ball of foot and top of foot is swollen and very sensitive after workout

I was doing a work out and i was kneeling on right knee with my right toes being bent, almost like a catcher for baseball team in the crouching position. i then felt a sharp pain go through my toe next to my big toe. I then finished my workout and approximately ten hours later my toe started to swell along with the top of my foot in the area next to my big toe and if i apply little pressure on the ball of my foot it is very sensitive in the area between my big toe and the toe next to it. I iced it several times with it being elevated and it did nothing as far as the swelling or discomfort. what can this be, broken bone, torn tendon, or what

RESPONSE

Where do I begin? This could be a number of issues all the result of minimal trauma to the foot.

Obviously, when you were in the "catchers" position you over stretched something on the bottom of your foot in the area of the second toe. Let me go through a few possibilities.

The first and perhaps the most common cause of your pain would be a condition known as capsulitis. There is a ligament known as the capsular ligament that is wrapped around the joint that is formed between the base of your toe and the metatarsal bone behind it. Crouching, climbing ladders, walking up stairs barefoot, gardening, etc. can all lead to a hyperextension of the second toe which ends up stretching this ligament on the bottom of the foot. If you take your second toe and pull it upwards and this causes pain, then you can be fairly certain you have capsulitis. The problem here is sometimes instead of just over stretching the ligament, you end up partially tearing it. This is known as a plantar plate tear and the healing process is much longer.

You mention that there is pain in between the first and second toes. If this is where the majority of your pain is coming from then a condition known as fibular sesamoiditis has to be ruled out. There are two bones known as the sesamoid bones that are on the bottom of the foot and lie just behind the big toe. The fibular (lateral) sesamoid lies essentially between the first and second toes and your crouching may have aggravated the ligaments attaching to the bone or in a rare case you may have actually fractured the bone.

Next is the possibility that you have a tendonitis of the tendon that bends the second toe downward, known as the flexor tendon. Again, overstretching the toe upwards may have overstretched the tendon on the bottom of the foot and that may be accounting for your pain.

Lastly, there is always the possibility that you sustained a stress fracture. The probability of this being the case is less than the other conditions that I have mentioned.

Now, whatever is going on here may start to improve over the next few days, but if you are not seeing a reduction in pain on a day to day basis then the best advice I can give you is to see a foot specialist in your area who should be able to make a definitive diagnosis.

Marc Mitnick DPM
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