.  

And so should you…..

If Your Knees Hurt, You’re Either Running Too Much and/or You are Overweight.

This weekend I had the pleasure of interviewing a potential client who described himself as overweight. He’s done a great job by losing 26 pounds in the past year – and with another 30 pounds or so to go, he’s got his work cut out for him. But this runner is very dedicated and I don’t doubt he’ll lose the weight he wants to; that’s if he can get past his knee issues.

Knees are sensitive and the more weight you carry around, the more pressure you are putting on your joints. When you run you exacerbate the potential for causing injury even if you are not over training. As you may already know, running puts a lot of pressure on the joints, muscles, and ligaments. The beginning overweight runner faces way more hazards than his or her thinner counterpart because of the stress running mechanics.

As I talked with this person it was clear he was doing the right things in terms of wanting to get in shape. He ran a marathon about 40 pounds overweight. All I can tell you is that running a marathon when you are in peak physical condition is difficult enough but when one is overweight, it is a MAJOR accomplishment. I give Stephen my unadulterated praise and I think he was taken aback when I told him he was part of a unique club; that of a marathoner.

When I learned about his knee pain, particularly the patellar pain or the pain right under his knee cap I would probably bet that was attributed to being overweight and I told him so.  A good article on patellar knee pain can be found at About.com. 

Just to give an example of how the knee is  impacted by simple movement, the force burdened by the patella is about two times body weight when climbing up stairs, and seven times body weight when descending. So think about the burden on the joints when running and then when running overweight. It is no wonder why people suffer knee issues.

Being overweight is not the only reason people suffer knee issues of course. Overtraining, meaning, running too much or running too much too fast all the time will create microtears in the muscles and ligaments in your body each time you run. A key indicator of improper training is injury; and for many, especially early in the running season, I hear a lot about ITB or illiotibital band syndrome.

The reason running coaches are becoming popular, I believe is because people, in their expectations of doing great things in a short amount of time often injure themselves or have recurring injuries that are cured simply with a good training plan.

Training with a trainer shouldn’t be expensive. I’ll blog more about that next time.

Alix

Piriformis Performance

Piriformis Performance
How to Beat This Pain in the Butt

Your piriformis is a narrow muscle is a big one lodged deep in your rear end. This muscle helps you run and rotate your hip. When the piriformis tightens up, runners and others will experience a deep, aching pain in the buttocks sometimes radiating into the thigh, leg and lower back. Both the piriformis muscle and sciatic nerve pass together through a small hole, or foramen, of the pelvis. Because the gluteal muscles get tight and contracted especially after running or sitting at a desk job, “trigger points” and spasms may also develop due to the lack of adequate blood and oxygen reaching the tissues. The problem is when the piriformis gets inflamed it will often compress the sciatic nerve. This causes pain to run down the thigh to the calf or can result in lower back pain.

Piriformis pain is not only a nuisance but will hinder your running. Like plantar fasciatis and other ailments, it is important to follow a committed stretching plan everyday and be committed to loosening the muscles in your butt.

Why Do Runners Have Piriformis Issues?
Why some people get piriformis injuries can have a lot to do with your physiology; but if you are like me and sit poorly, drive a lot, or have a running route with lots of hills, it is possible that these factors can add to piriformis pain.

Runners may experience an overactive piriformis; generally due to the forward motion required by our sport. Because we use the same forward motion over and over again, this results in tight hip flexors/adductors and weak abductors, an imbalance which can also lead to tightening of the piriformis. The piriformis swells and puts pressure on the sciatice nerve. Since the sciatic nerve is the largest nerve in the body when it gets squished, runners will feel the pain.  It is important to be cognizant of having tight hips or other conditions such as one leg being slightly shorter than the other, or a cocked hip, can also cause issues in the piriformis.

A Case Study – Piriformis Pain Comes on Quickly

This past weekend I went out for my long run. About five miles in my left hamstring started to bug me. Soon, my lower back was tight. I was on a long run with a lot of up and down hills; the type of hills that are great for hill workouts but not a long, slow run (LSD).

LSDs really should be run on a flat surface. In my town, that opportunity exists in a few places and while Virginia is not San Francisco, where I live it is hilly and avoiding hills altogether is impossible.  I realized after spending a good ten minutes this morning doing the recommended stretches I need to and sitting on a tennis ball which was amazingly painful that I should have driven to town and run up and down main street, which is relatively flat.  The route I ran took up some amazing hills, and by thet time I had run about 6.5 miles, my whole left side hurt; including my ankle.  I walked almost a whole mile for a cool down and have taken care of myself today by stretching and doing some ice skating – a light exercise that got me out of the house but one that didn’t bother my legs.

That said, my hips are very tight today.  There is a dull pain in my rear and down my left thigh.  These are all symptoms of a tight piriformis which I spent treating today.

Warning Signs

Piriformis does give some warning signs.  If you find yourself figeting in your car seat and changing the position you sit in as you drive, this is a sign that your piriformis could be acting up.

Also, if you sit with your leg crossed over your lap and you feel stiff, your glutes are tight and you should consider stretching them daily until the pain goes away.

Use Heat to Beat Piriformis Injuries

Unlike other injuries where you are told told to use ice, it is recommended for piriformis injuries that you use heat.

How to Stretch the Piriformis

There are some really great exercises for the piriformis muscle.  I recommend that you visit the Sports Injury Clinic website.

Preventing Piriformis-Related Injuries

Get out of the car. Now granted some of us have to drive long distances to work but if you sit for long periods of time in the car and then sit at your desk all day, you are ripe for developing a tightening of the piriformis.

Get up and walk. It is recommended that you get up and walk around often during the day and if you have time, go for a walk. Even on days that I am training, if it is nice enough outside to go for a walk during lunchtime, I’ll do it. 

Know your body. I have a cocked hip which is genetic. It causes one leg to be slightly shorter than the other which can cause tightness in the hip. Be cognizant of your own physiology.

Do Yoga. I find that there are yoga stretches that do wonders for the hips.  There is no need to go to a yoga class if you don’t want to; though attending classes for a while is a great way to enjoy stretching with others.  There are plenty of yoga tapes for athletes which concentrate on the stretching what we need to stretch.

Suggested Reading: 

http://www.runnersworld.com/article/1,7124,s6-241-286-289-12630-0,00.html

http://www.runningonline.com/zine/Injuries/

http://www.sportsinjuryclinic.net/cybertherapist/back/buttocks/piriformis.htm