Runners: what's wrong with my foot? (Already saw doc)

In My Humble Opinion
1

You are not a doctor, you are not my doctor, etc. I’m just looking for ideas and possibly tips on what to do next.

So: I am a 57-year-old female and I run 5k about 3-6 times a week, outside on the asphalt. I had been using the same running shoes for at least 1500k, maybe more. I know they should have been replaced sooner, but they had the Nike sensor slot, and you can’t buy those anymore. (I have since invested in a Garmin fitness tracker, so that’s now a non-issue.)

A few days ago I noticed that my foot was slightly painful on the top center - a bit below the middle 3 toes - and slightly swollen. Uncle Google suggested a stress fracture. I trashed the shoes and went to the doctor, not expecting much (our medical care in Indonesia is so-so). Indeed, he x-rayed the foot (although Google sources say that you cannot see a stress fracture on x-ray, you need an MRI), pronounced my bones fine, and said it was tendonitis and that it was up to me whether or not I wanted to keep running on it. (Google confirms this is a possible diagnosis although tendonitis in that spot seems fairly rare. However, I’ve occasionally had the mother of all foot cramps in that area; perhaps that could contribute to getting tendonitis?)

I didn’t argue - I was in a hurry and figured I’d just take a conservative approach myself. I am planning a three-week vacation in February during which I want to run 5 to 10 k most days; if my foot is injured and I can’t do that I will be SERIOUSLY pissed off.

So, I’ve stopped running and I’m just using my stationary bicycle (whimper…I hate it, but what can you do?) I have not walked much and my foot has been unchanged; not particularly painful, but the swelling has not abated.

The other day I did walk about half a kilometer carrying a heavyish computer bag and that seemed to noticeably up the pain (which is still fairly mild; I’m not in agony or anything) and possibly increase the swelling a little.

My plan is to go 6 weeks without running, just using the bike. If it’s really tendonitis, that may be unnecessarily conservative but I can’t see how it would worsen matters. If it is a stress fracture, hopefully it will be better in 6 weeks and I can start running again just in time to build my endurance back up to an easy 5k before I go on vacation.

Has anyone been through this kind of injury? How did the diagnosis, pain, and recovery process go? What do you think of my plan to just use the bike for 6 weeks?

Other possible questions:

  • The doc prescribed Celebrex but said don’t take it unless the pain is bad, so I have not. Would I get any information about the likely nature of the injury if I took one and saw if the swelling decreased?

  • Does anyone have tips on how to transfer the same quality workout from running to using a stationary bike? I feel like I’m not getting anywhere near the same quality of workout, but it’s very tiring and boring. Will it get any better if I persist? Are there any rules of thumb about how far you have to bike to match a run? (I imagine it depends on the resistance you have the pedals set to.)

2

I’m the same age as you, but male. No help on what to call your foot injury, but I bet after your six weeks of rest, you’ll be good to go again. That’s quite a bit of running you do which is great. My 5k frequency is about half of yours per week. I personally try to run in the grass or loose gravel alongside the road (perhaps 70-80% of the run), and also put extra cushions in my shoes. Like you, I keep the same running shoes until they blow, never believed the hype they had to be changed frequently. After nearly 1,700 miles, only have experienced two calf pulls.

I’d base it on the same heart rate you had while running, so whatever pedal cycle rate and resistance you need to get that.

3

Stress fracture test-tap your toes with a finger. A stress fracture will alert you it’s there.
I disagree on the shoes. 500-800k is the most shoes last.
I also would never buy a shoe that incorporates anything that locks you into that shoe.
razncain is right on the cycling-go by heartrate.
The reason it feels easier is you don’t have the fatigue caused by impact.

4

Thank you both, razncain and running coach. Of course - using heart rate to “equalize” exercise makes perfect sense; alas, I never measured it while running. The bike has sensors in the handlebars; I guess I should start keeping track.

running coach, I guess I don’t have a stress fracture if your suggested test works - tapping on my toes doesn’t cause any pain, whether I’m standing on the foot or sitting down. I don’t think we disagree on the shoes - I knew it was time to get rid of them, but just delayed because I didn’t want to switch gadgets. After this experience I will be much more careful about replacing shoes when they start to get worn.

5

If you have a computer and YouTube available where your bike is, consider the spin workout videos. I find using the videos of a class workout with the instructor very useful and a lot less boring. Search YouTube for “spin class” and you get lots of hits. Might take a bit to find one to your liking but once you do, you will likely find more than one from the same instructor/studio.

Hope your foot is much better very soon!

6

Good suggestion - I do! I’ve been watching Buffy the Vampire Slayer - one episode = one workout. But the spin workouts might be more fun.

7

My Plantar’s Fasciatis, when it’s bad, shoots pain across the top of my foot. Is this a possibility?

