Side of the Foot Pain

Hi Everyone,

Last week I started to experience pain along the outside of my right foot. It felt better after a few days rest and then started hurting again when I went out for a run today. I am a month out from my first marathon and just want it to GO AWAY. 

Any thoughts of how to stretch it out? – Amy

Amy,

This is going to be long so I hope that it is helpful. Many treatments are offered without knowing what the problem is. Treating the right problem with the right treatment is a science and an art. Many long time runners know more about handling running injuries than most physicians. The folks at the local running shoes store have usually seen it all and they can be a great source. They, along with sports physicians, sports Chiropractors and Physical Therapists are good resources to handle your problem. The most important thing to know is whether or not you have a condition that is dangerous. I offer my insights here and will post this on my blog at the Pasadena Pacers website, for future such inquires.

Pain along the outside of the foot can come from 3 main sources:

1The first and most dangerous problem is stress fracture. Stress fractures often come on slowly so they don’t feel like a fracture. Since these are micro fractures they are sometimes not painful until you put the bone under excessive stress, such as running. The pain often intensifies as you run, becoming more and more painful until the bone breaks. The outside of the foot is the most common place for this to occur, along the mid shaft of the 5th metatarsal. Try this test: Find the long bone along the outside of the foot and try to bend it by holding on the the ends and pushing up from the center of it with your thumb. If you feel pain in the mid shaft of the bone then you are probably in trouble and you’ll need to rest it for the next 6 weeks. Keep exercising with a stress fracture and you run the real risk of a broken bone and all of the troubles that ensue, including a cast and possible surgical pin. If you have pain while hopping on the foot, especially on the first hop, you may have a stress fracture.

2The second area is tendonitis at the insertion of the Peroneus tendon. This is the tendon that begins as muscle and narrows into a tendon along the outside of the calf and wraps around the back of the ankle bone known as the lateral maleolus. This tendon is attached to the outside of the foot at the wide point near the mid foot. The right foot often suffers from pain at this location because it is usually the foot on the low side of the road. This can be further complicated by a short right leg, thereby placing more stress on the outside of the foot. If you have this problem then there are several things that you can do to mitigate the problem but it will probably not go away anytime soon. You can usually run with peroneus tendonitis though, if you make some changes to the stresses on the outside of the foot.

Take a look at your shoes and see if the wear pattern on the sole of the shoes are more oriented to the outside of the forefoot. If there is, then you are over supinating, meaning you are running on the outside of the foot. Supinators get about half of the normal life out of their shoes and have to replace them much more frequently.

Speed is a major cause of forefoot stress because it causes you to run on your toes. If you add hills and speed you are putting maximum stress on the front of your foot. If this has caused the problem the the fix for it is simple, stop running fast up the hills. In fact stop running fast altogether until the problem goes away. This is what we call rest, which is relative, meaning give the afflicted part some rest from the stresses that caused the problem.

Anti inflamatories can be a help. There are a few approaches to anti inflamatories. Use over the counter medicines called N.S.A.I.D. which mean, non steroid anti inflamatories. Advil, Ibuprofen, Motrin are all pretty much the same. I wouldn’t recommend taking these for extended periods of time, since they can have some deleterious effects on you kidneys and may cause gastric problems. Many runners use Naproxyn or Aleve which can be taken every 12 hours instead of every 6 hours. The idea is that since you have to take less of it, you pose less of a threat to you stomach. The gel caps seem to be easier to digest and are easier on your digestive system. (I welcome Dr. Lerner’s comments here) Since the affected area is close to the surface, you may derive benefit from a topical anti inflammatory such as Aspercreme. Applying folk remedies like Vaporub, Ben Gay, China Gel, etc. are of limited value. they feel good but have no medicinal value. in other words, they cause no physiological effect and contrary to popular opinion, do nothing to speed healing. I use them though, just because they feel good.

Ice is the most powerful anti inflammatory I know of. Use a good gel ice pack that has been kept in the refrigerator. If your ice pack has been in the freezer, it may cause tissue damage so make sure that you have a sock or some other fabric between the ice pack and your foot. A 10 minute treatment time is sufficient, since the affected area is close to the surface.

Ultrasound works very well for this problem. The effect of a single treatment can be dramatic for this problem because the tendon is close to the surface and accessible to the therapy. This therapy should be done in a PT clinic or chiropractic office since the application requires a license. Don’t have very many of these treatments though. If this treatment is going to work, you will know within 2 or 3 visits. Usually 3 weeks of ultrasound is sufficient.

Epsom Salt soaks do a great job at reducing swelling and inflammation. Fill a bucket with enough very warm water to submerge the affected area and then pour in Epsom salts until is will no longer dissolve. This is called a super saturated solution and will draw out any swelling. Do this for 20 minutes every day.

If you are wearing orthotics of any kind, this would be a good time to scrutinize them since many of these appliances are made with the assumption that almost everyone over pronates (rolls the foot excessively inward) during the gait cycle. This often results in improper biomechanics, loading huge stresses on the outside of the foot. Shoes that have too much pronation control can cause the same effect. Take a look at your shoes and see if there is a lot of plastic or other cushioning material along the instep area. If the shoe is nearly straight along the inside of the arch then you may have “Motion control shoes” and need to switch to another type of shoe. Other shoes that control motion known as “Stability shoes” can cause the same problem. In general, runners with high arches should not use either of these type of shoes. The best way to tell if your shoes are the right type is to go to a running specialty store. You can tell if it’s a running shoe store if all of the people who work there are runners, track coaches, winners of running events or well known runners. They are generally skinny runners with stringy muscular legs. They will know what type of foot you have and what type of shoe will work best. Fitting running shoes is not an exact science and they can get it wrong but in general the specialty stores get right way more often than they get it wrong. The key to this is the return policy. Quality running shoe stores will have liberal return policies.

There are exercises that can help to strengthen the the muscles that attach to the tendon. Standing on a step and doing calf raises and slowly lowering can be helpful in developing strength and flexibility. The stretches that we use on Saturday mornings are a good way to stretch the outside of the foot. Start with the toes in contact with the floor and slowing rotate the foot in large circles. Do this for 20 seconds every hour of the day to develop flexibility.

You can try using a foam roller along the side of you calf. this will only help if the area is painful. if there is no pain there then you will not derive any benefit.

There are some don’ts to consider. Do not get a cortisone injection of this area. Not only is it painful but it can weaken your tendon. Do not get orthotics as a first treatment. They often worsen the problem or caused it in the first place. Don’t get off the shelf orthotics either. I often recommend the off the shelf orthotics but this is one condition where they are only going to prolong or worsen the problem. Only in rare cases do they help.

3There is a third problem that can cause pain along the outside of the foot. If you have contact pressure along the outside of the shoe it can rub along the wide bony area of the foot, causing an irritation. The best way to handle this is by locating the show laces nearest to the affected area and simple re-lacing the shoe to skip that area. Sometimes the shoes are fine during short runs but as your foot swells on the long runs there is more pressure and the area can get irritated. Sometimes it is just the fit and you need new shoes. The most troublesome shoes are new or very worn ones. Be wary of either. In general. runners are going to need 2 or 3 pairs of running shoes per year if you a Marathoner, less if you run less mileage. I always keep 2 pairs of shoes, new ones and worn ones. That way I always have a god pair to race on without having to run on brand new shoes. Besides, I love the smell of a new pair of running shoes.

Steve Smith D.C.

Be Sociable, Share!

    1. I find that ant-inflamatories can be pretty effective when it comes to managing foot pain. Good article, thanks for sharing.

    2. jjenny Samson07-30-2012

      Usfull info, Im not a runner bur a 63 year old lady who does zumba twice a week! I shall get some epsom salts and try the soak, thankyou

      • Walter01-25-2014

        Hi. Just wondering if the Epson salt helped your foot pain. Thank you.

    3. geraldine reilly01-11-2013

      Hi,I found this interesting,I’ve got a hairline crack on outside of my left foot I have it 10yr’s an it never bothered me till now I quit running a year ago but the problem arrived 3 months ago.I’ve a lot of inflammation n the foot but is settling after inflammatory’s but the bone is still tender,doctor said about putting a pin n a a cast 4 6 weeks,am not totally convinced as it never bother me before,also am a hairdresser which I stand all day an as its my own businesses I can’t be of work.is there any other options and if I get the pin an cast what is the down side of having the pin in.ur opinion on this would much appreciated.thanks

      • Dr. Steve Smith01-18-2013

        Geraldine,
        The pain often persists for a long time after the fracture has healed up and you shouldn’t run on it until the pain is completely gone. There is usually a stress reaction in the bone long before the fracture occurs. The stress reaction can only be identified by an MRI or bone scan. It will show up as a bone bruise. If you are not having any pain at work then I see no reason to put it in a cast but you should wear shoes that have a sturdy sole. Clogs can be helpful to avoid bending your foot but they are hard as a rock and may cause fatigue. Wear shoes that are stiff soled but have a cushioning to avoid fatigue. Stiff soled boots can be nearly as supportive as a cast but they are not a good option for the fashion conscious. I wouldn’t hesitate to get it pinned but there is a recovery time involved. If there is bone bruise then the pin might not be an option. Wear a night splint to avoid pain when rolling over in bed and putting additional stress on it.

        • Grace09-21-2014

          I’ve got into running in the last few weeks, and i noticed pain on the outside of my right foot. It starts as a dull ache, and as the run goes on it gets sharper, so by the end of it my foot really hurts. A few minutes after running it calms down a lot however. If I haven’t been for a run that day, it doesn’t hurt. I have Nike Running shoes which are great for my left foot, so i presume thats not the issue. Any suggestions on what this is and how I can fix the problem? Thank you.

      • Chris03-14-2014

        Reading your post have the same problem and am a hairdresser as well. I’ve found fit flop brand clogs and flip flops to be amazing. I stand all day w no real pain. It also helped my planters fashitis they’re expensive but worth a try. I buy at zappos, sole provisions and sometimes you can get barely worn ones on eBay Good luck

    4. Pauline Rowe01-13-2013

      Really helpful information. I now know I am off to the Doctors tomorrow to get my stress fracture checked out. Supposed to be going to Australia end of March this year so need to get mended soon!!!!!

    5. recenzje gitar01-18-2013

      “fantastic points altogether, you just gained a new reader. What would you suggest in regards to your post that you made some days ago? Any positive?”

    6. Probably one of the most thorough answers I’ve ever read across any subject. Thank you. I’m a new runner and shoes are a year and a bit old but with your comments – I can see they are too worn on the outside of the foot. My right foot is killing me after the Bermuda 10km. So rest and new shoes – and a visit to the chiropractor is in sight. Thank you

    7. sickoffootpain03-18-2013

      I am not a runner, but am looking for help for the same type of pain. I had surgery for plantar fasciitis in June. The pain on the inner part of my arch was taken care of from the surgery, but very shortly after (while doing PT) the outside of my foot started to hurt and now it hurts all the time. It did not hurt prior to the surgery. I do not want to have to have surgery again…and not even sure it would help for this issue. Any thoughts?

    8. Stacey03-24-2013

      My 13 yr. old daughter plays Jr. Olympics volleyball. At a tournament yesterday, she stepped (or landed from a jump, she doesn’t really remember) on a teammate’s foot. As the day went on, the outside edge of her foot started to hurt more and more. Today it’s very painful to walk on and just above her outside ankle hurts (this is her left foot/ankle). She says the pain in her foot is mostly along the outside edge towards the front of the foot and then under it just a bit, again more towards the front rather than the arch or heel. Advil does take the edge of the pain. Her foot, especially the bottom outside edge behind the pinky toe is especially painful to touch/pressure. Thinking peroneal tendon strain pain would be more directly below to slightly in front of the ankle bone rather than closer to the toes? Should I be concerned about a Jones fracture? There doesn’t appear to be any swelling. Just the pain and tenderness. She cannot walk w/o limping at this point.

      • Dr. Steve Smith03-24-2013

        Stacey,
        I would be thinking about getting an X-ray for this one. From the intensity of pain and the location of it there is a real possibility of a fracture. This doesn’t sound like a peroneal tendon injury. For now use ice on it and keep her away from bearing any weight on it until you can rule out a fracture.
        Good luck,
        Steve Smith

        • Stacey03-25-2013

          Thanks Dr. Steve. That’s kind of what I was thinking I was going to have to do. Call it that “mom instinct”, lol. Now I just have to get myself shoveled out. Mar. 25th in MD and I’m SNOWED in. Unreal.

          Appreciate your feedback!

          Stacey

    9. Sally Whitehead03-27-2013

      I have a pain that runs along the right side of my right foot beginning just below the joint of my small toes and ends where my ankel bone is. I’m 61 yr old female and do not run unless I really have to. This pain just showed up last night and I haven’t done anything I know of that would have contributed to it such as twisting my foot. I haven’t worn any different shoes and it’s only on the right foot. It’s not an intense pain and as long as my foot is still and facing straight out not an issue although I know it is there and when I turn my foot to the left or right I can feel the low grade pain. I can walk although when I raise my heel is when I feel it the most. In sitting down when I raise my foot from the toes leaving my heal on the ground there isn’t any “pain” at all. I did have bone spurs removed from the top of both feet in 1990 and my feet do “fall asleep” with the tingling sensation quite easily. I’m also right handed if that means anything. I also am heavy heeled since I was a military training instructor in the late 70’s and early 80’s so I have always stepped down heavier on my heels when walking. Any suggestions?

      • Dr. Steve Smith03-27-2013

        Sally,
        It’s difficult to tell by your description but if I had to guess I would check for cuboid syndrome. This is a misalignment of a small bone on the lateral sole of the foot. This condition responds well to a cuboid pad and manipulation of the foot. Unfortunately, there are few physicians who are skilled at this type of manipulation. I would go to a podiatrist and get evaluated but if this isn’t an option you can find cuboid pads on the internet. Look for a podiatrist, chiropractor, Physical Therapist who has experience with foot manipulation. Wear shoes that have a stiff sole to avoid flexing the foot. Roll your foot on a frozen water bottle if it is very painful or if there is any swelling. If the pain is mild and only present on positional stress then try rolling it on a warm water bottle.
        Please let me know how you fare on this one.
        Steve Smith

    10. Tony Morris03-28-2013

      I have been having a sharp pain in my right foot on the outside part behind my little toe area. If I step down on the right side of my right foot I get a sharp pain in that area of my foot. I am a runner and have been having this problem for about 4 weeks. Any ideas as to what the problem is ?

    11. Joan04-05-2013

      Hi, I have a pain just below my ankle bone, on the Inside of my foot. I can run on it but it hurts a lot after. I ran all week on old shoes, which I think caused it, but not sure how to treat it since I can’t quite locate the site of the pain

      • Dr. Steve Smith04-08-2013

        I am guessing that you are running on stability or motion control shoes that have lost their support. If this is the case then you are probably over pronating and may be putting a strain on the tibialis tendons where they attach at the cuneiform bone. This isn’t usually serious and you can just rest up until it resolves and use Epsom salt soaks, massage and a new pair of shoes. Stay away from the hard fast runs for a couple of weeks and try to avoid hills as much as possible. Run with the sore foot on the low side of the road to reduce the amount of pronation.

    12. steve04-08-2013

      I’m a big person but my footing has always been fine. A several months ago I stepped outside my front door for a second and came right back in. on the way back the corner of the storm door swung back and struck the base of my Achilles tendon on the inside of the foot. The force tore the door off the bottom hinges. The pain was horrific I thought I tore the flesh. I didn’t and after some ice and later some soaking I seemed ok. I started getting sore on the bottom out side of my foot and after some time I was walking to my car and I heard a popping sound I was afraid I wouldn’t be able to continue. I did and later went to a doctor with no good result. I can walk ok on the flat or if the incline is up toward the inside of my foot but if it is down toward the outside I have pain and little support. I’m on a weight management program and I have been doing water therapy for about 4 months and the foot is getting better in very small increments. I still can’t do yard work and wondering how long this injury is going to last..

    13. Jesse04-13-2013

      So I run for about an hour 2-3xs a week. Today about 10 mins into my run I had a sharp pain in my foot – along the outside, starting about half way down and stoping right before the outside of the heel. It is not swollen, it only hurts if I walk and if I relax it and try to rotate my foot inward. It does NOT hurt to push on the bottom of my foot with the thumb tricks mentioned earlier. Any thoughts ?

      • Dr. Steve Smith04-14-2013

        I can only guess but it sounds like you may have pain at the insertion of the Peroneus Brevis tendon. If this is the case then you might have been running on the outside of your foot. If so, it sometimes happens from running on the road crown with the affected foot on the low side of the road. Sometimes it happens when you get a new pair of shoes that over correct for pronation. Also check for tight calf muscles and stretch your calves. Patients who have been increasing the time or height of high heeled shoes will develop over tight calf muscles. A recent onset of hard hill running can over stress the peroneus muscles as well. In either case it doesn’t sound serious.I hope this helps, please let me know how it works out.

        • jenna04-15-2013

          I have the same problem right now I recently ran up Harlem Hill for the firs time and ran 8 miles for the first time this weekend- I am training for the half marathon-

          My foot hurts right under my right pinky toe to my ankle- when i flex my foot inward it helps and only really hurts when i walk on it- the pain started right after my run but not during- I also have IT band syndrome – perhaps the two are connected? I have been taking advil which helps a bit but I want to know when its safe to start working out on it again- the half marathon is the first week in June-

    14. Jessica04-15-2013

      10 days ago I started having foot pain after a run. It is my right foot and started at the top of my foot more towards the outside edge. My foot has felt pretty good but I have had some tightness on the outside of my calf but thought I would try running today. I got a few minutes in and the pain started so I stopped. It is not a sharp, shooting pain but it definitely hurts and I know I shouldn’t be doing it. After I stopped I had pain along the right side of my foot. Any thoughts?

    15. joe04-21-2013

      Went for my typical Saturday run yesterday, approximately 3 – 5 miles. Only difference is I wore new running shoes. I came home and all day yesterday and today I have a lot of pain on the outside of my right foot below the ankle, as well as pain on the outside of my knee. Any ideas of what may be causing this, I have been running for a long time and have never had this kind of pain.

