top of foot pain, midfoot pain

by Carolyn
(New York, NY)

I spent the month of August on crutches healing a stress fracture in my left hip (femoral neck). About 4 weeks into it I managed to hurt my left foot while sleeping. The sheets/bedding of the bed I was sleeping in were tucked in extremely tight. I was sleeping on my back with my foot straight up in order to not stress the hip. Because the sheets were tucked in so tight, I fell asleep with my foot bent back a bit towards my body. Now i'm not entirely sure what happened in my sleep (maybe i tensed the foot or pushed against the tight sheets/bedding) but I was woken several hours later with a intense sharp pain in the top of my foot. It almost felt like a charlie horse. I tried to massage it out but it made the pain worse...almost burning/stinging type of pain that spread throughout the top of my foot. It lasted about 5-10 minutes. I was able to fall back asleep. The next day I noticed that my foot slightly hurt when i bent it up and that it was slightly swollen (my shoe felt a little tighter than normal). This pain(when I lifted my foot up & tensed it) continued for rest of the time i was on crutches. I have been walking on my foot for about a month now and I still feel a sharp pain in the middle of my foot when step off with it. It felt worse when I first started walking on it but the sharp pain is still present. It doesn't appear to be swollen anymore but I'm also on Celebrex for my hip. I have had x-rays (non-weightbearing though) of the foot. They came back normal. Now my doc is sending me for an MRI because I have a history of stress fractures. I'm thinking possible lisfranc but both my physical therapist & DR don't think that the bedding could have caused a significant force for that type of injury. I was also told I wouldn't be able to walk with it. I insisted that the look for a lisfranc injury on the MRI as well. My ankle also aches mostly on the lateral side. I'm really scared that i might need surgery and/or have to go back to non-weightbearing again. I was wondering if you had any idea as to what I could have done to my foot?

- Carolyn

Hi Carolyn,
I would be surprised if it was anything more than a soft tissue injury, after all it happened as a result of your foot being in a poor position while sleeping (you were not even bearing weight on it). I would look at damage to one of the extensor tendons on top of your foot as the source. The MRI should be of value.
Marc Mitnick DPM