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Forefoot Pain in Athletes

Pain in Your Feet May Be Due To Your Shoes (or Lack Thereoff) – Not Your Training.

by Alix J. Shutello

It’s summer time! Good for your mood, bad for your feet. And if you are a woman who wears high heels all the time, you may be harming your feet year-round.

Look, I’m a corporate mom and a runner. I’ve had every conceivable injury known to man; I’ve been to physical therapy for patellar pain, post op therapy for both knees, and a shoulder injury (that one was yoga related; who knew you could dislocate your shoulder doing yoga?). I have worked through my own hamstring and plantar faciatis issues. Now I have to add metatarsal pain.

When I started to feel discomfort and experience swelling in my right foot (see my post, Metatarsalgia and Other Foot Swelling Issues, July 2010) I went to a podiatrist. An X-ray revealed that I had no fractures. What was wierd (and still is wierd) is that my foot only swells but there is no pain. This swelling started when I wasn’t training. I’ve been off for the past couple months though not on purpose. I had to take care of my 80-mile-a-day commute. The 3-hour commuting time ate up my running time so I vowed, that after my company moved in March this year to a location about 40 miles away, I’d do it for a while; but after experiencing a whole myriad of issues I vowed to find a new job. Let’s just say I just recently started a new job with a promotion, more pay, and a 2.43 mile commute from my house last Wednesday.

Oddly enough it was during this down time in my training regimine that my foot started to swell so I started to evaluate my shoes. Every podiatrist I’ve every talked to says it’s a big no-no to walk around barefoot and that flip flops, slide-on shoes, and high heels are bad for the feet. I’ve have a bad habit of walking around the house bear foot;  I also am a flip flop wearer and a fan of high heels though I keep the hight of the heels between 1.5 and 2.5 inches.

So I did some research and took a look at one of my running books and read Jeff Ostrowski’s comment to my blog post on metatarsalgia (Jeff owns Excel Physical Therapy in Philadelphia, PA and the managing editor of Impact magazine). Jeff said:

The first item to evaluate is loss of mobility in the calf muscles, achilles tendon and ankle joint. Restriction in those areas cause compensations in the mid-foot and forefoot, which can produce injury of course.

Remembering that I had problems with my heel last year I started to really stretch my calves again. I noticed that my right calf was excruciatingly tight. Since I’ve been on a break I haven’t been stretching as much; particularly because I took up swimming and biking on the weekends to keep some level of fitness as my job sucked all my free time from my life (remember I have a husband, kids, and at the time, 8 publications that had to go to press among other things for which I worked 24/7). I marched into my closet and evaluated my shoes. The mules and other supportless high heels and flip flops would have to go.

How to Protect Your Feet

If you are training and are having foot issues, over training and the shoes you wear when you are not training have to be factored in to evaluating the changes you need to make so that you can heel. If you have, like one of my readers commented, a diagnosed case of metatarsalgia you need to rest so that you don’t get a stress fracture.

Metatarsal Supports Really Help

If you are having mild swelling like I am and you have gone to a podiatrist, they may recommend foot supports like those seen to the left. These are recommended; and if that means you forego fashion for sneakers then do it. Your feet are more important than the Manolos, as cute as they may be. Men, this goes for you too; while women are more prone to pain and injury caused by wearing high heels, men who wear flip flops a lot can also create issues with tight calves and other lower leg tightness which can lead to a whole myriad of other problems…so keep stretching and be mindful of wearing flip flops when walking for long periods of time. 

Why High Heels and Flip Flops Are So Bad

If this doesn't send a message, I don't know what does

So if I were to post all the disgusting pictures of women’s feet that have been destroyed by wearing high-heeled shoes I can tell you the blog would be long and you’d lose your appetite.  The human foot has lots of muscles and bones and they are small. When we smash them up in a shoe like you see in this image you can imagine why you’d feel pain in the ball of your foot (or destroy the top of the toe). And if you feet don’t hurt they are still getting cramped up like this and whether you realize it or not you modifying your walk which can impact your knees. 

Chronic flip flop wearing is not much better though you won’t disfigure your feet. In the Washington DC Examiner Web site story, Flip-Flops May Be Hazardous to Your Health, the author cited examples and studies about how feet act in flip flops; that “[o]ver time, hardcore flip-flop wearers often experienced muscle and joint pain in the lower legs and their toes sometimes became tender and throbbed.”

This, coupled with calf tightness can cause other issues like plantar faciatis, heel spurs, and lord knows what else. We are all so different and our physiology plays a huge role in how affected we may be from wearing inappropriate shoes.

The Top Five Contributors to Ball of Foot Pain

So in summary, the ball of your foot could be in pain for many reasons.

(1) over training – increases in hill or speed work and/or mileage can play a factor.

(2) ill-fitting running shoes (go wide if you need to and if you are a woman who’s given birth buy a wide shoe especially after birth).

(3) biomechanical issues due to having a high or low arch that’s not supported.

(4) wearing heels or flip flops too much.

(5) Inadequate flexibility in the calf muscles – among other things where there is a loss of flexibilty in the toe joints.



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