    16. Celeste04-22-2013

      Hello,
      On Saturday, I did a 5km running corse with obstacles and through bush tracks, and I didn’t wear very good shoes as I didn’t want to destroy my running shoes. It was called warrior dash, and it’s crawling through mud etc… It was extremely cold aswell. anyway by saturday night, I started having pain in my left foot, running on the bottom outside part, from toe to heal. It hurts and aches when I walk, it aches up my leg and ankle when I’m sitting… It hurts to put my weight on it… So I’m limping around. I don’t know whether I should go to the doctors or not… If u could help me it would b great
      From celeste

    17. This is such a helpful and informative article! About a month ago, I woke up to find the top of my right foot swollen and painful I think maybe someone stepped on my foot?) I rested for a few days, but it didn’t hurt that much and the swelling went down, so I resumed my normal lifestyle of kickboxing, yoga, and other active activities. Now it is starting to hurt more on the outer edge of my right foot, and it hurts if i press on the top of my fourth toe. The pain is spreading a bit to the outside of my ankle as well. Does this sound like a stress fracture? I’m really hoping not, because 6 weeks of rest is so long! How can I help it heal faster? Thanks for your help!

    18. Robin04-26-2013

      I started playing softball again after a few years. This last week I noticed, when we had a scrimmage, that immediately as soon as I started to run I had this terrible pain in my left foot (outside) about an inch below the ankle bone. It’s almost like a shooting pain when I run. After the game and several days later I’m finding that sometimes it’s even hurting when I’m walking. Have you ever heard of this before? Can this pain go away by just doing some basic stretches?

    19. Cody Wienand04-26-2013

      Thank you so much for this info! I’m currently serving in the US Army and I started having this problem after a 8 mile ruck march with a 50lb ruck on my back, in combat boots and everything. Is there any advice you have for some one that is required to work out every day?

      • Dr. Steve Smith04-26-2013

        Cody,
        Your feet are under a continuous heavy load and are being flexed thousands of times during your march. Try using Spenco Gel insoles http://www.spenco.com/. Tight calf muscles will overstress your feet and stretching the upper and lower calf muscles several times a day will help. I recommend doing these stretches every hour if you can. http://www.youtube.com/watch?v=Wly__N3ZNvE. There are several other stretches on my youtube channel that will help reduce soreness in your legs, hips and feet.
        Thank you for your service!
        Steve Smith

    20. Amelia Faisandier04-27-2013

      Hello
      Thanks for this information, very useful indeed. I just ran my first marathon and I came away thinking ‘my feet are the only things which don’t hurt!’ The next day however I could barely walk (pain on the outside and arch) but I had to work all week so no rest. The pain has come and gone and come back again. Massage seems to help and of course rest. I used crutches one day! Could you please tell me if you think I just need to wait till the pain has gone to begin running again or should I bite the bullet and go to the docs :(
      Crossing my fingers waiting for your reply!
      Amelia

    21. gary rollason04-28-2013

      Have read your entire article…very interesting..my problem is my right foot, under the fourth and fifth toe, the bone hurts when pressure is put on it and the bone to the right of my small toe also has pain when pressure is placed. This is noticed when walking in bare feet…but not in my running shoes…thus padding seems to really help. I do not recall banging it….but I do walk 2-3 miles 2x a week…with no problems. I am 70 years old and seem to be in good shape….any suggestions…thanks, Gary.

      • Dr. Steve Smith04-28-2013

        Gary,
        Sometimes older people have atrophy in the fat pad under the metatarsals. This can cause pain at the heads of the metatarsals. I would try “Bunga Pads” they come in thin and thick weights. The thin ones are great but the thicker ones are too bulky and often cause blisters. Also, I have had good luck with “spenco” arch supports. The extra padding can really help if your feet are getting sensitive. Stretching you lower calf muscles and your feet can relieve the extra pressure that can happen if you become stiff, which concentrates huge forces on the metatarsal heads. You can see my stretches on the YouTube channel. Just go to http://www.stevesmithdc.com and click on the YouTube link.
        I hope this helps,
        Steve Smith

    22. gary rollason04-28-2013

      Thanks, I will certainly try what you have suggested…just to get rid of the pain…will let you know…

    23. 20something04-28-2013

      Hi, thank you so much for this information! I’m a twenty-year old woman in excellent shape. I was just recently in a pair of loafers walking on the street when suddenly I randomly got pain all along the outside of my right foot. I also have plantar’s warts on that right foot (one large and three cluster) as a result of working as a lifeguard/swim instructor. I have not been able to walk all day long and am wondering what is going on. It feels like something is strained or pulled along the outside of my foot. Do you have any exercises to recommend, or any idea what is going on?

    24. Antoni04-28-2013

      This article is probably the most relevant to what I have been struggling with for quite some time. Yet it doesn’t really explain what my problem might be. Here’s some background:
      14 months ago (!) after intensive cardio exercise my left foot felt quite sore on the outside. The next day it was very painful and the pain wouldn’t go away even if I swallowed the whole box of anti inflammatory pills. I went to see a physiotherapist and he said that it seemed to be caused by overuse. I thought that he was right as back then I would exercise 6-7 days a week: group fitness BodyAttack twice a week, tennis three times a week, badminton and squash once a week (plus weights training). Before that fatal day I had never have any problems, no sore muscles, no strains, no broken bones. Now over a year later I can’t get back to 100%. I can move again on tennis court (not as good as I used to) but I can’t get back to BodyAttack (lots of jumping) or running. I have this problem now in both feet. It’s simply sore on the outside between toe and the heel. Every now and again while walking I can feel a sharp pain as if something was being torn inside. So far I spent thousands of dollars on physios, doctors, surgeons, podiatrists, MRI, and only got “I dunno” diagnosis. I’m desperate. Have no idea who can help me. I’ve already developed signs of depression, there is no joy in my life any more. If it continues like this it’s very likely that I will need psychiatrist to stop me from suicide…

    25. fee Alexander04-29-2013

      I hurt my foot 5 days ago when I slipped backwards down some steps. I have had pain on the top of my foot on the outside. Walking and driving bith hurt. I noticed today that sitting on a chair with my feet on the floor makes the pain spread up around the front of my ankle. Any ideas what I might have done? It also hurts to turn my foot to the right. Thanks :)

    26. corey04-30-2013

      Hi there! I started having lateral foot soreness about 2 months ago after a run. My foot was fine after i stopped running. 2 days later, same thing. The soreness started under the 5th MTP joint and has worked its way back more towards the tubercle on the 5th MT now and also over the cuboid. Any shoe that wraps over my foot makes it more sore as well as any prolonged WBing. I am somewhat tender between the 4/5th MT head where the connect with the cuboid. I had initially thought that i was landing too lateral on my foot and that was causing the pain, as i do have a shorter leg on the painful side. I have changed shoes and had my orthotics adjusted. However, the same problem persists. I had an MRI to rule out stress fracture – it did rule that out. I was instructed to stay in a boot for 4 weeks. So my question is, if the MRI came back negative, should i request i get a bone scan to further reinforce the stress fracture/reaction rule out? What is the likely hood that it was a false negative? OR, of anything else I told you, do you think i should look into anything else? or try anything else? Thanks!

    27. carleen05-04-2013

      Great info! What do you think about using a valgus wedge to avoid peroneal tendinitis? I supinate and often have peroneal tenon issues. So I recently started using a wedge in my shoe. I think it has helped, but I also tend to get wary of anything that can change my natural gait. So I wonder if I should only use it when I get flare ups, or if it is ok to use all the time as a preventive measure.

      • Dr. Steve Smith05-06-2013

        I am wary of valgus wedges for runners. It sounds like a good idea but distance runners risk over-stressing the 5th metatarsal. It would be best to concentrate on stretching your calves and doing calf presses with your feet turned in to strengthen your peroneals. Supinators need frequent shoe changes due to excessive wear. It is not uncommon to replace them after only 300 miles!
        Good Luck and please let me know how it works out.

        Steve Smith

    28. MMG05-08-2013

      My daughter is complaining of side foot pain (left foot, outside). She has been running both at the gym and outside. After running on the treadmill at the gym yesterday she said her foot started to hurt and got worse as the day went on. When she woke up this morning she could not walk on it. Her pain level on a scale of 1 to 10 is a 6. The pain she has is a sharp pain and located on the side in the middle of the foot and a little towards the bottom. There is no swelling or bruising. Could this be a stress fracture?

      • Dr. Steve Smith05-08-2013

        It could be. A sharp pain is a red flag and I would get this checked out right away. She will likely have trouble weight bearing and careful palpation by your physician will reveal pain at the mid shaft of the metatarsal bone if there is a fracture.

        • MMG05-08-2013

          Should I take her to see the podiatrist or to the ER?

          • Dr. Steve Smith05-08-2013

            I would get this checked out by an orthopedist. They will usually get you right in if there is the possibility of a fracture.

    29. John05-08-2013

      I did a half marathon last sunday and all through the day it was fine up until 1 am that night. However when I woke up monday morning the pain was pretty bad and progressively got worse as the day went on. I have been icing it a lot and it seems to help quite a bit. Every time i rest it for even 15 minutes it will get better until i start walking on it again. And the more I walk on it the worse it gets. I have been reading a lot about what it could be and I keep reading it might be the tendon that goes through heel and middle of the foot. Most of my pain is in the upper half of my foot on the outside with the pain getting less and less as it gets to the heel. It has been three days now and its virtually exactly the same.Any idea whats going on?

      • Brandie Morast05-16-2013

        I have pain on the bottom outside of my foot. Just below the pinky toe. I also have been having issued with my Achilles and/or calf muscle. I run, hike and am an online speed skater. The pain just started and hurts mostly when I am speed skating. Sounds muscular to me but wanted your opinion. Thanks a bunch. I really enjoyed your article.

        • Dr. Steve Smith05-17-2013

          Brandie,
          Speed skating exerts heavy loading on the outside of the right foot and the fifth metatarsal head is where the brunt of the force is concentrated. From the sound of it, you may have a tight achilles tendon resulting from tight calf muscles. If this is true then it would explain why you are having pain on the side of the foot. The ankle doesn’t flex as much as it should when you have tight calf muscles, causing increased bending load on your forefoot. Try doing the upper and lower calf stretches for a week and it should alleviate the problem. A calf rocker can be helpful for this stretch ” Calf Rocker at Amazon.com‎ ” or you can use the stretches on my Youtube channel for the upper and lower calf http://www.youtube.com/watch?v=KKoVMMq6Tww&list=PL1C7B85DCFD5383C0
          Good luck and please lem me know how it works out,
          Steve Smith

    30. Shehnaaz05-17-2013

      Hi Dr Smith
      My work requires me to walk alot, and a few months ago, I had swelling on my right foot, and was unable to walk for a few days. An MRI was done which showed Bursitis. The Doctor gave me 2 Cortisone shot, and anti inflammatories, which releived the pain but gave me an ulcer.
      I also had 24 physio sessions, which helped a great deal. Turns out my Pelvis had moved, so one leg was shorter than the other. Thats been sorted out. I think the
      Bursitis is mostly cleared, but I am now getting in both
      feel pain on the outer side of the feet, and when I walk
      abit, much less than my normal walking, Theres an
      aweful ache around the ankle bone, going upto the
      back of my calf muscles. Sometimes, its almost like pins and needles on the outer area from the small toe through to the ankle. I am currently off all medication, and started acupuncture. I am 45 and desperate, I cant even do routine stuff like shopping. My livelihood is my feet, please advise and any exercises to strengthen ankle, knee, foot and calf muscles.
      I cant spend any more time away from work.
      Appreciate your help

    31. Christie05-21-2013

      Hello. I’ve been running for two years. After a marathon 2 months ago, things have not been the same. My IT band flared up in my right leg…something I’d never had a problem with. A month after that my foot on left leg got painful. It increased to the point where I can’t do over 3 miles right now. The pain is on the outside of my foot below my ankle, a little forward in that soft part of upper outside foot. I went to ortho thinking stress fracture. There is not one. I’ve been off my foot for 3 days. I haven’t run in a week. I still cannot walk properly. I want to run really bad. What does this sound like to you? Can I still run? Ortho said stretch and I got new cushioned shoes with a lateral heel wedge he told me to insert. He said I have a very high arch and a very rigid foot. What is going to get me back to running? Thank you so much for any advice you can offer!
      Christie

    32. jenna05-31-2013

      Dear doc, I find your advice very helpfull. I’m. Not a runner,but was told that I have calcaeous spur. I was fitted orthotics, but noticed on day 2nd of wearing it that the side of my foot and heel feels more swollen than ever. No anti flammatories was prescribed by podiatrist and I would like to know what kind of anti flammotories would assist as I’m a nursing sister who is constantly on my feet. I also notice a burning pain.although slight on the side of m leg. Please help!

    33. Elisabeth Cacciattolo06-01-2013

      Hi Doctor:
      I am not a runner but I have pain on the right side by the ankle for the past 2 years. I have been walking on the side of my foot and screwed up ny knee and just have a hip replacement. I am over weight but only 52 years old and still can’t walk without pain.
      I think its tendonitis but can’t take anti inflammatories what shouldI do?

      Elisabeth

    34. Kim06-02-2013

      I am a waitress at 45yrs old and on the outside of my left foot I have a bad pain. It only bothers me when I work long days. If I run my hand down side of arch it’s in he middle where arch is highest. When I come home I usually limp. But next day it’s fine any ideas of what it is

    35. Heather06-05-2013

      I am not a runner but I am on my feet for 17 hours a day. I woke up feeling pain in the side of my foot three days ago.as it goes on the pain is just worse! My foot is swollen it hurts underneath just below my big toe and along the side.and when I put an ice pack on it my calf muscle was cramping up.I am in severe pain I can’t put weight on it at all.

    36. Shehnaaz06-06-2013

      Hi Dr Smith
      Please advise
      My work requires me to walk alot, and a few months ago, I had swelling on my right foot, and was unable to walk for a few days. An MRI was done which showed Bursitis. The Doctor gave me 2 Cortisone shot, and some anti inflammatories, which releived the pain but gave me an ulcer.
      I also had 24 physio sessions, which helped a great deal. Turns out my Pelvis had moved, so one leg was shorter than the other. Thats been sorted out. I think the
      Bursitis is mostly cleared, but I am now getting in both
      feel pain on the outer side of the feet, and when I walk
      abit, much less than my normal walking, Theres an
      aweful ache around the ankle bone, going upto the
      back of my calf muscles. Sometimes, its almost like pins and needles on the outer area from the small toe through to the ankle. I am currently off all medication, and started acupuncture. I am 45 and desperate, I cant even do routine stuff like shopping. My livelihood is my feet, please advise and any exercises to strengthen ankle, knee, foot and calf muscles.
      I cant spend any more time away from work.
      Appreciate your help, what is the best type of doctor, specialist I could visit.

    37. Charlie Sennes06-13-2013

      Hello,
      I am 32 and just started getting in shape over the last 18 mo. I have started running with some friends and we did a 5k on memorial weekend. that went fine but realized i need to get out of the gym/track and do something with more terrain changes since my time on the 5k was a bit more than the what I normally do. I went with my friends to run on a route that was all sidewalk and mostly uphill for 3.6 miles and the overall trip was about 7.5 miles which is twice what I had ever done. I ran all but about .25 miles on the way up and when I got to the top I started back down about 100yds, met a friend and ran with him back up to encourage him to finish strong and sprinted about the last 50 yards. I did that twice. Then we walked and ran occasionally on the way back down. I felt pretty good until I got home and rested a bit. We had started at 6 PM and it was about 95 degrees. By the time I went to be I was limping from pain in my left foot on the outside at about the midpoint. It has now been 3 days and it is still painful but a bit better than the first day. It is not sore to touch. When I put my weight on it it has slight discomfort but when I remove the weight the pain increases considerably so I have been limping a bit. I put Ice occasionally the first couple days and used BC Powder twice a day the first two days which helped. I have checked my wear on my shoes but they are pretty new (3mo.) and do not show much wear pattern yet, Adidas AdiZero Hagio. I like them and had not had a problem until now. I believe the pain is from overdoing it and not being use to the shock from concrete. Would like to know what you think and if it is anything I should have checked out.

      • Dr. Steve Smith06-13-2013

        Charlie,
        I would not do anything for now. If it is improving then take a wait and see approach. This could be just a sore tendon or simple joint strain. It could also be the beginnings of a stress fracture but if it is you will have to just wait for it to stop hurting before you put any stress on it. Avoid running for now, wear stiff supportive shoes and try using the elliptical trainer or aqua jogging to maintain the fitness you have achieved. After the pain resolves and you are able to walk without exacerbating your symptoms you can doa test run. This involves doing a slow warm up for about 20 minutes, slow run for 10 minutes and a cool down for another 10 minutes. If you are not symptomatic the next day then you can do another test run by warming up 20 minutes walking gradually increasing your speed and then breaking into a slow run for 20 minutes followed by a cool down walk. If you get away with this and there is no pain the next day then you are probably good to resume training, being careful not to up the training gradient too quickly.
        Steve Smith

    38. Alana06-20-2013

      Thanks for your article. I have had problems with my feet for almost 10 years when playing netball and other sports, sometimes even just walking and very quickly if I try to run/jog. The past couple of years I have tried to find a diagnosis or solution. My GP was no help so I saw a podiatrist. Although he was helpful I don’t think they knew what it was either and just offered orthotic insoles to try to correct the overwear on the outside of the foot. After changing GPs I tried again and finally got an xray which showed one foot having a stress fracture although I don’t believe this is the cause of the problem, as both feet are a pain and since it has been happening for 10 years a stress fracture lasting this long is, I thought, unlikely. I actually think the stress fracture came from the orthotics as they caused new types of pain!! My theories from research were some sort of tendonitis. Finding this article gives me new insight to the possible cause – good to know there are others with this it is not just my odd feet! I have tried antiflamm rubs and Ice spray to sooth the pin but I think the one I had was more of a homeopathic remedy than a medicine so I am going to see if I can find one here in NZ that is going to be preventative.

    39. M. B.06-22-2013

      Thank you for this informative article Dr. Smith.

      I have only started running 8 weeks ago and loved it! I slowly increased my mileage from 1 to 6.2 miles. And 4 days ago, after running the 6.2 miles on the treadmill, I felt pain along the outside of my right foot, in between the end of my metatarsal (?),-long bone and my heel, about 2 hours after my run. I felt some pain towards the end but not enough to make me stop. I didn’t pay any attention to it but as advised by others, I was supposed to not run again for 1-2 days after a long run, so I did yoga and strenght training. After 2 days, I started really feeling pain along that side, and felt like there was a small “ball” attached under where the pain was. The top side was very slightly swollen so I used ice packs and heat. Now, 4 days since my run, I’m feeling sharp pain when I lift up my foot while walking. It also comes and goes as I try to walk avoiding to put weight on the right outer side.

