pains across ball/sole of left foot after 6-7 miles on impact only - disappears quickly when walking

by Paul
(Liverpool, UK)

Hi - I am training for a half ironman - part of which is a half marathon.

My running has been around the 10-12k limits up to now.
The pain I have starts around 6-7 miles and is an ache across the ball of the left foot only.
I saw a foot consultant who suggested a podiatrist as it is some form of mechanical problem and as such nothing he could do.
I have tried anti-inflamatory pills - changed the inner soles to have gel pads - changed socks - ice straight after - heat after the ice - done some calf and toe stretching (but not much) - done some tennis ball rolling on left foot.

RESPONSE

Hi Paul,

I would need more of a history, actually I would need to examine you and question you to come up with a definitive diagnosis, but lets see what I can offer with the information provided.
I assume the pain that develops well into your running, will also disappear a short time after you finish running, because if the pain continues even after you have finished running, then that would change my diagnosis.
So, assuming the pain ends after you are done running, the first thing I would consider would be Morton's neuroma. You can read about it on my site. One of the plantar (bottom) nerves becomes irritated because it is rubbing in between the metatarsal bones. As you run, the rubbing (and irritation) continues until you finally start to feel the symptoms. Symptoms include pain in the ball of the foot; the pain may travel into the toes. Sometimes the pain will travel back into the foot. Other symptoms of neuroma would also include tingling, burning and numbness in the ball of the foot. Once you stop running, and the nerve stops getting irritated, the pain should subside, perhaps a couple of hours after you finish running.
Other conditions that may have a connection with your pain would include what is known as a sub metatarsal bursitis. This is a bursal sac that forms under the metatarsal bones. The constant banging of the foot against the ground while running, could cause the bursal sac to inflame and cause pain in the ball of the foot.
Metatarsalgia, or pain in the metatarsal heads could also give you similar symptoms.
Other considerations would include a stress fracture. The thing about a stress fracture is that it would tend to continue hurting even if you were not running, so if the pain is subsiding after you finish running, I am thinking it probably is not a stress fracture.
Well, there you have it. The only way to find out for sure what is going on would be to visit a podiatrist. The conditions I have discussed, except for stress fracture, can usually be treated with a combination of oral medication and orthotics, but obviously you have to have an accurate diagnosis before starting any kind of treatment.

Marc Mitnick DPM
DISCLAIMER