8

Plus, my Plantar’s Fasciatis was all gone and then I let my shoes get way too old and it came back (after nearly three years being gone). And then I got new shoes and iced my foot and did all the recommended stretches and it went away. And according to my dr. you can feel the Plantars almost anywhere on your foot. I hope that’s not what it is.

9

But you will feel it on the bottom/heel of the foot first.

10

No, I don’t think so - as running coach says, PF pain starts in the heel.

I started to get an incredibly mild case of PF once; I stopped running for a couple of days and it has never come back. It’s a pretty distinctive twinge-y feeling, in my experience. This is nothing like that; it’s a dull ache that is worse when pressed on. In fact, except for the fact that there is no wound or redness, and the swollen area is not increasing, I’d say it feels most like an infected wound. I mean, I KNOW that’s not what it is - but that’s what the sensation resembles.

11

Look up a lisfranc injury. This is what I had a couple of years ago. It was missed on xray at the ER- they told me I just had a sprain. I went to the podiatrist a few months later because it still hurt (in the same place yours does, with swelling, too) and he ordered an MRI. It was also missed by the radiologist that read the MRI, but the podiatrist also read it and found it.

12

Yikes! Thanks for that, Alice The Goon. I hope that’s not what it is, but if I am not better in a few weeks, I will find a podiatrist and insist on an MRI to be sure. Not knowing isn’t going to help matters.

13

On the flip side, I’m younger and had a very similar sounding injury about 5 years ago which was never adequately diagnosed by any of the three doctors I saw, and took me over a year, along with some months of physical therapy, to recover from.

There are a lot of moving parts in a foot, so foot injuries can often take a long time to heal, especially if you can’t/don’t avoid walking or moving it at all. I’d approach your recovery with caution. My pain was a line across the top of the foot from about an inch behind my middle toes towards the outside edge of the foot. The podiatrist thought she saw a stress fracture, the osteopath couldn’t see any evidence of it even while looking at the same X-ray. The podiatrist was actually an idiot, as her treatment plan for me caused a cascade of secondary injuries that I eventually had to self-diagnose and treat myself (really painful trigger points in my calves which referred pain to my heels in both feet, so now I could barely walk, too). The osteopath got me in to physical therapy, and my physical therapist was awesome, but I could not run AT ALL for the duration or I re-injured myself. I had to re-introduce it VERY slowly (as in, I could only allow myself to run for 60 seconds once a day at first), and only AFTER some months of PT.

If you completely avoid stressing the foot for 6 weeks, and it still hurts, I’d avoid running until you had a chance at some PT yourself.

14

Thanks for sharing your experience, Kaio. Like you (and just about everyone, I’d guess), I am not in a position to just stop walking entirely, absent a doctor putting my foot in a cast and giving me crutches.

I am trying to imagine a vacation that involves lots of bike-riding but no running (or hiking), just in case I’m not better by February. Fingers crossed that I’ll be fine by then, though.

15

What my podiatrist did was have me wear over the counter orthopedic inserts, which stabilised my foot and helped it to heal. Without them, the foot rocked too much and wouldn’t have healed. I walk a lot, and he said that was actually good for it- the electrical impulses or something like that helped the healing, too. He didn’t say anything about running because I don’t run. You might try the inserts. I had a good bit of pain before I got them but instantly stooped hurting and limping when I put them in.

16

I got osteonecrosis from jogging. This manifested as an intense pain in my foot that had me limping everywhere. At first it was even painful just lying down, then lessened as I was less active (and stopped running). Basically the bone at the end of one of the metatarsals started crumbling away. There’s no treatment except to wait, a long time, for it to heal. Years later it is much better but I still have pain there sometimes.

I did not have any swelling, and it sounds like your pain is less intense than mine was. But I wanted to mention it as a possibility.

Here’s a tip–whatever is going on, if they give you a walking boot, figure out a way to make sure your other foot is at the same level. Wear a thick soled shoe, or use an insert. Otherwise your lower back will get jacked up too.

17

Y’all are starting to scare me a bit. Didn’t know the foot had so many different things that could go wrong with it.

18

Nope, not exactly right.
Yes, look at HR, but also look at cadence (pedal RPMs). High gear with low cadence is cardio intensive but it’s going to hurt your knees. Look at HR while maintaining a cadence of 70-90, preferably the higher end of that range.

runningcoach, I’m surprised you missed that.

19

I’m surprised I missed that, too. I almost always remember to mention cadence.

Though in my limited experience with stationary bikes, I find more people keep to a reasonable resistance more than those riding outdoors.

20

I called it the pedal cycling rate, wiki calls cadence (or pedaling rate) so what am I missing? I didn’t remember how many cycles it was, so I didn’t list it.