      It would completely devastate me to think I cannot run anymore. Please share what you think?

      ~MB

    40. Hayley06-27-2013

      Thank you for the informative article Dr. Smith.

      I have been experiencing pain along the outside of my foot for about 6 weeks now. It hurts when walking and standing and the pain subsides while at rest. The pain seems to be localized end of the bone (the part that is closest to the ankle) and feels almost like a bruise.

      I am a teacher, so I an on my feet all day. I had hoped that when the school year came to an end the pain would improve, however that has not been the case.

      I have had x-rays taken by my primary Dr. and no stress fracture was seen. I was advised to take ibuprophen for the pain. I did that for 2 weeks, and there has been no change.

      Is it possible for a stress fracture to be missed on an xray? Is it possible to get a stress fracture from standing all day or could this be something else?

      Thanks for your advise.

      • Dr. Steve Smith07-01-2013

        X-rays are more likely to miss a stress fracture than catch it. In fact x-rays are a poor way to diagnose stress fractures because of the likelihood of a false negative. I would go back to the Doctor and tell him that the problem persists and he will more than likely order more imaging or make a referral to an orthopedist. An MRI would be a good choice to image your foot to see what the problem is. This sounds like a joint problem to me, possibly a cartilage injury. A tendonitis would probably have improved with rest and anti inflammatories so I would rule that our for now.
        Good Luck and please do shoot me a message to let us know the outcome.
        Steve Smith

    41. Jody06-28-2013

      Thanks for your article. I ran across it when trying to find answer to my own foot pain, but thus far I haven’t been able to discover a fit. Perhaps I am missing something, if you wouldn’t mind taking a minute to analyze my info. I woke up one morning with pain on the lateral side of my right foot, just anterior inferior to my lateral malleolus. It’s pretty much in the middle of the side of my foot if I am not counting my toes. It hurts when I apply pressure such as walking, causing a limp. The pain is localized to a two inch by two inch area, and does not resonate towards my ankle or toes. When applying pressure to my arch there is some pain, but not in the arch itself, but more because the pressures carries up, putting pressure on the 2 inch sq area. There is pain when I rock forward on my toes, but not much when I rock back on my heals. Does this sound like something familiar? I was considering trying ice and Epsom salts to see if that has any affect as trying to sleep it off has done nothing. I haven’t been running regularly, my last run was probably over a month ago..which makes this whole thing even stranger. Thanks!

    42. jacob07-17-2013

      Hey im jacob and the same thing is happening to me and I play baseball its only when I run that its start hurting but whwn I get done running it hurts for me to walk and Im going to panama city beach to play baseball and I done what you said with the stress fracture and it did hurt real bad but I dont wanna take a six week break what do I do

    43. runningw/theone07-26-2013

      Hi, I am an avid runner and I fell out of running for a while when I went through a divorce. I gained almost 50 lbs from laziness and stress. So in Nov of last year I found myself with no car so I decided I would fun and walk everywhere I needed to go. I purchased two pair of running shoes in Jan ( mizuno wave creation 13’s and Nike air Pegasus29’s love them both!) I am now back down to my goal weight 145 lbs . Ok now that you have my story I have a few ?’s . Oops I forgot to mention my sister and I just started a training regiment for our first 1/2 marathon in Nov ! We got the training plan from our run keeper app. It’s a sub 2hr plan though I’m shooting for an hour and a half! About two weeks ago I started having some pain in the outer part of my right foot and up the outside of my right leg to the back of my calf. After reading this blog I think I’ve narrowed it down to paronel tendonitis. I’ve been icing, massaging, and taking some naproxen twice a day. It seems to help some but the pain persists. Outside of my training I am forced to do 6.5 mi round trip to work and back Mon-Fri. Our training is starting to get a bit more rigours and I definitely don’t want to risk any further damage. Do you have any tips to keep me from having to stop my training all together? Also I think the cause of the whole problem was the mid sole of my mizuno’s were cracked! I just purchased some new asic gel noosa tri 8’s which I love !!! Any advice would be greatly appreciated!! Look forward to hearing from you!! We have also started a new facebook page entitled (runningw/theone) feel free to come like our page and or join us for a run sometime we are from Oklahoma City, Oklahoma!!!!
      Thanks,
      runningw/theone

    44. Suzanne08-08-2013

      This is terrific information. Thank you! I’m fairly certain that I’m dealing with peroneal tendonitis related to running but I’m puzzled about how this came about. The onset was quick. I’m in relatively new shoes (around 50 miles on them) which were fit at a specialty running store. I have found them to be extremely comfortable up until the last week or so when my weekly mileage began to increase. With the increased mileage I was beginning to experience soreness in my arches. I would say I have moderately high arches. I’m in a neutral shoe. I was also experiencing tenderness on the back edge of my heel. In response to this discomfort I explored over-the-counter orthotics/inserts from the shop where I bought my shoes. In hindsight the consultation and selection experience wasn’t the best – not at all like the experience I had when buying the shoes – and I’m fairly certain that the orthotic were not what I was after. They seemed to be far to stabilizing when I was looking for more cushioning.
      With that said, I wore the orthotics in my running shoes for 2.5 to 3 hours around the house – intermittent standing and moving. I found them increasingly uncomfortable and when I finally removed my shoes I felt the pain at the outside of my foot at mid-foot. As time passed, the pain crept back toward the ankle and slightly underneath the side of my foot. The pain subsided to mild discomfort but within 36 hours I had swelling below my ankle bone. It is possible that the short time in the orthotics could have triggered this issue or was this a storm that was already brewing and the timing of the orthotic trial was just a coincidence?

      I’m scheduled to see my Primary Care MD tomorrow but I’m fairly certain that he will tell me to do what I’m already doing – rest, ice, take NSAIDs. What I’m interested in is figuring out what factors lead to the problem so that I can address them and prevent reoccurrence.
      I imagine there are various specialists that could weigh in but I’m particularly intrigued by the chiropractic prospective. I see a chiropractor regularly related to spine issues (history of surgery for a herniated disk w/free fragment at L4/L5). While I’m pleased with the care I receive for that issue my doc seems to only focus on the spine. I absolutely believe that the various parts of our body are connected and our ailments tell its story. I just need someone to help me to interpret the messages. So I wonder, could give me some advice about finding a chiropractor in my area who either specializes or has particular interest in caring for runners? I’m in Kentucky so seeing you is just not an option.
      Thanks so much!
      Suzanne

    45. Kevin B08-12-2013

      Thank you for taking the time to write such a detailed article. I stumbled upon it because I’ve had an odd foot discomfort for 2 months and while I’m pretty convinced its not a stress fracture, I’m having trouble being certain. I can illicit a pain response between the head and the bony midfoot on my left outer foot by compressing my foot (squeezing my foot by grabbing the inside and outside and squeezing the 5th bone towards the first bone. It’s been at a 3 or so out of 10 and doesn’t happen all the time and tends to get better if I hold the squeeze. I can hop on that foot. I’ve also ran well over 200 miles on it since I remember feeling it. It never hurts during a run unless I notice it at the beginning but it goes away pretty quickly.

      The one change is that I switched shoe models to their new version which I heard has a smaller toe box. I’ve made accomodations with lacing but it hasn’t seemed to help. I’d hate to try new shoes so close to the marathon but my main concern is that I’m running on a stress injury without realizing it.

      Can this be as simple as shoe irritation?

      Thanks so much in advance for any peace of mind you can offer.

      • Dr. Steve Smith08-15-2013

        Kevin,

        It doesn’t sound like a stress fracture. I would bet that your shoes were just a bit tight. Sometimes skipping a lace or two can help to relieve the stress on the forefoot but it is always best to have good fitting shoes. Try this test: stand on your shoes and if the forefoot is larger than the shoe then they are too tight.

        Steve

    46. garry08-15-2013

      Hi, A great article and something that’s really help me try and understand my problem. My left foot started hurting about 4 months ago and I thought it might have been down to stress on my plantia as the pain was always high first thing in the mornings and if I was sitting for long periods of time at my desk. The pain would reduce slowly once I started walking. I bought arch supports for my shoes and night support socks for sleeping in. The problem I’m having now though is my pain is still there but it seems to be now worse on the outside of the foot mid way down. Its sore to touch and I’m now worried it may in fact have been a stress fracture. Should I be taking anti-inflammatory drugs too. The pain subsides once I have stopped using the foot but the soreness to touch remains. Any thoughts?
      I’m active away from work so the pain is sending me crazy and will soon drive me to the doctors if I cant sort it out myself.

      Please can you help thanks so much.

      Garry

      • Dr. Steve Smith08-15-2013

        Garry,

        From what you tell me it sounds more like Plantar Fasciitis. there are 3 branches of the plantar fascia and it sounds like the central and medial branches were irritated and now the central branch is doing better, leaving the medial branch to heal up later. I would give it more time and continue with a night splint and stretch the lower calf and feet. If you have pain on hopping or severe pain on walking then it’s time to go to see your Doc.

        Steve

    47. Jennifer08-18-2013

      Hi!
      I am 13, and I play soccer a lot. I usually have soccer everyday of the week, sometimes twice a day. The outside of my foot has been hurting.

      It only hurts after I have soccer, and when I am walking around my house, but not running… Any thoughts as to what it might be? It hurts when I press on the top and the bottom of my foot, and when I bend my toes too far. The pain is kind of a full, ache-like pain that is along the outer portion of my left foot. I have sprained that ankle 4 times and wear a brace for soccer, if that info helps at all. The pain has only been around for a few days, maybe a week, and I think it is slowly getting worse. It has begun to hurt more when I am just resting, instead of when I am walking or playing soccer.

      I am wondering if it is a stress fracture, or what.

      Thanks for any replies, as they are welcome. :)
      Jenn

      • Jennifer08-18-2013

        I also have has severs in both feet, and Achilles tendinitis in both feet also.

        • Jennifer08-18-2013

          The pain is right along the 5th metatarsal, to help pinpoint the location.

      • Dr. Steve Smith08-19-2013

        Jennifer,
        It doesn’t sound like a stress fracture. More likely it is a tendon attachment that causing your problem. I am wondering about your previous ankle sprains causing an alteration in your running gait. You may be turning your foot or tensing the muscles on the outside of your lower leg in an attempt to protect your ankle. If this is the case then your tendons on the outside of the foot will put extra stress on the attachments at the fifth metatarsal. Check your running gait and if see if this is the case. If so then you will need to do ankle strength exercises. There are several exercises that help with this, toe tappers, theraband resistance turning the foot to the outside and inside, theraband pulling the foot toward you and away from you, one legged calf raises with the foot turned out, turned in and straight ahead. Some self massage over the specific tender areas can really help to ease the pain. Go slow with any massage and probe carefully for the most tender area, applying steady, even, deep pressure. If the pain is definitely along the mid metatarsal shaft then you may may have a stress fracture and should get it looked at by your sports doc.
        Steve Smith D.C.

    48. Gaynor Jakeman08-19-2013

      My son has been complaining that the area around the bone on the outside of his foot is sore. This has gone on for weeks now and is particularly sore during/after sport and at the end of the day. Was checked by local GP a couple of months ago but no xray. Pain seems to have been made worse by a fall off a tree? Any suggestions?

      • Dr. Steve Smith08-20-2013

        Gaynor,

        If it has gone for a long time and is not resolving it is a good idea to take action and do some imaging. Start with a visit to a sports doctor or a podiatrist and get and examination. A careful history and examination of the foot may be all that it takes to get an accurate diagnosis but I would bet that an x-ray is warranted by now.

    49. gaynor08-20-2013

      Many thanks for your response. Have tried to self refer to such depts today but due to being only 10 years old must go through GP for referral but agree as it is certainly not healing on it’s own.

    50. Danielle Atkison08-21-2013

      For about 3 weeks now I have had a pain on the outside of my left foot. I started exercising in January and have lost a total of 52 pounds. I worked out 3-4 hours everyday. I run 8 miles almost everyday, do combat, attack, and pump classes. 3 weeks ago while I was running my foot started aching, so bad I couldn’t even finish a mile. I have been trying to rest it for the past 2 weeks. I still do pump and I try to do cycling for cardio. The instructors from the gym tell me that cycling shouldn’t hurt it, but it does. I am wondering what you think is wrong? There are days where it really doesn’t hurt at all, and other days it hurts pretty bad. I just feel like if there was something major wrong it would hurt a majority of the time. I don’t want to be resting my foot if nothing is really wrong. I miss my running! :)

      • Dr. Steve Smith08-22-2013

        Danielle,

        I think you are right, it doesn’t sound like a fracture to me. More likely is is the peroneus tendon. Try self massage therapy on the outside of the foot and use an ice pack. Change your shoes if they are getting worn. Do the step out calf raises on one leg for a couple of weeks but only if it can be done pain free. Use the elliptical trainer and consider aqua jogging to maintain your fitness level while you heal up. In the meantime, give it a complete rest from running for a couple of weeks or at least cut back on frequency, intensity and duration of the current workouts that are causing your pain. If there is no resolution to it then you are going to need to get it looked at. Unless you regular Doc is sports oriented, skip it and go to someone who understands the importance of what you have done. Weoo done on your program and your success, I love your story and thanks for sharing it!

        Steve Smith DC

        • Danielle Atkison08-22-2013

          Thank you!

      • Dr. Steve Smith08-22-2013

        Danielle,

        I think you are right, it doesn’t sound like a fracture to me. More likely is is the peroneus tendon. Try self massage therapy on the outside of the foot and use an ice pack. Change your shoes if they are getting worn. Do the step out calf raises on one leg for a couple of weeks but only if it can be done pain free. Use the elliptical trainer and consider aqua jogging to maintain your fitness level while you heal up. In the meantime, give it a complete rest from running for a couple of weeks or at least cut back on frequency, intensity and duration of the current workouts that are causing your pain. If there is no resolution to it then you are going to need to get it looked at. Unless you regular Doc is sports oriented, skip it and go to someone who understands the importance of what you have done. Weoo done on your program and your success, I love your story and thanks for sharing it!

        Steve Smith DC

    51. Jennifer08-21-2013

      I know that I have already asked for an opinion, and not many days ago, but my foot has begun to hurt more and in different places in addition to where it hurt before.

      As before, the edge if my foot, along the fifth metatarsal hurt after soccer and while resting sometimes, and if I pressed on almost any part of the bone along the outside, near the middle of the outside bone. It was a dull, achy throbbing pain. Anyways, now, my foot has begun to hurt more towards the top and middle, and around my ankle. I have a small bruise on my heel from something, but I am not sure what. It has begun to hurt when I put all my body weight on that one foot, and my ankle has been a little stiffer than usual.

      If anyone knows what might be going on, please let me know.

      Jenn

      Oh, and by the way, I play soccer everyday, and sometimes twice a day, and do quite a lot of running during those practices. Could these be signs if a stress fracture?

      • Jennifer08-21-2013

        Sometimes it throbs when I am trying to sleep… :/

      • Dr. Steve Smith08-22-2013

        Jennifer,
        I don’t know if you saw my original answer so I’ll copy it here:
        It doesn’t sound like a stress fracture. More likely it is a tendon attachment that causing your problem. I am wondering about your previous ankle sprains causing an alteration in your running gait. You may be turning your foot or tensing the muscles on the outside of your lower leg in an attempt to protect your ankle. If this is the case then your tendons on the outside of the foot will put extra stress on the attachments at the fifth metatarsal. Check your running gait and if see if this is the case. If so then you will need to do ankle strength exercises. There are several exercises that help with this, toe tappers, theraband resistance turning the foot to the outside and inside, theraband pulling the foot toward you and away from you, one legged calf raises with the foot turned out, turned in and straight ahead. Some self massage over the specific tender areas can really help to ease the pain. Go slow with any massage and probe carefully for the most tender area, applying steady, even, deep pressure. If the pain is definitely along the mid metatarsal shaft then you may may have a stress fracture and should get it looked at by your sports doc.
        Steve Smith D.C.

    52. Jennifer08-22-2013

      Thank you! I did not actually see your original answer, but I do now. (Sorry! )
      :) Thanks again!

      Jenn

    53. painful puppies08-26-2013

      I am a server, so I am on my feet constantly. I am also on the heavy side (5″8 190). I have heavy to moderate pain in what I believe to be the outside bottom of my calcaneus. The pain is from a small area on the bottom of my heel And goes up the side of my foot about an inch and a half. The pain stops below my ankle. It sometimes feels as though the tendon along the bottom of my foot is too short for my foot, and I often have to walk tip toed after a shift. I would really appreciate an opinion on why my foot hurts like this. Do you think I need new shoes, or different insole maybe?

      • Carly Evans08-27-2013

        I started having ankle pain in my right ankle around 2 weeks ago, immediately after a 9k run. I have signed up to my first 10k which is at the end of September, I have never really done much running before. I had no pain during the run but as soon as I stopped and started to walk, it became difficult to walk and became progressively worse as the day went on. There was no swelling but I continued to hobble in pain when walking for a few days after. From the day after I also had the same symptoms in my left ankle but on a smaller scale. After around 4 days the pain had subsided. This weekend (a week after the original injury) I have spent 4 days at a music festival which involved a lot of walking, dancing and general jumping around. There was a little discomfort in my right foot but nowhere near as bad as the original pain, and I could still manage to walk around without any problems (I did wear wellies the whole time). It wasn’t until I got home yesterday and had a proper look at my ankle that I noticed how swollen it is! Only my right one though, the left seems to be OK. The swelling is located next to the ankle bone on the side towards the front of the foot. I have pain on the outside of the sole my foot from my little toe back to my heel and my little toe is turning numb. It is also uncomfortable on the outside of my calf. No sharp pain though. I’m guessing I won’t be able to manage the 10k race. Maybe I did too much too soon? I went from only being able to run 4k to 9k in less than 3 weeks with not very many rest days. I am running on a treadmill in standard running shoes. Any advice you can give me would be greatly appreciated!
        Thank you for your time.

