Pain under 2nd metatarsal head

[Matt M.]

For the last 3 weeks, I have had soreness and pain on the bottom side of my 2nd metatarsal head. I don't know if it is metatarsalgia, stress fracture, or what. Could someone clarify the difference between metatarsalgia and a stress fracture?

It hasn't improved a whole lot in the past 3 weeks, but about 3 or 4 times (unfortunately) I went running. It felt like it didn't bother too bad, but it did a little when running. But I can always feel the pain if I press on it. I am resolving to wear shoes that take pressure off it and not go for any more runs until I get better. Can anyone offer input? Stress fracture, metatarsalgia? Thanks.

 

[barefoot.zumba.runner]

Does it hurt when you put

Does it hurt when you put pressure on your foot? I'd keep off of it to avoid further fracture, if that's what it is. I came out of a sf about 2mo ago after having been out for 6 solid weeks. Definitely take a break from your runs, continue to massage your feet, get a good amount of vit D and calcium to promote bone growth or repair in the damaged areas. I don't know the difference between the two, hopefully someone else can chime in about that. Listen to your body, you're it's biggest advocate.

 

[Matt M.]

Yes, it does hurt to put

Yes, it does hurt to put pressure on my foot, like when I'm walking or putting weight on it. The pain seems pretty direct and straightforward, as in it hurts in the same places I can feel when I touch it. In order to feel the pain when touching it I need to put pressure on it. It is not extremely sensitive, but it is fairly sore. I have to massage it in order to feel where the pain is. It feels sort of like a bruise, to give a general idea of what it's like.

When I went running it didn't hurt so much on smoother surfaces, but if something would poke up into the area it would hurt. When I wake up each morning, the pain hasn't changed from the previous day.

Also, I should mention that a callous has formed over the sore area. There is NO pain at all on the top of the foot. It sounds to me like stress fractures are more commonly associated with pain on the top of the foot? The symptoms seems somewhat stuck between metatarsalgia or stress fracture.

 

[Barefoot TJ]

Or Morton's Neuroma.  Do you

Or Morton's Neuroma. Do you have Morton's Toe? It's where your second metatarsal (not necessarily toe) is longer than your first. People with MT tend to develop calluses in that spot, but not necessarily; I have both MN and MT, and I don't callus there. MN and MT don't necessarily go hand-in-hand either; you can have one without the other. I happen to have both, lucky me.

Look into Morton's Neuroma and Morton's Toe on the Internet.

 

[Matt M.]

Wow, it's actually really

Wow, it's actually really close to tell whether I have Morton's Toe or not. We're talking like 1/6 or 1/4 of an inch or so. It's a little close, but not MT. Regardless, I don't think I have the Morton's neuroma either. The pain is directly on the metatarsal head, not in between the metatarsals.

The pain started suddenly while I was on a run. About 1 or 1.5 miles into the run I stepped with my right foot, and the 2nd metatarsal head suddenly started feeling sore (on the bottom of the foot). Unfortunately I ran the 1 mile back, but I have had the same sore feeling ever since then. But the important thing here is that it started suddenly. It did not hurt at all before then - no hints of pain, soreness, or anything. Then it began feeling sore after that specific step, and has been pretty much the same since.

Interestingly, about 5 months ago when I first started running barefoot I had a similar soreness on my left foot. It was a fairly similar sore feeling and near the same spot (maybe 2nd or 3rd metatarsal head on bottom). But I don't think it hurt as much as now, it didn't come on suddenly, and it eventually faded away after a few weeks.

 

[Barefoot TJ]

A bone bruise then or deep

A bone bruise then or deep tissue injury?

 

[Codeblue]

I would see a doctor or head

I would see a doctor or head to one of those first-come, first-served minute clinics and get an xray, just to rule out a stress fracture if you're worried you may have one.

Otherwise, can see two possibilities if isn't a neuroma. The first is as you say, metatarsalgia, when the cartilage capsule surrounding the metatarsophalangeal joint becomes damaged or, at worst, breaks. This can be caused by too much too soon (happened to me when I first transitioned to Vibrams and barefoot) when starting out, or increasing mileage too rapidly, in minimalist shoes or barefoot, because as far as I know it's pretty rare for runners in cushioned shoes.

The best remedy is rest. If you can take a break from running, do it; I didn't and it took me three months to get over it. An ice/heat pad routine, followed by a massage, helped immensely. If you want to continue running, you can relieve the pressure by modifying a metatarsal pad. They are sold in most grocery stores (Dr Scholl's or the generic) and are a gel-based pad that is supposed to sit under your forefoot. You can cut a hole in the area where the joint/head is so that the pressure is relieved. I'll just warn you that this may lead to complications because you're off-loading the weight from the bone to the surrounding ones.

The other possibility is called a dropped metatarsal. I'm not sure how it develops, but it's a condition where the metatarsal head rides lower than the others such that it disproportionately bears weight. I don't know how this is treated, either, but your doctor would probably be able to diagnose this, as well.

 

[Matt M.]

