painful and swollen feet

by sara
(Beirut- Lebanon)

I am on diet working with a doctor. he asked me if i can walk for an hour daily

I spared one hour at the evening for walking. I said to myself let me run for 10 min. in this hour, thus i burn more calories. i did for couple of days,but since i never ran in my life, i ran on tiptoe. I felt pain in the feet,I persisted for a week and after that pain is unbearable and my feet are swollen now. what can i do please, I am in pain

RESPONSE

Hi Sara,

I don't suppose I have to tell you this, but the primary reason your feet hurt is because of the improper way you are running. The only people who run on the balls of their feet are sprinters and for the rest of us we run in a normal heel to toe gait which is more or less exaggerated walking.

So, because you have been running in an improper manner you are now suffering from the consequences.

The question then becomes, what actually did you do to your feet?

Since they both hurt and I will assume they hurt equally, the first condition I would consider would be capsulitis, which is an inflammation of the ligaments that attach the metatarsal bone to the toe bones. By running on the balls of your feet you have done two things.

One you are coming down on the heads of the metatarsals and this will put excessive pressure on the area where the capsular ligaments are located.

Secondly, running on the balls of your feet causes your toes to bend excessively upwards, which will also over extend the capsular ligament.

The problem then becomes one of hoping the condition will quiet down with rest and cessation from running. However, every day walking may also aggravate the capsular ligaments and so you remain in pain even though you are not running.

The second most probable cause of pain and swelling in your feet may be due to a stress fracture in your forefoot.

Running on the balls of your feet and even just running in general can create tremendous stress on the metatarsal bones and the repeated stress can cause the bones to fracture.

Obviously, the first thing you have to do is get a proper diagnosis. This would require an x-ray to rule out a fracture, keeping in mind that sometimes an x-ray may not initially show a small fracture.

If an x-ray does show a fracture then the foot/feet will have to be immobilized, otherwise the fractures will not be able to heal. Along with immobilization your doctor should give you pain medication to help relieve your pain. Simple uncomplicated fractures can take upwards of six to eight weeks to heal. Once immobilized, the fractured bone will become less and less painful.

If the x-ray proves negative for fracture and a diagnosis of capsulitis is made, or any other soft tissue diagnosis for that matter, a round of anti-inflammatory medication can be very helpful. If you are still in a lot of pain then immobilization for a shorter term than a fracture should also be helpful. You may also consider physical therapy as an option as that too will resolve your issue much more rapidly.

These are the two potential issues that come to mind, but there are certainly other possibilities, that is why you should be examined by a doctor.

Once you have resolved your foot pain you could then return to running, but this time doing so in a more natural jogging type of gait in an effort to avoid renewed pain.

If you find that running is not your "thing" then you should consider other forms of exercise.

Marc Mitnick DPM
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