        • Dr. Steve Smith08-27-2013

          Carly,

          This sounds like tendonitis. It involves the peroneus muscle and tendon and isn’t dangerous. The increase in mileage is a training error that is common, too much too soon. I am suspicious about your shoes. You probably have shoes that correct for overpronation, I am guessing they are stability or motion control shoes that transfer the biomechanical load to the outside of the foot. If this is the case then get new shoes and use some ice and self massage on the affected areas. Go to a running specialty shoe store to get your shoes. The folks who work at these stores know which shoes to give you for your type of foot and can tell you if you have the wrong shoes. If all this is correct and if you get new shoes, the massage and ice works and you are not sore then I would give you the green light to run the 10K this weekend. this assumes that you are in good enough condition to run it. Your general fitness and age has a lot to do with the wisdom of running this race.
          Good luck and please let me know how it works out.

          Steve Smith

    54. Catherine08-27-2013

      Hi Dr. Smith, thanks for such an informative article. My foot problem started a week ago. For two days I ran errands in flip flops– walking around the mall, grocery stores, etc. (Usually I wear running shoes when I’m going to be walking that much.) The day after all of that, I had been doing housework for most of the day in my bare feet and intermittently taking laundry out to the clothesline in my flip flops. Late in the afternoon I was working in the kitchen and I started to feel a lump forming on the bottom of my right foot, on the outer edge, halfway between my heel and little toe. It felt like I was standing on a soft wad of putty. I didn’t think too much of it until it started to hurt a couple of hours later. When I looked at my foot, that area was swollen. No redness, not tender or warm to the touch, but slightly discolored. I elevated and rested my foot that evening, but the swelling increased and the lump ended up being a 2×2 inch purple square that wrapped around the outer edge of my foot. You can see a half inch of it on the top side of my foot if I’m standing, and my foot “puffs” out where the swelling is. I already had a callous there, and this bruised area formed right underneath my callous. One thought I had is whether my stiff flip flop strap was pressing too hard on that area when I was at the mall. The strap wraps around my foot right at mid-foot and I actually stand on the part of the strap that connects to the sole. Another thought: 10 days earlier, I had done yard work where I used a spade to shovel a couple of scoops of hard clay soil, and I put weight on that part of my foot to turn the shovel. Also that day I had been breaking branches with my right foot. Not too many, but a few. I wore some thin-soled canvas shoes at the time. Could I have done the damage at that point and it just took a few days to flare up after I did all that walking?

      The podiatrist took x-rays and didn’t see a stress fracture… he thinks it’s some form of peroneal tendonitis, and said that I may want to consider wearing a boot. I’m not sure if that’s the right thing to do. Any thoughts on that? He also has me on Meloxicam, rest, ice and elevation. I use crutches to get around right now.

      A bit more background info: 49 years old, 5’6″, 128 lbs. I did sprain my right ankle, but that was 35 years ago. I had achilles tendonitis 10 years ago. More recently, I strained my left adductor muscles last September, lost flexibility in my left hip and groin, had a meniscal tear in my left knee in December, followed by surgery for it in May. That’s why I hesitate wearing a boot, because I don’t want to cause a flare in my left side by being uneven. But 6 days from now I head to Disney World with my husband. I would sure like to be able to enjoy the parks, so I’m hoping for the right treatment and some quick healing! (Or do I need to think about using an ECV when we’re there?)

      Any advice would be greatly appreciated!

      • Dr. Steve Smith08-27-2013

        I can see how you could have bruised your foot doing the activities you described and this is what I think it is. If it is bruised, then give it a rest, stay off of it, use ice and self massage doing stroking toward the heart and continue with the anti inflammatories. I’ll bet that it gets better in a week and you can travel. The x-ray is good for peace of mind but there is no guarantee that is not a stress fracture. A bone bruise is a possibility but they cannot be seen on x-ray either. If this is the case then it will take several months to heal up. You’ll know over the next 10 days or so because if it a simple bruise then it will fade away and you have a good time at Disney World.

        • Catherine08-27-2013

          Thanks so much for your reply!

    55. Paula Dickinson09-03-2013

      Very informative article and will try the Epsom salt soak. I was wondering if a muscle or tendon spasm could cause this pain, as mine started in the middle of the night on the underside of my left leg and up the outer side of my calf and beyond. It felt very much like it does when I know I am getting a cramp in my toes or hamstring, which I can usually help by standing up, taking extra potassium/magnesium and/or using a heating pad. This pain persisted all the next day not matter what I did including Advil and ice packs. The next night I took a muscle relaxant that I had been given for a back injury and the next morning the feeling that there was a spasm was gone, but the tendon on the outer side of my foot was very sore to touch and walk on and throbs most of the time and there is still some pain up the outer side of my leg I am a 68 year old woman who is fairly active, exercising most days. I would be very interested in knowing if a spasm could cause this and if there is anything different that I should be doing, if it is.
      Many thanks for your helpful information.
      Paula

      • Dr. Steve Smith09-03-2013

        Paula,
        It sounds like you did have a muscle cramp and the course of action you took makes sense to me. Muscle cramps are still an enigma to the medical community. Despite the many articles written on this problem, there remains no definitive solution to treatment. Potassium, magnesium, calcium, salt, quinine and water all seem to have benefit. If you have repeat episodes I would suggest increasing the potassium in your diet. A diet rich in beans, oranges, bananas etc. will help. Add some Calcium and magnesium as a supplement as well. If you are not consuming enough water, an increase may help as well. You can learn more about the nutritional value of foods by downloading the free app. “My Food’ or ‘My Fitness Pal.”

        Steve Smith

        • Paula Dickinson09-03-2013

          Thank you so much for your reply. Now I have two other questions… I do drink a lot of water, take magnesium and calcium supplements daily. When I get cramps, I usually take the potassium, but was wondering if it could be lack of sodium as well. Because of heart issues, I avoid salt and wondered if the muscle spasms could be lack of sodium. My other question is whether if a prolonged spasm could cause a more long term tendonitis? I did try the Epson salt soak and think is has provided some relief, though have not been on my feet much since soaking. Again, thanks for your fast response. Paula

          On 9/3/13 5:37 PM, “Articles from Dr. Steven Smith” wrote:

          > runmastergeneral commented: “Paula, It sounds like you did have a muscle cramp > and the course of action you took makes sense to me. Muscle cramps are still > an enigma to the medical community. Despite the many articles written on this > problem, there remains no definitive solution to t” >

          • Dr. Steve Smith09-03-2013

            I haven’t heard of a cramp causing tendinitis but you may have other stresses on the tendon that, coupled with a cramp produced a problem of greater magnitude than would be warranted by a spasm alone. Check your calcium intake and shoot for 1,000 to 1,200 mg per day. Your magnesium level is going to be about half of the amount of calcium. If you continue to have cramps you can try taking some quinine. They don’t sell it over the counter but you can get tonic water in liquor stores and it has a small quantity of quinine. I wouldn’t increase sodium intake if you have high blood pressure but a brief intake for experimentation shouldn’t be a problem. Your doctor should be consulted on this though.

            This may be one of those simple problems that will go away in a few days on its own so I would give it the old tincture of time treatment and just wait it out for the next couple of weeks.

            Please post the outcome so we can all see what comes of it.

            Steve Smith

    56. Michelle09-03-2013

      You are so great for maintaining responses on this article. I think my problem is a stress fracture, but Id really like to hope that it isn’t. Maybe you will have some advice.
      I ran a typical 5 mile run last Thursday, and noticed a moderate pain on the 5th metatarsal, near the ankle bone. The pain has continued to increase over the last few days and has reached a severity of about 7/10 while walking, and a dull throb while resting. I did run 5 miles this morning and felt it at the beginning of the run, with an intense pain after I stopped. I cannot walk without a limp at this point.

      I am also just getting back at 100% after recovering from bilateral grade 2 stress fractures in both tibias in April, so the pain is familiar in its patterns. Is this another stress fracture? Or maybe a result of something residual from my tibial stress fractures?

      Any advice would be appreciated!

      • Dr. Steve Smith09-03-2013

        Michelle,

        It does indeed sound like a stress fracture. I hate to give bad news but I would like it even less if you kept running on it and fractured your foot. I would get an x-ray of your foot first and if it is inconclusive then an MRI. Until you prove otherwise, treat it as a stress fracture. Stay off of it as much as possible, wear the most supportive shoes you have and use ice. A shoe with a very stiff sole will help prevent movement of the affected area.

        I hope this helps and please post the outcome of any I,aging or treatments.

        Steve Smith

    57. Glory09-03-2013

      I am 51 yrs old, I am in reasonably good shape, I wake up each morning with very sore feet as soon as the touch the floor. After a while they let up, but I do have a constant ache at outsides of my feet the bone near the heels and sometimes on top. I work on concrete floors all day and pack a lot so I really can,t stay off them.
      Glory

      • Dr. Steve Smith09-03-2013

        Glory,

        This sounds like plantar fasciitis to me. If I am correct on the diagnosis then you probably have a lot of pain when you first step on it in the morning or after a long car drive. If this is the case then a night splint on your foot will help. http://www.nationalbraceandsplint.com/Adjustable-Night-Splint_p_379.html You’ll have to get used to the splint but it is well worth it. You will notice and appreciable decrease in pain after just one night. Skip the soft splints and get the hard one. You don’t have to tighten it very much for it to do the job of keeping your foot stretched out during the night. Try sleeping with your feet out from under the blankets and sheets to avoid plantar flexing. Try doing the lower calf stretches every hour. Do the stretch for 20 seconds on each foot. You can see the stretches by going to my website http://www.stevesmithdc.com and clicking on the youtube stretch videos. A frozen water bottle will serve the dual purpose of massage and ice treatment. Freeze the water bottle until it is hard then put on a thin sock and roll your feet on it for about 10 minutes each. If you have plantar fasciitis it may take a long time to resolve if it is severe. Try the above measures for 3 weeks and if you don’t see a improvement then it’s time to go to the doc.

        Please let us all know how you are doing.

        Warmest regards,

        Steve Smith DC
        http://Www.runhealthyrunstrong.com

    58. Michelle09-04-2013

      Thanks for the reply. I had X-rays today that came back negative. My PA thinks it’s a stress fracture, will have a bone scan in the coming weeks. Until then, I’m in a CAM boot until further notice. I did have a little swelling and slight bruising show up this morning. Bearing weight is a no go without great pain. Not good for helping my pace out. I won’t be running for a bit!

      • Dr. Steve Smith09-10-2013

        Michelle,

        Sorry to hear it but it sounds like you are on the right track. Bone scan is a good idea and will show up hot if you have a stress fracture.

        Good luck.

        Steve Smith

    59. Ashley Ciecko09-06-2013

      Very interesting article. I have been having similar pain for this entire week and since I have been slowly incorporating running into my exercise routine over the last few months I am very frustrated that my foot hurts! My pain is on the left outer edge of my left foot. It seems to start around my ankle bone and there might be some very slight swelling around the ankle but it’s hard to tell (I’m just comparing it to my right ankle). I can walk on it a short ways with no problem but then it starts really hurting and I have to sit down. I do wear orthotics in my work shoes to correct over pronation but I do not wear them in my running shoes. I usually stand on a cement floor at work for 3-4 hours at a time and that’s when I initially noticed the pain. I’m really hoping I can heal this quickly and get back to running soon. Thanks for any help.
      Ashley

      • Dr. Steve Smith09-10-2013

        Ashley,

        I’m suspicious about the orthotics that may have caused your foot to supinate, placing stress on the outer foot and ankle tendon. The tendon that I am thinking about, (Peroneus Brevis) runs through a sheath that curves around the outer ankle bone (Lateral Malleolus) and terminates at the widest point of your foot Base of the (fifth metatarsal). If this is what is causing your problem then stop using the orthotics and apply massage to the area. Use a slow deep stroking technique along the tendon followed by a 15 minute ice pack. Us anti inflammatories if you are not averse to it. I like to use a combination of ginger, turmeric and botswelia for inflammation, since there are no adverse side effects to your kidneys. I often use a 3/8 heel lift on both feet to reduce tension on the tendons. Don’t attempt to put a heel lift on one foot because it will cause back or hip problems. Please let us know if this works for you by posting your results.

        Good luck,

        Steve Smith

    60. David Rasmussen09-11-2013

      I am a 72 yr. old active male. I walk, ride a bicycle, and golf 3 times
      a week. For 4 weeks I have been having intermittent pain on the outside of my right foot. On days that it hurts I contemplated calling my doctor, then it starts to feel better. I feel it is nerve pain, as it can occur at night in bed to the extent it wakes me up. On my last physical my doctor said my sugar was 105. He wasn’t too concerned, but said we keep a watch on it.

    61. HI – I wonder if you can offer me any advice. Five weeks ago I fell and my ankle twisted under me and was very painful. There was a lot of swelling and bruising in the foot. After a couple of days the pain started to subside and it was improving. Three weeks after the fall, the pain has started again but this pain is on the right outside edge of the foot more towards the arch area and nowhere near the toes. I have just started using crutches to try and keep the weight off the foot. Over the last couple of years I have had to have a tremendous amount of Xrays and the reason I have not gone to the hospital re the injury to my foot is fear of more radiation from more Xrays. The pain seems to be when the foot is flexed or if I happen to put the weight on the side. I realise you cannot give a diagnosis but wonder if in your opinion this has the potential to resolve itself if I keep my weight off it, or does it sound as if there could be a broken bone that will require Xrays and treatment. I would value your opinion. thank you

      • Dr. Steve Smith09-19-2013

        Rita,
        This is a case where I would definitely recommend an x-ray. I appreciate your concerns about X-rays and would recommend that you be cautious if you have had radiation treatment for cancer or a lot or CT scans. If your radiologist or oncologist tells you that you have reached your limit on X-rays then you should probably get an MRI, since they emit no significant amount of radiation. If you have just had a few standard x-rays then i would not hesitate. You are probably aware that there are X-rays naturally present from solar radiation. The amount of x-rays on a three view foot is roughly equivalent of being in a high altitude such as Denver Colorado for a few months. In your case the amount of damage that may be caused by lack of proper medical care probably outweighs any potential risk of an x-ray.
        Please let us know the outcome so that we may all learn from you.
        Steve Smith
        Author, Run Healthy Run Strong

    62. Hi many thanks for your reply. The advice is very welcome. I guess you have suggested what probably deep down I suspected. I have up to now been hopeful that the problem would just resolve itself without the need for more X-rays. In the last two years I have had over 25 Xrays, 3 MRI’s, 2 CT scans and live fluoroscopy for a disc replacement. I will follow this through as obviously I need to think long term. thanks again

    63. Kim09-21-2013

      Dr Smith I’m wondering about in ability to supinate the foot can cause side if the left foot pain, I am disabled and am trying to walk again, I still have paralysis in my ankle and wear a leg bracethe goes under my foot and up my lower leg to my knee. I can use my had to move my ankle, but doing calf raises is not possible. What do you recommend for my side of the foot discomfort?please email me!
      Thanks!
      Kim

    64. Schiff09-23-2013

      I found this post while researching my foot pain and hope you might have some advice since you seem to respond to everyone’s questions.
      I’m 29 and have been Marathon training for 15 weeks, regular runner before that essentially since middle school. On Saturday after an easy 4 miles I was doing some strides in the park and stepped in a hole. Slight ankle roll but no pain, did 3 more strides and went home.
      On Sunday, woke up feeling a bit of pain on the outside of my left foot, ran in a one mile race as scheduled, and since then have continued to feel pain in the area when walking. It does feel worse than it did at the outset but only moderately so — in general it is quite uncomfortable. I would say it runs more towards the heel than the toes.
      I’m trying to get an x-ray scheduled but in the meantime I’m wondering what your initial diagnosis might be and what you would recommend as next steps.
      Thanks!!!

      • Dr. Steve Smith09-23-2013

        Steven,
        I don’t really have much information from what you have given here but i would make a guess that you sprained your ankle. it is possible that you have a small avulsion fracture (where a small piece of bone has been ripped loose by a tendon that has been over stressed) in which case you will need an x-ray. If you can bear weight on it, that is a good sign and if you can do a calf raise that is even better and you might just want to wait for a 10 day or so and if it is getting progressively better then it is probably going to resolve without intervention. If this is an ankle sprain then it may turn purple and over the next few days may turn a yellowish color that spreads toward the toes.
        Hope this helps, please let me know the outcome,
        Dr. Steve Smith D.C.
        Author, Run Healthy Run Strong

    65. jennifer09-25-2013

      how long does this take to heal and does it cause further problems to try to run thru the pain? I am a runner and out of nowhere had a stabbing feeling in the bottom of my foot. Could not walk well for the following 24 hours. No swelling, could balance on the foot but it hurt to walk. Rested it and want to get back to running. When I tried, It hurt on the top area of my foot and not the bottom where th pain originated from. I can jump on it, balance on one foot but the running movement is bothersome. How long does this typically take to heal and can I do more damage by trying to work thru it? I’ve been doing the bike and elliptical pain free. I am not usually injured and this has thrown me for a loop!

      • Dr. Steve Smith09-26-2013

        Jennifer,
        I’m not sure what the problem is but my general advice is don’t run through pain in the foot until you know what it is. You will not lose much conditioning by continuing on with elliptical trainer and bike while whatever it is goes away. Judging from what you have told me here it sounds minor and will probably be gone in another week to ten days. You’ll be better off running without pain rather than to come back too soon and restart the clock on your healing time.
        Steve

    66. Jyoti09-29-2013

      Wow great post I found looking for something for my foot pain. I went for a walk yesterday – after 6 months of leaving the gym where i did an hour of high intensity aerobics- for an hour 3 days a week. Yesterday i went for a walk and thought maybe i can jog for a minute – just one minute, I did, but when i came back the outer length of my right foot is paining – no swelling, no nothing – but when i walk i cant do so without a pain. what could this be, i am am thinking i pulled a ligament. Also whenever i did aerobics, i had a pain in the same region which lasted for 10 minutes after exercise and went away. Could this be something breeding – serious?

    67. Erin09-30-2013

      Such a great article! I recently took up running and am doing the couch to 5k program (I haven’t exercised in over 5 years so this is big for me:). I started out on the treadmill and have tried to transition to pavement so that I’m ready for my 5k but have had some difficulties. My shoes were a bit worn and I felt major joint pain from the waist down (hips, knees, you name it) when I tried to run on pavement for the first time. I figured I would buy some new shoes and went with a very well known running brand. Did the 2nd pavement run this morning and it was worse! Had major pain within 5 minutes on the bottom outside edges of my feet however no joint pain so I guess it’s a wash. Should I continue to try and break the shoes in or just switch to a new pair? I might add that I am a larger female with over 100 lbs to lose so I know for sure that is a major factor in this. Any insight would be helpful. Thanks!

    68. notsolightonmyfeetnow09-30-2013

      Hi I am a 22 year old studying abroad and don’t have the luxury of getting my foot x-rayed or looked at by a physician, so I thought you might be of some help.This past weekend I ran a 10K, which is more mileage than I have been doing. I typically run pretty comfortably on a daily basis for 30 to 40 minutes, but this race took me a right at one hour and was about double my normal distance. I run with a mid-foot landing, if that information helps any. I didn’t notice any pain during the race, but hours after I began to notice a sharp pain on the lateral side of my right foot. The pain is pretty concentrated on the 5th metatarsal and has not improved at all- it actually has increased. I wear the women’s Asic Gel Forte shoe. It’s a motion control shoe that was “ordered” by my physical therapist because I have Morton’s neuroma in my left foot.The neuroma has not been a problem for over a year. I have been reading some of the comments and responses on this blog and I think my shoes might be the issue, but I am weary to just assume that. The pain in my foot is a pretty constant throb. When I walk and put pressure on my right foot, the pain is stabbing and shooting (I tread as lightly as possible to avoid extended time striding with that foot). The pain level when I put pressure on it is about an 7. I have not run since the race on Saturday and don’t think I will be able to anytime soon with the level of pain I am experiencing in my foot. Any ideas?

      • Dr. Steve Smith10-02-2013

        Kathleen,
        I does indeed make me suspicious about your shoes. Motion control shoes should only be used with runners who have marked over pronation. Runners who are very flat footed often wear motion control shoes. If you have a high or medium arch and your foot does not over-pronate then you are concentrating too much stress on the outside of your foot at the cuboid and fifth metatarsal head. When you go into the push off or propulsion phase of your gait you are also putting a lot of strain on the peroneus tendon. Try this: Carefully feel the head of the fifth metatarsal, that’s the widest bony point on the outside of your mid-foot.
        Feel around the bone and see if you can identify an area of tenderness. If this area is tender put some massage oil or moisturizing cream on it and massage it until the soreness diminishes. If there is tenderness there, you can often trace it along the side of your foot to the lateral malleolus, that’s the large bone on the outside of your ankle. there is a soft spot behind that bone and it may be tender to deep pressure. If this is the area of pain then you have tendonitis. Give it 10 days before you try to run on it again and do the massage technique every day for about 3 or 4 minutes. When it is no longer tender to deep pressure massage then you are ready to run but don’t use the motion control shoes.

        I hope this helps. I wish I could take an x-ray over the internet!

        Dr. Steve Smith D.C.
        http://www.RunHealthyRunStrong

    69. BCM10-07-2013

      Thanks for that great informative article, but I want to present you my specific problem. I have been training for a 10k (with a local running store’s training program) for about 8-9 weeks now. A week or two ago I noticed some pain in my right foot. That pain was in my heel near my arch on the inside of my foot. It wasn’t enough to keep me from running so I just have been pushing through it. This past Saturday I did a long run of 6.5 miles and several hours afterwards, I started getting pain on the outside of my right foot. It seems like it runs from my pinky toe almost to my heel, but it is most pronounced about midway between the two. Also, now my heel/arch pain seems worse too. Both pains in that foot had me limping around the rest of Saturday and all day Sunday (and this morning too). I did your aforementioned push test on the outside edge of my foot and didn’t really feel any pain. The outside area is not painful to the touch either, but if a poke around my heel/arch that area is. I only seem to have the pains when I put weight on my foot. If I flex my foot and really point my toes hard, then I do feel some pain on the outside of my foot. I run in neutral shoes (Air Pegasus indoors on the treadmill and Brooks Ghost for outdoor runs) and always have. Even before the outside edge pain, I had been trying to stretch my calves a lot and the they really don’t feel tight (and I seem to have good range of motion). My 10k race is in a couple weeks so I am really hoping there are some things I can to help me get back on track soon.

      • Dr. Steve Smith10-07-2013

        BCM,

        It sounds like you are developing Plantar Fasciitis. There are three branches to the plantar fascia and the area you are having trouble is the lateral branch. Do you have pain during the first step in the morning? If you do then this is nearly proof positive that you have plantar fascitis. Try stretching your feet on a step or doing the stretches on my YouTube videos. The stretches work but only if you do them every hour or so. You’ll need to keep your feet stretched and stay off hard surfaces in your bare feet. Use a frozen water bottle to ice massage your feet in the evening before bedtime and then wear your splint all night. If you are developing Plantar Fasciitis it would be wise to give it a rest until it goes away. I know runners who continue to run and most of the time it just delays the healing process and certainly increases the risk that the condition will worsen. At the very least, it will slow the healing process if you continue to run.

        Steve Smith
        Author, http://www.RunHealthyRunStrong

    70. Gina10-30-2013

      Hi! I read the article but unsure if it applies to my situation. A few weeks ago, I had some sharp shooting pains in my heels off and on for a few days. That seems to have mostly subsided. However, more recently, I have swelling and pain on the outsides of both feet. It has become very uncomfortable and especially difficult at work these past few days.

      I have been working a retail job for the past 4 years. The past two years have been full-time. An average day is spent mostly on my feet with the past month or so almost entirely on my feet. (I have been a walker all of my life (5-7 or more miles a week and hike frequently as well) and have never experienced any kind of foot pain previously. I don’t have pain when not standing but some tingling for awhile when I’m first off my feet. One other thing is that when I get up in the morning, my feet feel so stiff that I seem to stumble a bit and feel a little unsteady. I am in good health (53 yrs old) and fit (other than being 15 lbs overweight) and have enjoyed Pilates, swimming and other exercises for many years.

    71. Gina10-30-2013

      I should’ve mentioned that this is the ‘bottom’ outside of both feet. I first became aware of it when standing up after putting on my shoes — when I mistakenly thought something must be in my shoe. I am not a runner but several times in the past month have worked one minute of running into every four minutes of my walks.

      I appreciate any suggestions/ideas you may have.

    72. Gina11-08-2013

      After a couple of days off my feet, the pain is only on the bottom outside of one foot. The other symptoms must’ve just been coincidence (simply too many hours on my feet) but this one foot has brought me to a halt.

    73. Dave Stauffer11-11-2013

      My outside bone and under midfoot hurts bad when going up hill or down hill. This just started. What is it? What can I do?

    74. samantha morrison11-18-2013

      Hi, I would love some help please! About 3 years ago, I came off a curb wrong and rolled my right foot. The severe pain I had that night was unbearable. I was on holiday and didn’t see a doctor for it. I had 3 days of wearing sneakers and limping. Then the pain went away. 1 1/2 years ago, I had a charlie horse in the same foot and ended up with plantar fascitis under the mid way of my foot. I went to see an orthopedist and was given an X-ray, a walking boot and stretches to do. I saw someone else when the pain didn’t subside and got an MRI and 2 cortisone shots. Now the pain is solely on the outside of the foot from the edge of the toes down to mid way of foot. It is unbearable now and hurts when i walk and hurts to be rubbed. I get hot flushes through the foot every now and again. Please advise, Samantha

    75. Jenna11-20-2013

      Hi!
      I injured my knee three weeks ago playing soccer, and was on crutches for 2 weeks, and a few days. After I started walking withy knee brace, I noticed that the outside of my left leg (the one with the hurt knee) was hurting. It was sharp pain, but not constant, and mostly hurt when I am walking. I have not told my physical therapist for my knee about it and I’m not sure if I should. There is a small lump on my leg, just a little above my ankle, and it hurts to press even just lightly on the bone there. I think it is right above my fibula, but I’m not sure. Any thoughts as to what it may be?

      Thanks!
      Jenna

    76. Gretchen Johnson12-04-2013

      Can I bike, swim, or do the elliptical if I have a possible stress fracture and or possible peroneal tendonitis? The podiatrist could not determine my problem, but I am in a walking boot.

      • Dr. Steve Smith12-05-2013

        If it is peroneal tendonitis then the elliptical trainer is a perfect exercise modality. It will help you maintain your fitness and if you are a runner you will not loose much ground if you are training for a race. If it is a stress fracture then complete rest is best, usually for 8 weeks. However, stress fractures can tolerate the pool and you can aqua jog and still maintain a fairly high level of fitness. Use the bike only if it is not painful. I would definitely get on the elliptical trainer and give it a 10 minute test to see if it is painful. If not then gradually build up time on it and assume that you have peroneal tendonitis.

        Here’s how to tell the difference: Carefully investigate the peroneal tendon by putting the tip of your thumb along the tendon and try to find an specific area of tenderness. Try using a moisturizing cream or massage oil to help you slide your finger over the area, moving along very slowly, a few millimeters at a time. If you can definitely feel an area of sharp pain along the tendon then just hold pressure there and slowly roll your thumb over the site. If it is tendonitis the tenderness will probably lessen quite a bit. If this happens then you have tendonitis and you can expect a good recovery. Do this massage technique every day, use an anti-inflammatory, do epsom salt soaks and stretch the lower calf. Take a look at your shoes to see if you are wearing on the outside of the FOREFOOT. If you are then it is time for shoe replacement. Please let me know how it works out.

        Steve Smith DC
        http://www.runhealthyrunstrong.com

    77. Gretchen Johnson12-06-2013

      Thank you so much for this info. This was definitely more helpful than the two doctors I visited here. I am going to hold off on massaging it or doing any cardio (I think I aggravated it by massaging it about a week ago and continuing to do cardio) until I go for a check up on Monday. It feels much better since I have been resting it and wearing the boot. Hopefully, I will have a better idea of what the problem is and then go from there. Again, I cannot thank you enough for this valuable info.

    78. Lyndsay12-07-2013

      I recently started running to train for a 1/2 marathon and this exact pain started on the outside of my right foot. I really appreciate the lengthy explanation. It has helped me determine I have peroneal tendonitis and now I know how to approach its recovery. Thank you so much for your insight. Best of health to you!

    79. Pamela Melton12-08-2013

      I have begun to have burning in my right foot on the right side, midway. I broke the bone going to my pinkie toe in 1980 and never really had any problems from that, wore a cast for 6 weeks. I wear flat shoes and boots most of the time. The boots have heals, about an inch. I’m just wondering what I can do to help this burning sensation to stop, if possible.

    80. Lee12-08-2013

      I have new orthotics due to very flat feet which are garnished with bunions and I foot strike outside and then follow through the gait rolling the knee in until the inside of the foot hits the road. I suffered ITB but never foot pain (only ever on the left side). The new orthotics have been fine and I have graded down my shoes to the Asics 3000 instead of the heavy support shoe I was running in. I run usually in the centre of the road (no traffic where I live) and avoid side slopes where possible. I have just increased my milage over time and since the new shoes and orthotics I have come home with the above problem. I can hop on the foot and after a few days of non running it goes. I do still get the ITB that side which aggravates the hip and below knee, sometime refers into upper calf but not as bad with the orthotics, but I don’t like this new thing. I ran a long run today and noticed I began to feel pressure in that left arch from the orthotic then the outside sole pain began.

      • Dr. Steve Smith12-09-2013

        Shinez,

        There are always new pressures and altered biomechanics when Orthotics are introduced. This is the nature of the beast and without those changes the orthotics are are no value. The question here is: did the orthotist get it right? Correcting the alignment of the foot is very tricky. Getting just the right change in just the right place is part science and part art. The person id familiar with these challenges and will more than likely make adjustments in the orthotics to accomodate for any problems. But, you have to give yourself some time to adapt to the new orthotics and this is usually a 2 to 4 week period of time. During this time you may have differing symptoms and as long as it isn’t particularly severe or painful I would ride it out and see where it goes. Definitely give the Orthotist or Podiatrist a call or a visit and let them take a look at it though.

        Hope this helps,

        Steve Smith
        http://www.runhealthyrunstrong.com

        • shinenez@yahoo.com12-21-2013

          Hi Steve, I had the orthotic checked and the podiatrist tweeked it a bit, I did a 19k run two days after, absolutely no pain. He thought the outside top edge of the orthotic may have been flicking up and causing irriation on the centre part of the outside foot which eventually caused my to complete the run unbalanced by trying to run off it. Thanking you once again for your advice. cheers, have a great Festive Season!

    81. lee12-10-2013

      Thank you so much for answering me. I was quite concerned. I have had the orthotics for about two months but the last two runs were much much longer than I had run before with them in my shoes. I will call my Podiatrist and have a chat.
      thanking you once again.
      cheers
      lea

    82. ayanda12-19-2013

      Hello, I spent a month preparing for my 10km race and i extended my distance a bit while training. While doing my hills there was a whole on top of the hill, I entered one foot on the whole while my heel was on the edge I guess I got a strain from there, but it wasn’t painful so I streched. The following week I extended a distance again but my foot was sore everytime I stride especially next to my ankle towards my small toe and below my foot. I stop running for two weeks because I couldn’t even walk properly. I’ve been taking ibrufen and using some heat rub ointment but the pain comes back again, so will I be able to run again?

      • Dr. Steve Smith12-20-2013

        Ayanda,

        It is difficult to tell when you will be able to run from what you have told me here. Do you have any pain when you stand up and put your weight on your foot? You may have a contusion (Bruise) deep the foot that is causing the pain. If this is the case just give it a rest and soak your foot in hot water with Epsom salt. Wear a hard sole shoe, such as Dansko Clogs, that prevent the forefoot from bending to give the area a rest. Diagnosing this type of problem is difficult but you can often tell if you have pain when you carefully apply deep pressure to the bottom of the lateral foot. You may also have a tendon that is sore and if this is the case it will go away in a few weeks. Don’t run on it until you are sure that there is no fracture or bone bruise.

        Dr. Steve Smith
        http://www.Runhealthyrunstrong.com
        http://www.stevesmithdc.com

    83. Paige12-25-2013

      Thank you so much for this information, and for keeping up with responses over a year later! Like so many others, I have a question about my particular problem.

      I’m a 27-year-old group-fitness junkie, and I generally work out at least 6 days per week with high-intensity bootcamp, cardio-kickboxing, and weight training. I started getting pain on the outside of my right foot 2 and a half weeks after badly spraining my left ankle in mid-November (yes you read that correctly – right foot, left ankle – go figure). I was on crutches for 2 weeks, and would often jump on the right foot around the house because it was just more convenient than using crutches when I wasn’t going too far. About 5 days after starting to walk on my left foot again, and 3 days after restarting my workout regimen (I did spin, elliptical and some weight training including squats with some extra weight on my shoulders), the outside of my right foot began to hurt. It worsens with use and improves with rest, which, judging by your article, makes me think that it’s a problem with the peroneus tendon.

      All of my symptoms don’t quite match up, however. For example, pressing on the outside of my foot with my hand didn’t cause any pain at all. I also realized that walking on the ball of my right foot makes the pain go away completely. Doing a full heel-to-toe walking motion, however, would slowly cause considerable pain.

      I had no pain at all for almost 2 weeks, and then it randomly started hurting again when walking about a week ago, but not nearly as bad as the first time. I went back to walking on the ball of my foot (probably not good for my hips), and it seems to be better again. I’ve gone back to more intense cardio-kickboxing workouts, and they don’t cause pain because the workout is almost always on the balls of my feet, and/or the full motion is ball-to-heel, not heel-to ball. So here’s my question: Can I continue my intense workouts if they’re not causing pain when I do them, but then also use ice and NSAIDs? I’m a PhD student, and working out keeps me sane after spending 9-10 hours every day at a computer!

      Again, thanks so much for responding to our questions and concerns – Happy Holidays to you and yours!

    84. Sydnee12-30-2013

      I have tendonitis on the side of my foot and I was put in a cast and it felt better and then it started hurting again! The doctor gave me inserts for my shoes but they don’t seem to be working! What should I do?

    85. Diana Balbuena01-21-2014

      I’m a 13 year old who is going to run the La Marathon on March 9 but in two weeks I have a 18 mile run and if I don’t make it I won’t qualify.There is a lot of hills and rocky roads.My mother doesn’t want to take me to the doctor even though the outside of the side of my right foot hurts when I walk.I’ve rested it for about 7 days but there is still pain.After icing it the pain decreases.I’m scared I won’t make it to the Marathon ,all of my effort for nothing.PLEASE HELP ME!!!!!!!!!!!!

    86. Walter01-25-2014

      I have planter fasciitis on both feet. A few weeks ago it was so painful I compensated and was walking on the outside of my feet for a few days. Now the outside of my feet (bottom and top) are in more pain then the planter fasciitis. Actually, the PF is better but the outside of me feet are getting worse by just every day walking. Any help please would be very much appreciated. I did see a foot DR. X-Ray’s came out fine except I did have a few heel spurs. They fitted me for orthotics which I won’t get for about a month. Thank you.

    87. nema01-28-2014

      Hello Dr,

      I have a pain on my right ankle from last 3 months. And now slowly it has increased to my leg and thigh, hip. I went to the doctor twice, and he took all the x-rays and said everything looks fine. There is no issue with the joint, bones. When I drive the car, my ankle hurts a bit. Now I cannot even sleep right turn. I do wear flats all the time. I am not much a exercise person and most of my job is to sit n work on computer. Few weeks back I also noticed a small blood clot on my right hip.. not sure if it can be a problem. Also I forgot to mention this to my my doctors.. as I didnt know if it is even related. Please advice? Due to this, I cannot walk properly.. as my right leg hurts/pains.
      Thanks!
      Nema

      • Dr. Steve Smith01-28-2014

        Nema,

        I have a few questions for you:
        How old are you
        What is your general health condition
        Any recent weight change
        Do you have an exercise program
        Any recent change in activity
        What does the pain in your ankle feel like
        Is there any particular movement that causes you to feel pain in your ankle
        Is there pain in the ankle when resting, standing, walking
        Do you have any back pain
        Do you have any pain when coughing or sneezing
        The answer to these questions will get me started toward an understanding of your problem, then we can work out a solution.

        Dr. Steve Smith
        http://www.runhealthyrunstrong
        http://www.stevesmithdc.com

        • nema03-28-2014

          Sorry for the late reply. I was out of town and had limited access to internet.
          How old are you – 28 yrs
          What is your general health condition – normal
          Any recent weight change – not much. A little weight loss
          Do you have an exercise program – not recently
          Any recent change in activity – I used to do GYM, Yoga. But from last May didnt do anything.
          What does the pain in your ankle feel like – stiffness, and constant pain
          Is there any particular movement that causes you to feel pain in your ankle – not sure.
          Is there pain in the ankle when resting, standing, walking – stiffness is always there. But resting postion helps. Even there is not much while walking or standing.. Sometime it develops.
          Do you have any back pain – I do feel stifness in my back these days
          Do you have any pain when coughing or sneezing – no

          Also now I started feeling pain in both knees. Lower part. And stiffness in back leg. Burining sensation in thighs.

          Please help and guide. I did MRI… and nothing came. All normal

          • Dr. Steve Smith03-31-2014

            Nema,

            From what I am seeing here it looks like a more serious problem than a simple tendonitis. I am guessing that you may have a problem involving the Sciatic nerve and You may have a problem with your piriformis muscle or back problem. Get this checked out by a physician and get a definitive diagnosis. The piriformis muscle passes across the gluteal region and attaches to the the boney area on the outside of your hip. If it becomes tight or inflamed, it can pinch the sciatic nerve, which extends down the leg and into the foot. A herniated disc or other pathology in the lower back may also compress the nerve.

            Dr. Steve Smith
            http://www.stevesmithdc.com
            http://www.runhealthyrunstrong.com

            • nema03-31-2014

              Thank you so much Dr! This is really helpful. But can you help me with what definitive diagnosis should I have?? I already had an MRI done, and it didn’t show anything. Will this nerve pinch wouldn’t be visible in MRI. I am all confused with what I should do?
              Is there any excersie you can recommend?

              Thanks,
              Nema

    88. Kyla02-02-2014

      What a great article, very informative and easy to follow. Thank you so much! I am a 29 year old healthy active female who had a baby 3 months ago. I ran up until I was 36 weeks pregnant(about12-15 miles/week). I began having pain in my forefoot when I was about 5 months pregnant. I do have femoral anti version and a weaker left hip. I purchased some insoles for more support on the ball of my foot…possibly metatarsalgia…it felt a bit better. I could run off the discomfort and it would the most after the run or the next day but not during. Very tight feet/ankles in the morning. I rested it for 8 weeks and the pain went away. The minute I ran on it, it came
      Back. I’ve learned to walk on the outside of my foot, if I put pressure I the whole foot then it hurts badly when walking. I still run however, about 15-20 miles/week. I have an appt. for an xray and to see a podiatrist. My primary care doc wanted me to rest it…however; I already true that so I kindly said that won’t happen and he put in a referral to podiatry. I have a hard time resting it when I don’t know what it is…I’ve lost almost all of my pregnancy weight and love to run. I got new shoes and all with more room in the toe box. Now the outside of foot hurts too, right At that bone that sticks out and extending into my midfoot. A lot of information, I know, any advice? Thank you in advance!

      • Dr. Steve Smith02-04-2014

        Kyla,

        This sounds like metatarsalgia. Runners with femoral anteversion have a tendency to overpronate, putting more stress on the first and second metatarsal heads. Try this: locate the ball of your foot. that’s the area just behind (proximal) to the big toe on the bottom of the foot. Feel the bony prominence on the bottom of your foot. this is the area where the most powerful part of your forefoot makes contact with the ground. Now move over to the next bony prominence and feel the second metatarsal head. This is the area where many people place too much stress. If you are tender in this area, then you probably irritated it from being pregnant. Your hips tend to move differently when you are pregnant, in addition to an increase in weight. You probably over stressed this area and now have very tender metatarsals. If this is the case then try using “Bunga Pads” when you run. http://www.bungapads.com/bunga-diminutive-metatarsal-pad-mp.html These amazing pads can really help to reduce the stress on your tender metatarsals. I have yet to see the runner who can use the large size so make sure you order the small size “MP-S”

        Please let us all know if this solves your problem.

        Good luck,

        Steve Smith
        http://www.runhealthyrunstrong
        http://www.stevesmithdc.com
        http://www.pasadenapacers.org

    89. Jake02-05-2014

      I walked on the beach barefoot for about an hour now I have pain on the outside of my left foot with shooting pains up to my ankle and calf. It doesn’t hurt when I’m stationary, but as soon as I start to walk it hurts. Any ideas?

    90. Michelle02-08-2014

      Dr. Smith,

      Thank you for the article. It was very insightful. I have a problem I’m hoping you can shed some additional light on.
      The last 3 years I’ve been working out to get in shape for the Marines. I was never active before then (unless you count marching band in high school). Last year is when I really started to pick up the intensity in my runs. I went from running maybe 1 mile here and there to 2-3 miles about every other day. Almost exactly one year ago I injured my right foot. I had very intense arch and heel pain and it was very painful to walk on for nearly a week (and then just painful to stand on at work-cashier- for the next 2 months). Because I was trying to compensate for the arch pain, I walked more on the outside of my foot. Then I started having pain there (but not continuous). I did go see a sports medicine doctor who told me I had sprained/strained my foot pretty good and that I should invest in inserts and custom support shoes (apparently I have low arches and over pronate). I did just that and it helped a lot. I stopped my training for a few months to rest my foot (focused on weight training instead). I started running again in the last few months and picked up intensity again just recently. My original injury (the arch area) is a bit tender as I reintroduce it to running, but I have found that compression sleeves and stretches are helpful with that. My problem of late is now the outside foot ache while I run. After about 1/2-3/4 of a mile (out of a total mileage of 3 for the Marines) I start to get an ache along the outsides of my feet that makes it pretty uncomfortable to run. It’s not a sharp pain and it lessens some as I go along. After I finish my run the ache diminishes relatively quickly and I have no lingering pain. I only feel this discomfort while running (and it is greatly slowing down my run time for the PFT).
      I had been taping my injured foot for extra support while running and was wearing my laces tight. I tried a small run with no taping and looser laces and that helped some, but the discomfort was still there. I’m not sure what this could be (over supination??) and how I can fix this. Last I was able to go to the Dr., stress fracture was ruled out by xrays and I was more concerned with my arch at the time and didn’t inquire more about the outside aches (and now I’m unable to go back to the Dr. for awhile). Like I mentioned above, I use Superfeet insoles to help support my arch (they help a lot with that) and have the overpronation running shoes. Do you think that perhaps the shoes are making me put more pressure on the outside of my feet thus causing the discomfort? Should I invest in shoes with no overpronation support and instead get supination support?
      I have about one month to get my run time fast enough to be considered for the Marine Corps board so I can go to OCS this summer. I want to figure out what can help because when I do go to OCS, I want to have the best support I can for my feet as I’m sure the rigorous activities at training will be more stressful than just my normal running; I’d hate to get there only to be sent home for a foot injury.
      Any advice you have would be greatly appreciated. I’ll be going back to the running store soon to inquire about new shoes (even though my current shoes are still relatively young) for whatever it is I have wrong with my feet.

      Thank you so much, sir.

    91. Diana02-10-2014

      I was happy to find your article as I feel it may have already answered my question. I am 55 and just started water zumba and water aerobics. After the first week I noticed intense pain on the outside of my left foot. As I have severe arthritis of my subtalar joint of the right foot, I decided I needed to wear water aerobic shoes for support and modify some of the foot movements so not to have issues. The outside of my foot will swell some just below and in front of the ankle bone on the left foot. I do have pain when walking and I notice pain when I push on this area. Does this sound like tendon?

      • Dr. Steve Smith02-10-2014

        Diana,

        This sounds like the peroneus tendon it irritated. The approach you have taken sounds like the way to go. You might benefit from some massage to the tendon as well. Use very specific finger pressure over the tender area and massage it with some oil or moisturizing cream. I’ll bet this resolves in a few days.

        Dr. Steve Smith
        http://www.runhealthyrunstrong
        http://www.stevesmithdc.com
        http://www.pasadenapacers.org

    92. Niv Baumel02-12-2014

      Dr. Smith.

      I am 18 years old and I work out every week 3 times in a pre-military (I’m from Israel) group to get in shape, but I have a pain on the side of my foot only when I’m running or putting my feet under stress (running, jumping, etc…), after a short rest (standing and shaking my legs for around 5 minutes) the pain will disappear, but when I continue to work out it hurts again.
      when I do lunges after the pain appears the pain wont stop either.
      I’ve been diagnosed with Shin Splints two months ago and took a break for one month.
      I replaced 3 pairs of shoes this year (!!!) and had personally crafted arch support, TWICE!

      I’m desperate, I don’t know what to do, I have tests for Jet fighter course in a month and I HAVE TO GET IN SHAPE, this pain just doesnt seem to go away, I’m frustrated.
      Do you know what can it be? what’s wrong with me?

      Thanks, Niv Baumel.

    93. Marcya02-14-2014

      I went running one night and it was a good run. I was fine that night, but then the next morning my foot hurt. I would walk normal and I would have a pain on the side and bottom right before my ankle bone. If i massage it, it feels good when im doing it but then hurts even more after. I went to the doctor and he told me to take Advil to take the swelling down..but heres the thing…. Its not swollen at all. It feels better when i stay off of it but when i walk for a while it starts to throb. It has been a week now and i dont know what to do. Is it just a tight tendon?

    94. bridget02-18-2014

      Dr Steve – I’ve developed a bit of soreness on the outside of my right foot, and tingling/painful second toe on my left foot, after purchasing some new running shoes designed to correct my gait. The shoes are lovely and very light. I’m trying to stay with them hoping the niggles will go away. I’ve run about 25 miles since I bought them. Should I take them back or hang in there?

      • Dr. Steve Smith02-18-2014

        Bridget,

        I am wondering about your gait. Is there a specific problem that you are trying to correct by changing your gait? There a a few gurus out there who insist that your gait must be corrected to a midfoot or forefoot strike. In truth your gait is almost entirely dependent on your pace. Forefoot strike is what happens when you accelerate or run at a fast pace Think about sprinters who have a 30 degree forward lean. They run on their forefeet and couldn’t strike the rearfoot even if they wanted to. Long distance runners use a heel strike to gain economy of motion. Evolution has taught us how to get the maximum forward motion with the least amount of energy spent. Running with altered gait, knees high, extra effort on the backswing phase or careful foot placement comes with an energy cost. That energy cost comes in the form of extra muscle contraction and more fatigue while doing absolutely nothing to mitigate ground reaction forces. While it is true that you can change the amount of force on your knees, it is also true that the forces must be absorbed elsewhere, namely your lower legs. This is why we see so many foot fractures, shin splints, calf strains, achilles tendon problems, plantar fasciitis and a host of other problems when runners make gait changes to run on their forefoot or midfoot. There are so many different gait styles that one could have a heyday correcting them all. A quick look at Priscah Jeptu on YouTube you would give you the impression of a terrible runner. That is, if you didn’t know that she won the London, Paris and New York Marathon last year. She is shown passing the lead runner in the New York Marathon who by the way has a perfect looking running form.

        If you have a gait problem then I would suggest the source of the diagnosis be looked at with scrutiny. If you changed your gait because you had no problem but wanted to improve your running economy then take the shoes back to where you got them and go back to what you were doing before you has your current problems. Also, consider that we developed our ability to run millions of years ago. Our cerebellar programming can handle any adaptive changes that running shoes have introduced into our gait, just as we can handle any terrain, slope, texture, or traction changes.

        I hope this helps,

        Dr. Steve Smith
        http://www.runhealthyrunstrong
        http://www.stevesmithdc.com
        http://www.pasadenapacers.org

    95. Jacque Campbell02-18-2014

      Before this pain in my foot (which by the way it burns in that spot when I walk) I was constantly getting a cramp in that area. Can constant cramps cause stress fractures? Every step I take now there is pain in that foot.

    96. Karen02-18-2014

      I’ve had side of the foot pain in both feet since my late teens (I’m 48 now). I am a former athlete in several sports and coach now. The area gets as hard as a rock even now when I’m coaching and merely walking around or jogging. In the past, at halftime during several sports, I’ve had to have people actually lean with their knee on the side of my foot – like an extreme deep tissue instant massage. I feel like it might be a very tight muscle as it does loosen up when someone does this. I can’t even go for a walk and I am suffering from weight gain now. I’ve been x-rayed and have no fractures. The podiatrist did not have any helpful input. He just said possibly there was a little arthritis there and no orthotics were needed. I take Advil. I also limp after I first get up from sitting for awhile until it loosens up. Any insight would be greatly appreciated! Thank you!

    97. Ruth02-19-2014

      Hi,
      Thanks for the article, I have been training for a marathon and through most of the training I have been fine, but I experienced pain on the outside of my right foot. I rested and iced it etc and was ok after a few days. I have then done another 3 weeks training and then experienced the same pain but now on my left foot! I have been to the hospital as my ankle was also swollen (even though the pain was on the side of my foot, not my ankle) and they said nothing was broken and it must be tissue inflammation from running more than usual. After one day the swelling has gone and my foot feels a lot better but I’m not sure if I can run again yet. After reading your website I thought that maybe it could be from my shoes as I do have wide feet and this only seems to happen after long runs. If this is the case, should I just try missing out some laces and try running again? Or would I need more rest after this pain has happened? Sorry I know it’s vague but the hospital weren’t very helpful and I really want to get back into training but don’t want to injure myself badly as I only have 6 weeks until the marathon. Any advice would be great. Many thanks.

      • Dr. Steve Smith02-19-2014

        Ruth,

        I think you are on the right track in suspecting that the problem is coming from your shoes. Here’s how to tell if this is the cause: Put your shoes and socks on, preferably at the end of the day when your feet tend to be more swollen. Now slip your finger inside the shoe and press on the area where you are having the pain, then press on the outside of the shoe and find the same spot. If the problem is from your shoes you will find an area where the laces pass through an eyelet and there is some overlay of folded material. Sometimes the logos of the eyelets and laces pile up to create a hard point of contact that causes pressure on the tendon sheath (Extensor Halucis Longus) or one of the nerves. As the miles accumulate, your feet swell and even light contact over a tendon or nerve will become irritated. I don’t know how to post graphics on wordpress yet so I’ll send you those in a separate email.

        Dr. Steve Smith
        http://www.runhealthyrunstrong
        http://www.stevesmithdc.com
        http://www.pasadenapacers.org

    98. Steven Martinez02-21-2014

      I’m an athlete that plays many sports like soccer, basketball, football, baseball and many others. I had a soccer game on Tuesday, I was running and when I stepped I felt like a little tweak on the inside of my right foot. As soon as that happen I could not take a step because of the pain that would hurt. I’m still hurt right now, every time I walk I’m always limping because of the pain that is still in my foot. The pain in my foot makes me limp and I can’t walk right. Any thoughts on what it could be?

    99. Teresa02-22-2014

      Hi, I am having so much trouble with my right foot. All the questions above deal with the outer part of the foot but my pain is in the inner part and the top part. I have no idea what i did to make it hurt but it hurts so bad when walking it makes me stop cold. I can rub my foot all over and it does not hurt, and i am now walking mostly on the right side of the foot so it wont hurt but i would forget about it and start walking normal and wham… it gets me again. It’s my right foot and the pain is on the inner side, in the middle area and also on the top of the foot in the middle area. Thank you for responding :)

      • Dr. Steve Smith02-24-2014

        Teresa,
        You probably have an area of contact from an eyelet or overlays of materials in your shoe that is applying a subtle pressure on a sensitive area where the tendon sheath passes underneath. Try this: Put your shoes on and stand with your weight on the affected foot. This is best done late in the day when your feet are most likely to be a bit larger. Carefully feel the area where you have the pain. Use your fingertips and feel around, pressing through your shoes to identify the pain site. Take your time and use very specific pinpoint pressure until you find an area that is very tender to the touch. Look at your shoes and identify the area and re lace your shoes to skip that area. I will send you the graphics of the process in a separate email, since i don’t know how to post them on my blog. I am almost certain that this is the cause of your problem. Alternatively, you can get a new pair of shoes. The running shoe manufacturers are aware of thes problems caused by overlays and have taken it seriously enough to completely redesign the way that graphics, logos and support strips are applied to the shoes. New, thinner laces, lighter materials and heat transferred overlays have eliminated many of the extra thick areas that can apply pressure points to your tender feet.

        Dr. Steve Smith
        http://www.runhealthyrunstrong.com
        http://www.stevesmithdc.com
        http://www.pasadenapacers.org

    100. Teresa02-22-2014

      I forgot to mention, i can “stand” on my foot without it hurting just cannot walk normal without it hurting. Thank you again!

    101. Liina02-26-2014

      Hello,

      I was wondering if you could give some input/insight. Just over a year ago I sprained my ankle while walking around New York City in very old and worn UGG boots. The first thing I noticed was what felt like a cramp in my (left) calf, and then pain on the outside of my foot and going under it. That February I saw an ER doctor, two podiatrists, had xrays and an MRI done (the MRI showed fluid, swelling, and inflammation), was put on crutches, had a soft cast on for two weeks, and then was sent home to walk. Except I couldn’t. So I asked for physical therapy. For over two months I did physical therapy and went from using crutches to a cane and then walking with a brace (very slowly building up my endurance/ability to walk before inflammation and swelling became worse). After seeing that I was still having problems, my primary care physician sent me to a different physical therapist, where I did PT for another two months. That seemed to help more, and by September I thought that I was (finally!) returning to ‘normal.’ In November I started a job (I’m a music therapist; prior to this I had been unemployed) and perhaps because of being on my feet more, or having to go up and down stairs to my third floor office, I notice that the swelling had returned to my ankle. (Mind you I usually wore Dansko clogs.) Thanksgiving weekend I went on a roadtrip with my sister to check out a couple of museums. The first day, when we got to the museum, I put on my new UGG snow boots, which I thought had more support. After being in the museum for less than an hour I started feeling the familiar pain/inflammation I had initially felt in New York. So I changed back into sneakers. The next day I wore my clogs, however after doing the first floor of the museum, the bottom of my foot and into my ankle felt even more inflammation and pain, to the point that I had to put my brace back on for the first time in months (I brought it with me just in case because of the prior day’s inflammation). Since then, so for the last three months, I have had issues with swelling every day, inflammation quite often, and sometimes pain; usually in the outer part/going under my foot and under my ankle, but sometimes into the calf. The beginning of January I went to an orthopedic clinic where a PA put me in a boot, which I thought was making it worse because I had more pain. So when I had a follow up with the ankle specialist, he told me I could not wear the boot and just wear the brace as needed. I had an MRI done again and it showed that I still had swelling, fluid and inflammation, so same as last year but a little less of it. The doctor said he preferred to go back to PT before considering any sort of surgery (which I do not want to have unnecessarily, however this injury has greatly affected my life and lifestyle; while I’ve never been a runner I have been an avid walker and hiker, love dancing and skiing (*which I haven’t been able to do for a few years because of my knees, I have chondromalasia in both knees which my second physical therapist said could be impeding with my ankle healing), and am usually overall very active, however this injury has kept me from being able to do any of that!). I started back up with PT but have not been able to do it as often because of work. My physical therapist has even tried dry needling twice. However, ultimately I am still having the same issues I did last February: swelling, inflammation and occasionally some pain (depending on how much I’ve walked), and therefore limited activity.

      • Dr. Steve Smith02-27-2014

        Liina,
        This is a case that is clearly not resolving. Usually time and therapy will get you to the point of resolution with an ordinary ankle sprain. Also, a sprained ankle doesn’t usually involve pain in the foot so I am suspicious that there is something else going on here. with the number of hands on your problem and 2 MRI’s I am guessing that the correct diagnosis would have been made by now. This is a case that I have little chance at resolving without an office visit and review of imaging. I would want to review all of the history including the diagnoses and treatments done. I would be most interested in what the ankle specialist and Physical therapists had to say, since they often are very astute in assessing these problems. If you are ever in Southern California, I would love to take a look and see if i can solve this puzzle.
        Dr. Steve Smith
        ww.runhealtyrunstrong
        http://www.stevesmithdc.com
        http://www.pasadenapacers.org

    102. Jorge Zamanillo03-02-2014

      Hello Dr Smith,

      I am 45 year old male and usually run 2-3 times a week for 2-3 miles. I have pain in the joint between my 5th metatarsal and phalange for my small toe. I’m guessing the 3rd reason for outside foot pain in your article above is the closest to my condition but the pain is not there when I run. About a month ago, I was playing and racing in the sand with my nephews at the beach. When I left the beach I felt a sharp pain at the joint but blew it off. Over the next few days it got worse after wearing dress shoes to work. I cut back on my weekly running even though the pain is not present when I run. I tried different work shoes but by the end of the day I have increased pain and soreness in the area. There is no swelling.

      I feel some pain when I’m barefoot and in running shoes also but not as bad. It hurts more when I press down on the joint from the top and more so if I press below the joint along the side of the metatarsal right where it meets the phalange.

      Any help will be appreciated. If I do need a physician, which type of specialist do you recommend?

      Thanks

      Jorge

      • Dr. Steve Smith03-05-2014

        Jorge,
        This sounds like a simple joint strain. I am guessing that you strained some of the small tendons surrounding the metatarsal-phalangeal joint. If this is true then it will take a little time to heal up, probably a few weeks. Forefoot injuries will feel better with stiffer shoes that do not allow for forefoot flexion. for this reason wooden clogs, although very hard sometimes help. If your running shoes are stiffer than your dress shoes then this is the case. I would give it a couple of weeks and see if it improves with a little time and if it isn’t getting any better then let the Podiatrist or orthopedic foot specialist take a look at it.

        Steve Smith
        http://www.runhealthyrunstrong
        http://www.stevesmithdc.com
        http://www.pasadenapacers.org

    103. Manoj Tiwari03-06-2014

      Hello Dr. Smith,

      I am 35 year old male. I a struggling with constant pain in left foot arch. It started 3- 4 months back. Earlier it was not hurting too much but now it is constant pain. I usually do foot exercies to get releif but it is not helpful for long term. I am not a runner.

      Any help would be highly appreciated.

      Thanks,

      Manoj

    104. rhonda03-10-2014

      I rolled my ankle and have had pressure n mild pain all day. Then this evening when I was getting ready for bed I noticed swelling on the outside of my foot. It goes around the back of my ankle n down my foot. Should I be concerned because this has never happened before. I have pain when moving my foot. I initially thought I had just sprained my ankle but know I am not sure.

      • Dr. Steve Smith03-12-2014

        This sounds like a sprained ankle to me. If it is what I think it is you can expect your foot to turn purple then yellow along the outside of the foot and into the toes. The swelling in your ankle may be profound but a soak in hot water with Epsom salts will help. You should wear an ankle brace or very sturdy boots that can help to stabilize your ankle. If you can bear weight on it the you most likely do not have a fracture. Do range of motion when you are resting then elevate your foot to help reduce the pressure in the ankle. Range of motion is done by moving your foot in figure eight patterns. Ice applied with an ace bandage does helps reduce the swelling.

    105. Snads03-13-2014

      I am fit and healthy and enjoy walking a brisk 4 or so miles at a bit over 4mph quite a few times a week. I have never had foot pain. I have just spent a week x country skiing and again no pain or apparent injury. On the last afternoon of my holiday I walked about a mile UP the mountain and back down. The next morning I could not put my heel to the floor and walking was agony. My GP diagnosed plantar facisitis. A week on dosed up with Naproxen I can put my foot down and walk with some discomfort and limp. However I still have an aching pain in the outside of the foot mid way along. Any thoughts?

    106. brian03-13-2014

      I have foot pain, went to an MD and also my chiroprator who’s a CSP, (chiro sports doctor) only to be told to get some inserts for my shoes, they don’t know what’s causing it.

    107. Steve Watson03-14-2014

      THANK YOU!! I finally found what I was looking for!! I am a marathon runner who has started participating in Ironmans and needless to say have had to amp up the mileage. Well, beacuse I wear stability control shoes (Mizuno Alchemy) and have a prescribed orthotic for ridiclulously high arches I started having serious sharp pains in my right foot.

      I took out the arch supports and BOOM!! No more pain!! I have gone to 2 doctors who misdiagnosed the problem. Now I can get back out there and complete my training, marathons, and Ironman this year!!

      Thanks for the info!!

      • Dr. Steve Smith03-14-2014

        Sometimes orthotics do more harm than good and they are very expensive. If i think the patient is going to need orthotics, I often recommend Superfeet or a high quality off the shelf orthotic first as a test. You can usually tell if you are on the right path if the patient tells you that it seems to be helping. Runners with high arches usually have rigid feet fare better with a cushioned shoe. Good luck on your coming competitions!

        Dr. Steve Smith D.C.
        http://www.runhealthyrunstrong
        http://www.stevesmithdc.com
        http://www.pasadenapacers.org

    108. Dani03-15-2014

      I am a professional soccer player and recently have been experiencing pain on the outside of my foot when i turn to the outside on that leg. We are in preseason and have been doing some intense training about 5 days a week. I got an xray done but the pictures came back with no problems . I rested for one week an came back to training still experiencing discomfort. It doesn’t hurt to the touch and when the doctor was moving it around i didnt feel pain. This injury seems to have come suddenly just while changing direction in training. Any idea what it could be ? Tendonitis ? What is the next step ? Thanks

    109. Nathaniel03-17-2014

      Thanks for the article. I spend a lot of time barefoot or in minimalist shoes in the summertime, and last August I started experiencing a pain on the outside of my 5th metatarsal that made it difficult to run and even walk sometimes. I haven’t run or spent any time barefoot over this winter, and it seemed to have gone away. But I ran barefoot on grass yesterday (casually; no longer than 5 minutes) and it all of a sudden hurts again. Could this be a stress fracture? I would have thought that all that time to heal would have solved the problem. I want to be able to stay active this summer. Thanks!

      • Dr. Steve Smith03-17-2014

        Nathaniel,

        Unfortunately, barefoot running has a higher incidence of foot and lower leg injuries. The fifth Metatarsal is particularly vulnerable to stress fracture for barefoot and minimalist shoe runners. At first look it would seem like running on grass or sand would be better for your feet and lower legs but this is not the case. In you think about it, primitive runners would probably not run on these surfaces because there is a higher energy cost and therefore greater stresses on the lower leg and feet. You may have significant stress on the head of the fifth metatarsal or the cuboid bone, causing your pain. Now that the area has been over stressed it may have weakened the ligaments supporting the joint. You may have to abandon the barefoot strategy and make the switch to hard surfaces while you rebuild up your mileage. Try it and if you feel better then move in the direction of wearing stability shoes. If it is really important to you to run barefoot then you can make another attempt when you can run distances again.

        Please let me know how it works out,

        Steve Smith
        http://www.runhealthyrunstrong
        http://www.stevesmithdc.com
        http://www.pasadenapacers.org

    110. MICHAEL DEVANEY03-19-2014

      Hi i would appreciate any comments regarding a case of plantar fasciitis that started jul-2012. I have been through a variety of treatments most recently being shock wave therapy. I am a 61 year old runner and i have been at this since i was in my mid twenties. I had this sore spot that did not go away that was basically at the point where it pf attaches to the heel but slightly away from center to the inside part of the foot. It appears that the latest therapy has helped quite a lot with this and I am now running every other day on the treadmill at a slow 5-6 mph pace for 25 minutes. Now it seems that i have been developing soreness to the outside part of the foot which i don’t really feel when i am running but later on after i have stopped. Perhaps my foot is adjusting to the return to running but thgis has been going on for almost 6 weeks now. I should mention that i have very high arches and i am running in a minimalist running shoe (Altra’s). This soreness is usually a lot better the next day but it doesn’t go away completely so i am hesitant to increase the mileage or the pace until i feel i am doing the right thing by doing so.

    111. Orie03-26-2014

      I AM A 72 YEAR OLD MALE. I DO NOT RUN AND AM NOT VERY ACTIVE. I HAVE SEVERE PAIN ON THE RIGHT SIDE OF MY FOOT. THIS HAS HAPPENED SEVERAL TIMES BEFORE AND GOES AWAY AFTR I ‘BABY’ IT FOR ABOUT THREE DAYS. I HAVE NOT INJURED THE FOOT AND THE PAIN UPON WALKING ON IT IS REALLY BAD.

    112. Wendy McCormick03-27-2014

      I am a 61 year old female and have the same foot problem as Orie. I used to walk a lot, stopping about six years ago. I am not very active and can not imagine what this is from. My husband wants me to walk the dogs with him. I have a few times but the outside of my right foot is so painful. After reading your article and other comments on here, I am going to make a dr.’s appt ASAP. This pain is no fun. It also wakes me up at night with stabbing pain. There is nothing, that I can recall, that I could have done to it. Just seemed to sneak up on me. Hope everyone gets the treatment that they need! Good luck to all of us. Thank you, Dr. Steve for your article.

      • Dr. Steve Smith03-27-2014

        Wende,
        I think your instinct to go to your doctor is correct. I would want to check you uric acid levels to rule out gouty arthritis. Night pain in the foot is often caused by uric acid crystalline deposits in the small capillaries. If this is the case then you will need to go on medicines to control pain. For simple cases doctor may recommend a trial of Advil or other non steroidal anti inflammatory, which more often than not, relieves the problem in a day or two. Please let us know the outcome.
        Dr. Steve Smith
        http://Www.stevesmith.com
        http://Www.runhealthyrunstrong
        http://Www.pasadenapacers.org

    113. Wendy03-27-2014

      Thank you for your reply. I will let you know what the Dr. says.

    114. Amanda04-09-2014

      Hi Dr. Smith,

      I am a 25 year old training for my first marathon which is in June. Last week, after one of my shorter long runs (9 miles) I starting feeling pain on the outside of my foot proximal to my fifth metatarsal to maybe below my lateral malleolus. I can’t pinpoint the exact location, but in general it is right on the border of my foot and maybe slightly on the bottom. I do run supinated, but am very good about changing my shoes out as soon as I feel them wearing down. I also alternate the side of the road I am running on. I am currently going to school to be a physical therapist assistant and my instructor tried palpating around to find a specific tender spot with no luck. One thing I have found interesting and puzzling is that I feel very little pain (sometimes none at all) while walking around barefoot. It is when I put my shoes on that it becomes very uncomfortable. I have been icing several times per day and have been cross training (pool jogging and cycling). This marathon means the world to me as I am doing it for the kids at St. Jude. Any advice would be appreciated more than words can describe!

      Amanda

    115. Cris04-10-2014

      Another interesting one for you:

      I have heel pain that builds when I run and fades away with rest. Pain is NOT worst when I wake up in the morning, but rather worsens with walking and running. The pain is with push-off of the foot. Not with placing weight on the heel unless I really mash it into the ground.

      The pain is located a) at the very back edge of my heel, at the very back tip of the calcaneus and b) as a burning feeling on either side of my heel (on the sides, not underneath). When you press on the foot, you cannot find a tender point. Calf raises do reproduce the pain.

      When wearing shoes, softer shoes or higher heels seem to aggravate it. For example, a minimalist running shoe is significantly more comfortable than a traditional running shoe.

      This has been going on and off for about 9 months. If I rest, it goes away, and returns when I come back. I have been an avid competitive runner for a while, and have successfully trained at a much higher mileage than I was holding when this developed.

      For reasons unrelated to this heel, I’ve had a nerve conduction test (came back normal, though they didn’t test the post tib on this foot) and been tested for autoimmune factors (all negative). I had an MRI of the foot that showed a bit of everything (not surprising – I’m 40) but nothing glaring – the plantar fascia was thickened but not inflamed.

      Separately, I’ve had a lumbar MRI to rule out sciatica in my other leg – that MRI came back clean.

      The ankle also tends to click when I walk, though the clicking is not painful.

      Any ideas what this is? Plantar fasciitis/achilles insertional tendonitis is an obvious candidate, but the location isn’t quite right, and no first step in the morning pain. I have seen a PT (who I really trust), two chiros, and a very good podiatrist, and I still don’t have a clear answer.

      • Dr. Steve Smith04-11-2014

        Cris,
        I would bet on insertional achilles tendonitis. The achilles tendon has insertion points all over the calcaneus. There are little tendrils that extend down the calcaneus and insert along the medial, central, lateral and plantar surfaces. The tendon inserts through the periosteum, an onion skin type of outer lining of the bone. With insertional tendonitis there is a periosteal lifting and consequent bone reaction. It might show up on a bone scan but probably not on an MRI. If I am right about the diagnosis then it will be painful but you not in danger of an achilles tendon rupture. I would take a careful look at all of your shoes and be certain that there is no contact pressure over the painful area. Running shoes almost always have a plastic heel cup and in some cases the shape of the calcaneus will exert pressure that can cause or perpetuate tendonitis. Lower heeled shoes can change the concentration of force on the heel, resulting in more pain when heel is raised.

        The Alfredson Protocol sometimes helps to resolve this condition. This involves heavy load eccentric contraction exercises. There are two versions of the exercise, use the bent knee calf lowering. Recent research shows that you don’t need to do 180 repetitions to achieve best results, just exercise to tolerance.

        A very careful deep palpation with the fingertip of your thumb may reveal a tender point. You’ll have to use heavy pressure and more slowly, investigating every square millimeter of the calcaneus. If you find a tender point, carefully move the fingertip around to identify the borders of the pain. It will be an area about the size of a pea. Deep pressure applied with a cross friction movement will be painful but the pain will reduce in a minute or so. You only need about two minutes to achieve good results. Use a massage oil or lotion and you can do this once per day.

        I hope this helps, Please let us all know how it works out.

        Dr. Steve Smith
        http://www.stevesmithdc.com
        http://www.runhealthyrunstrong.com
        http://www.pasadenapacers.org

    116. Zach04-21-2014

      Dr. Smith,
      I went for a hike on the beach the other day and around the 6 mile mark my outside arch started hurting on my left foot. It got worse over the next 1.5 miles. The next day i had to limp to walk around. It doesn’t hurt if I’m not on it. When I push on my outside arch there is no sharp pain, more like a sore muscle. It does hurt quit a bit though when I walk on it. Any insights? Many thanks in advance for your time.

    117. holly desantis04-22-2014

      dr steve thank you for posting this information. it’s been very helpful. i started running 2.5 years ago (ran my first half last june). i was diagnosed with PF last october – it’s been under control for the past few months). i’m an avid runner and i plan on running my second half in may however over the past few weeks the outer side of my right foot from heel to pinky toe has been giving me problems to the point where i can’t even run .25 mile without it burning/pulling but not in a good way. not sure what to make of it. i’m worried that i won’t be able to run my half at the end of may because of this. foot doctor did give me a pair of orthodics to try but they hurt too much. i have high arches. i purchased an inexpensive pair of orthodics (airplus) that seem to help cushion my heel but i’m still experiencing this pulling/burning sensation in my right foot. is there anything i can do to fix this other than seeing the foot doctor again (i do yoga to help with stretching – i do have extremely tight calf muscles/hip. thank you for any help.

    118. Nike Free Run04-23-2014

      Good day! Would you mind if I share your blog with my myspace group?
      There’s a lot of folks that I think would really appreciate your content.
      Please let me know. Thank you

    119. Vaporizer Pen04-23-2014

      Fabulous, what a blog it is! This weblog gives helpful data to
      us, keep it up.

    120. jgl.info04-26-2014

      Spot on with this write-up, I actually feel this
      site needs a lot more attention. I’ll probably be
      back again to read more, thanks for the advice!

    121. Jerritt04-28-2014

      Ok so last year in march 2013 I ran my first 10k in a pair of Brooks running shoes and couldn’t finish without walking several times due to severe pain in my left ankle. I’m in the military so I had been rucking in a pair of the Nike boots and come to find out in April a week before my first half marathon I have a collapsed arch so I go to my local specialty running store where I got the brooks shoes from (because I’ve been fighting shin splints sine I joined in 2009) and they gave me some arch supports and I ran my half perfectly with no issues. Fast forward to end of summer 2013 I started having pains again so I laid off running during PT unless I had to and stuck with short distance runs (800m or less) and high intensity resistance training. I never ran further then two miles from August until this week. I ran my two miles for my pt test on Friday, walked a lot on the golf course Saturday, then ran a 10k Sunday (I wanted to do the full marathon this year but knew from my 2 mile runs and without being able to train that was never going to work) but my friends needed me to run a 10k portion of their relay. It took me over an hour and a half. Way worse then the pain from my collapsed arch during my 10k last year, and definitely not shin splints. I was running in a more minimalist cross training shoe the rebok nano 3.0’s cuz the doc said a couple months ago to try a minimalist shoe to strengthen the foot and get away from the arch supports. (He also said not to do the run but I was also raising money for charity) I have talked to the running specialists and a doctor and been on the full range of running shoes the last year and am still having problems. I have some pretty important training coming up in June I can’t afford to have surgery or anything like that right now but I can’t decide what to do. Thoughts and help would be much appreciated.

      • Dr. Steve Smith04-29-2014

        Jerrit,

        From your message I couldn’t discern where the pain is located but if i had to guess, your arches are hurting. I can say with confidence that running a 10K in minimalist shoes caused a lot of stress in your feet and lower legs. If you have collapsed or fallen arches then a minimalist shoe is not the right choice for you. Wearing minimalist shoes to correct fallen arches is not going to correct the problem with your feet. If I had to guess, I would say that your flat feet are likely to have been genetically predetermined. You don’t treat flat feet using minimalist shoes. Flat feet require motion control shoes. There is a popular trend, thinking that you should run in minimalist shoes because the modern running shoes have caused us to lose our ability to run properly and our feet have become weak. There is no sound science to support this but the belief has gained supporters. The idea came about after a popular book suggested that we should all be running barefoot, as our ancestors did. In the wake of this trend is a long list lower leg and foot injuries that starts with foot fractures and continues with shin splints, achilles, calf, and a host of other lower leg and foot problems.

        The second problem is that you ran a 10K without the training to support it, preceded by a day of walking the golf course. This is the classic “Too much, too soon” type of stress the is the leading cause of injuries.

        Here’s what I would suggest: Go to a sports injury specialist and get a diagnosis. You need to know what the problem is exactly. Fallen arches is not a diagnosis, it is a description of your foot type. You probably need to be fitted with new orthotics and you probably need motion control shoes. The problem here is that if you get orthotics made, motion control shoes will cause you to over supinate, causing pain on the outside of your feet. You will need to have the orthotics in hand when you get fitted for your new running shoes. Make sure that you have worn the orthotics for at least a month and are comfortable in them before you get your new running shoes. Get your running shoes from a specialty running shoe store. Don’t just go to the local sporting goods store, online or the post exchange. What you need is a place where they sell only running shoes to runners. If you have to drive a great distance to get to one then so be it. Fitting running shoes requires experience. It is part art and part science. They don’t always get it right the first time either. Sometimes you have to go back and forth to get your hoes just right but you should continue to go to the same place and get fitted. That way the store is familiar with the evolutionary process of your shoes and they will make logical decisions on how best to proceed. Your orthotics require the same process. You have a good chance that they will fit just right the first time but there is also a good possibility that they will require fiddling around to get them just right.

        All too often I see patients who have orthotics that they only wore a few times because they just didn’t fit well enough. You should not accept orthotics that are too rigid. If you are using them for running they need to be flexible, not hard and stiff. They should have adequate support for your arches though, otherwise they will not be functionally corrective. Striking a balance between correction and comfort is tricky, so you will need to give some time to allow for your feet to adapt. I always make orthotics that extend all the way to the toes so that I can avoid having the problem of putting the insoles over the orthotic. Running shoe insoles have intrinsic arch supports and and you cannot combine them with an orthotic. If you leave the insoles out of the shoe because you have a short orthotic, there is no forefoot cushion.

        For now you should rest your feet and use the elliptical trainer or bike to maintain your fitness. You can stretch your feet and lower legs to gain flexibility. There are some good stretches on my website: http://www.stevesmithdc.com and on my app: Stretch&Run. Use a frozen water bottle to roll out your feet in the evenings and after you have been on your feet for extended periods of time. You can try soaking them in hot water with Epsom salt for 20 minutes, to reduce any swelling. I can’t make a recommendation for specific exercises, since I am unsure of the diagnosis.

        Good luck to you and please let us know how it all works out.

        Dr. Steve Smith
        http://www.stevesmithdc.com
        http://www.runhealthyrunstrong.com
        http://www.pasadenapacers.org

    122. mario04-30-2014

      I have had bad feet since my teenage years, would turn ankles. Played sports, but was always carried too much weight. Later had fracture in metarsol on left foot that required surgery in early 20’s. When I run now and do activities , get pain and discomfort along side opposite foot. I have to literally take my shoe,sock off and rub what feels like a tiny knot along the metatarsol bone. After rubbing and pressing down on the tiny knot, It almost feels like a “pop” sensation and instantly the pain goes again.

    123. Kim04-30-2014

      I have experienced lateral foot pain on and off for years. 2 months ago is started hurting severely enough I saw my family physician. Ex rays did not show any break or fracture.
      He put me on anti inflammatory and pain med, asked me to give it a couple weeks and
      let him know if any improvement. One week later I called back, because even with the Meds I was at work and in a lot of pain. My job requires I am on my feet 60hrs a week and it was not going so well. My family Dr. recommended I see a specialist and I have. I was diagnosed with peronail tendonitis left foot, plantar fasciitis left foot.. He took me out of work for 4 weeks and put me in an aircast. I have been at home since 04/07 and I still have sever pain seems to be right at and under where 5th Metatarsal sticks out midway down the foot. My ankle clicks at times (does not hurt) I know have pain in my arch and my ankle. I also have a swollen pouch behind the ankle. I have sharp pains at times intermittently and yesterday I felt as if my foot was going to break in half while I was cooking dinner. (I was in my aircast.) Does this sound common to personal tendonitis? Thanks

    124. Dawn05-05-2014

      I am so glad that I stumbled upon this website! I used to be an avid walker but I started having pain along the outside of my left foot 4 years after participating in a 40-mile (2 day) charity walk. It snowballed into even more foot problems where it felt like I was walking on sharp golf balls in my forefoot of both feet. The first 2 podiatrists I went to didn’t do much to alleviate my pain although one did think I had Peroneus Tendonitis but did not give me a treatment plan other then to take megadoses of ibuprofen which I can’t due to IBS. Another podiatrist made me custom orthotics that are very rigid, but I use them as they do alleviate my forefoot issue, but the pain along the side of my foot is back full force and more painful than ever. My current podiatrist did surgery to remove a large fibroma on my left arch. I thought that with my foot being immobilized for as long as it was in the surgical shoe that it would help, but as soon as I started walking again the pain came back. I was told to wear running shoes 24/7 (preferably Brooks) so after doing research I bought a pair of Adrenaline GTS 13 and my pain escalated. I can feel my foot rolling outward when I walk and I swear that it is my custom orthotic. On my last visit with my podiatrist, I mentioned again the side of foot pain and he said the Adrenaline is probably too much of a stability shoe for me and I should be in a cushioned shoe such as a Glycerin. I bought a pair (I should own stock in Brooks at this point!!) but the pain is still very bad. My mind keeps going back to the diagnosis of Peroneus Tendonitis but my doctor still thinks the problem is footwear. My thought is to chuck the custom orthotics and find an OTC insert with a metatarsal pad for supination. Do you have suggestions on a good brand? I would appreciate any advice you can give!

    125. Hannah05-06-2014

      I have been having pain along the outside of my foot from like the bridge or widest part to my pinky toe for the past couple months. I have been walking more often as I am trying to lose weight. I am not heavy by any means but know that I have extra weight to lose. The pain comes and goes and is never worse at any point in time. However, the last day or two the pain has gotten more consistant and more often. I am currently sitting at my desk at work and the pain is like a sharp, numbing, burning type pain. I can press on it and the pain does not get worse. I have not tried the hop test but last Friday I did do some skipping and it did not make the pain worse. I am at a loss of what this could be, please help!

    126. anonymous06-03-2014

      My dad has a small bump on the top of his foot it comes and goes and its very painful any idea what it could be? please help

    127. Gaby06-14-2014

      I have been having pain along the outside of my foot from like the part to my pinky toe (neck). Mainly if I squeeze my foot sideways is when it hurts the most. I have been walking more often as I am trying to lose weight and to give my shepherd exercise and play tennis. I am guessing it may be a stress fracture??? It has been a couple of months now. I went to disney and walk around all day with a new pair of teva style shoes. that night it hurt bad but is not as painful. I amused that it would have healed by now but still the same. Any advise? Thanks

    128. Lynn06-15-2014

      I had a hairline fracture in my right foot back in 2001 and in 2012 I fell and have a torn meniscus in my left knee and since the injury to my left knee I have been having problems with my right foot the two baby toes up to my ankle feels broke but the hospital never can find anything thing wrong I’m on my feet constantly and it makes it hard to work and walk and no matter what shoes I wear don’t help it any advise on what to do.

    129. Kristen06-22-2014

      Great explanation. I believe I am having the tendonitis you describe in the second scenario. I absolutely over supinate, even when just standing. Thank you for the calf exercises. I tried the foam roller and I do have tenderness to that area of the calf. I had only been using the foam roller on my ITB.
      I’m curious, I have been having ‘first-step’ pain for about a year now to the top of my foot from about mid foot to my ankle. I really do not think it is plantar fasciitis because it is no where near the heel area. I have not been able to find any information about this other than plantar fasciitis. I limp for the first several steps every morning because of the pain and tight feeling. Could it be related to this new pain I am feeling in the lateral foot. The lateral foot pain seems to come on during the day once I have been on my feet for a bit and almost has a burning sensation to it.
      Any thoughts would be appreciated!

    130. Jennifer Arbelaez06-25-2014

      Hello,
      I have been training for a 12 mile race.
      Yesterday after my morning workout, I started feeling a sharp pain on the outer edge of foot (lateral foot pain). It only hurts when I walk/put weight on it. However, it does not hurt when I put pressure with my hands around the area.
      Any ideas on what the issue is? Should I go visit the doctor?

    131. Hannah Page07-07-2014

      I have been having foot pain for quite awhile now. It isn’t my whole foot thought, it is just the heel. It has been hard for me to deal with because I am an avid runner. I have had to take some time off recently. I need to go see a doctor before it gets any worse.

    132. Niki Gonzalez07-16-2014

      3 years ago I walked on un even ground in flip flops on vacation limped around the rest of the trip went to dr nothing, went to different dr 1year later did mri he said showed something on bone under bottom of 5th pinkie toe so here are my symptoms when I try to bend my toes my 5th pinkie toe wont bend and 4th toe won’t bend either severe pain when push thumb on the outer bone close to 5th toe sometimes if I stand a certain way my pinkie toe and the 4th toe next to it will start to tingle if I reposition my foot it will stop I need help I baby my outer foot cause if someone hits it it is so painfull this will be 3 years this august. It feels like a bone out of place before we went on a hike my daughter fell down a hill I raced over to grab her and my foot turned side ways as I grabed her but no pain after that then went up and walked on rocks and un even ground and then I was limping in pain I havnt went to a foot specialist yet just a orthopedic dr x2 thanks for allyour help niki

    133. Janipher07-22-2014

      This was an amazingly helpful response – thank you, SO MUCH!! I have been trying to figure out why the outside of my foot has been hurting after my long distance run. It makes sense. I ran purposely trying to force down the inside of my foot more to stretch out the cramping I sometimes get along my inside ankle. After that, the outside tendon on that foot was useless and I’ve been limping around the house ever since. So good to know what’s wrong with it. Thanks again!

    134. thomas09-08-2014

      I find this to be very helpful and understanding. My problemis his pain came out of nowhere. So now I have been taking everything for the pain on the outside of my right foot I even soaked it in epsom salt and iced it for hours. Why is my pain not going away. Mind you im to stubborn to go to the doctor, but its really irritating me. Once I get up and moving I limp badly but im also walking on the ball of my foot and I think that is making it worst. What shall I do? The pain is bad

    135. Grahame09-14-2014

      Hi I have experienced pain in the right side of my midfoot area on my right foot for over 10 years now and recently the pain has got worse. The pain is at its worst when I raise my heel slightly and put pressure on the front of my foot. I am a postman and it seems the more I walk and the heavier my bag the worse the pain is. I cannot take part in any sporting activity because if I try to make quick movements in any direction the pain is too severe, I would love to be free of this pain! Any advice would be gratefully appreciated.Thanks.

    136. Kristen09-21-2014

      Thank you so much for this information. I inured my right for after a 10k in May after seeing a doctor and having many x-rays and a MRI we learned it was just tendonitis of the peronus longus. Yesterday I completed a half marathon and am now experiencing the same pain on the left. Guys my body doesn’t like that many miles

      • Dr. Steve Smith09-22-2014

        Kristin,I am going to make some guesses here, based on many of the peroneus Longus tendon problems I have seen in the past. Sometimes runners have either high arches or tend to naturally run on the outside of the feet. If this is the case you will see a wear pattern on the outside forefoot. You may be a supinator. If this is the case then wearing a STABILITY or MOTION CONTROL shoe will only worsen the problem. If this is the case then all you have to do is change the type of shoe you are wearing and the problem will resolve. I have also seen peroneus Longus tendonitis in runners who wear NEWTON shoes, which can over stress the tendons in some runners. Use a shoe store that specializes in runners. Bring them a well worn pair of shoes and tell them the problem you have been experiencing and they may be able to steer you in the right direction. Be aware the fitting the right shoe to a runner is not an exact science, so a good return policy is vital to getting the correct shoe type.

    137. Michael Kilby09-29-2014

      I found your discussion about lateral foot pain very useful. I am a 50 year old training for my first marathon. I’ve been doing long runs at a ~10 minute/mile pace, and some speed/tempo work on shorter runs at ~7:30-8:30/mile pace. I’ve been injury-free until right at the transition to tapering down my mileage (week 22 of 24), which I understand is pretty classic (or at least Murphy’s law in action). Following my latest (second ever) 20 miler, I had some left lateral midfoot pain which I didn’t think much about (it didn’t occur during the run itself). The next couple of shorter runs, including fast mile repeats, there was a dull ache but again nothing that notable. A week later, I felt good the first 8 miles of a 12 mile run, but then ended up limping home. The pain seems to start from the styloid process of the 5th metatarsal (I’m a physician, but I study viruses! So ortho/podiatry is not my forte!) and late in the run it radiates more diffusely to the deep midfoot and lateral forefoot. It gradually improves the day or so after running, and tennis ball massage, NSAIDS, and ice virtually eradicates it. But of course with my first marathon just two weeks away, I fear I will be limping and/or dropping out late in the race.I was worried about a stress fracture, but palpating the 5th metatarsal causes no pain. There is essentially no point tenderness along the ankle and foot and tendons, and only very slight dull ache if I try to bear all my weight along the outside of my foot. Thus significant pain only comes on after an hour or more of running. I would appreciate any thoughts about diagnostic or therapeutic maneuvers beyond what I’m doing already. Thanks! Michael

      • Dr. Steve Smith09-29-2014

        Michael,You probably have tendonitis at the insertion of the peroneus brevis. Try careful deep palpation of the area and see if you can locate a specific area where the tendon attaches. If this is the case then you can do some deep tissue massage to the area and follow up with an ice pack. Do this every day for up to 10 minutes and if my hunch is correct you will feel a lot better in a couple of weeks. Using the elliptical trainer to maintain your aerobic fitness and running muscles will keep you in good enough condition to run a good race. Aqua jogging is also a great way to continue your training for the Marathon. Do some cross training with shallow squats, lunges and working your legs, gluteal and core muscles. It sounds like your training is adequate to get you to the finish line. Resting the area will keep the problem from perpetuating. Take a look at your shoes to make sure that they are not overcorrecting for pronation, causing you to supinate during the propulsion phase of your gait. At this point you have enough time to make a switch before the race. I hope this helps, let us know how it all works out and good luck on your Marathon!

        • Michael Kilby09-30-2014

          Thanks so much for your advice and expertise, Dr. Smith. This is a great help to me!

    138. Stacie10-01-2014

      This was very helpful – thank you! I believe I have the issue you described in a reply where a new shoe is over correcting for over pronation. I have pain on the outside of both feet while running, starting at the middle of the foot going down. I’m in a new stability shoe (Brooks Adrelaline GTS 13). My question- do I need a different shoe or will this work itself out as I break in the shoe? Going on about a month of running with this shoe and still having the pain.

      • Dr. Steve Smith10-01-2014

        Stacie,Unfortunately, you are probably going to need another pair of shoes. If the shoes cause over supination then they will never “Wear in,” they may be structured in a way that just isn’t right for your particular type of foot. Take a look at my YouTube video on running shoes and see if this informations helps. http://www.youtube.com/watch?v=n35LtP5UP2

    139. Fred Davis10-24-2014

      Dr. Smith – Greetings and thank you for such a well-written and thoroughly explained article. My situation is this – I’m 6-1, 200 lbs, work out regularly, good shape, etc. Exactly one month ago I had a blister on my left foot on that popped, and it became infected and turned into a staph infection. It was on my arch. After having it cut and drained, the foot started to improve, but then a week later, waking on the ball of my left foot, I rolled the foot slightly, nothing too serious. Unfortunately a few hours later the side of my foot, just in front my heel, became swollen and red. Doc said I had cellulitis, put me on Cipro and Clindamycin . 3 weeks later, still taking the Meds, infection seems to be gone, and incision is almost closed & healed, but there’s no pain coming from it. Problem is, I have continued pain on the side of my foot that feels like I’m stepping on a Rock when I try to walk normally. Is this just pain from not waking normally on it and it will eventually go away – or is there something possibly more severe at play..? I’ve asked my doc, a VA podiatrist, and he’s not all that sure, suggesting that I bruised the foot when I rolled it and lingering infection. Either way, I’ve been trying to walk, it’s still painful especially when it’s been idle and then I try to walk. I appreciate your time and any insight you can provide. Thank you.

      • Dr. Steve Smith10-24-2014

        Fred,It’s hard to tell but i would guess that you sprained your foot, possibly the cuboid bone. I have seen cases of so called cuboid syndrome that seem to respond to manual manipulation of the cuboid bone. This bone can pop out of alignment and a skilled chiropractor or other health care practitioner who is familiar with manipulation techniques can put it back into alignment. Sometimes just taping the foot can help but after an infection I am wary of this. Bone bruise, ligament sprain, tendon strain are all on the list of possible diagnoses. Ask your podiatrist about these possibilities and if it doesn’t improve, push for imaging. in the meantime, don’t exercise on it and I would not suggest the use of heat if there is the possibility of cellulitis since, heat tends to dilate capillaries and may help spread infection.Hope this helps, let us all know the outcome,Dr. Steve Smith

    Leave a Reply

    captcha

    Please enter the CAPTCHA text