It seems to me that the best

It seems to me that the best possibilities are metatarsalgia or a dropped metatarsal (is there really a difference in those 2 either?). Maybe the metatarsal just dropped a bit then got sore/beat up as a result from running on it.

One thing I got wrong is that the pain has been going on for 2 weeks as of yesterday - it started on 8/30. I first felt some pain during a run 3 weeks ago, but it didn't come back until 1.5 miles into the next run I had a week later (on 8/30).

I will cease my runs and take a rest break for it to get better. Also I'm going to see if ice massage will help. Hopefully it just needs some time, and will heal with rest.

 

[Barefoot TJ]

Do you take ibuprophen?  It

Do you take ibuprophen? It works to relieve inflammation, even though you may not see it. You would have to take it in the highest allowed (safest) dose though for the longest allowed (safest) period. Along with ice and rest, you should hopefully see results in a few days.

 

[deviantrunner]

You are describing the very

You are describing the very same thing that I experienced within my first two weeks of BFR. ...a too much to soon injury in my opinion.

I am no doctor but at the time I researched many foot injuries before consulting with a friend who is a podiatrist. Without having x-rays done we agreed that it was a stone bruise or capsulitis. Either way, the bottom-line is don't do any activities which cause pain.

It took about 7 weeks for mine to heal before I could run again. I wore running shoes because I could walk in them without pain. After the 7th week, I started running barefoot again very cautiously. That was about 7-8 months ago and I just ran my first half-marathon barefoot.

Hang in there, but let it heal before running. Good Luck.



Steve

 

[Matt M.]

Thanks for sharing your

Thanks for sharing your experience, Lownox. I would have to agree, what you are saying seems right on the spot. I'll try taking some NSAIDs and icing as well. Of course I will rest too. To be honest, the whole thing really does sound kind of like an actual "bruise". If inflammation is a problem, that wouldn't be too bad to take care of. The soreness just needs time to heal. I'll be careful and keep watching things.

 

[Matt M.]

I have been taking the

I have been taking the maximum safest amount of pain relievers for nearly a week. Also I have been staying off of it. It feels a bit better, but hasn't really healed yet. I'll continue to taking medicine until the 10 days is up, and keep resting too.

But I have come to wonder about something. I hear that from wearing shoes, our metatarsals actually get fused together with cartilage over time. By running barefoot, it helps to separate the toes so we are able to spread them. Could it be possible that dropped metatarsal, like what this probably is, is caused by the metatarsals separating, only we push through the process? Maybe the metatarsal gets detatched, but since we push through it, the metatarsal gets damaged, causing the dropped metatarsal/metatarsalgia symptoms?

The reason I wonder this is because I felt this type of pain in my left foot a few months ago. But I did not run as much then as I did now, and it went away. Also, the right foot (currently injured) seems less able to spread the toes than the left foot (uninjured) which also went through that pain stage earlier.

I was just thinking maybe we could discover something by looking at these facts. Or maybe this is old news to people, I don't know :bigsmile:

 

[deviantrunner]

It is my understanding that a

It is my understanding that a "dropped metatarsal" is pretty rare. But then again, this is all based on reading I have done at the University of Google. LOL... When I went through this apparently same metatarsal experience, I basically couldn't run for like 7 weeks. When I started again, I still knew I was/had been injurred... but I started slow and worked up to my mileage again.

At this point, I have broken all the "rules" regarding increasing mileage, so I am not surprised by the minor injuries that I have suffered through this process. The only time my metatarsals really bother me now is when I spend long periods of time in minimal shoes on surfaces that are hard and flat... like tile floors.

I hope you get through this soon. Just remember that the body does heal and you can get through this and be successful at running barefoot. Hang in there. It would have been easier for me to give up and wear shoes but I stuck with it... however, I don't think I am fully transistioned yet. I was a religeous wearer of Dr. Marten shoes since High School... so you can imagine how weak they were when I started this adventure.

 

[Matt M.]

I agree lownox, we don't

I agree lownox, we don't exactly have a formal education on this stuff I guess it's just one of those TMTS things, where we run too much while our feet our going through their changes.

Hopefully it's not just the pain relievers numbing the pain, but it does seem like it's improving.

 

[Barefoot TJ]

Matt, how is your chest pain

Matt, how is your chest pain doing? You better?

 

[Matt M.]

Ah yes TJ, thanks for

Ah yes TJ, thanks for asking!

I haven't really even thought about it since my appointment Sept. 9th. I haven't had the slightest hint of pain since then. My parents keep asking me all the time how my chest is doing. I keep getting annoyed by it because it's the last thing on my mind :X But it's good that they really do care for me though.

But yes, I haven't noticed anything wrong, so it looks like things will be okay. At least the worst that could happen is the pain coming back, but I know how to get rid of it now. Hopefully it won't be a problem in the future.

Thanks for your concern

 

[Barefoot TJ]

No, no, no.  You don't want

No, no, no. You don't want to just take ibuprophen to "get rid of it." If it comes back, tell your parents right away, and have them to get you to the doctor immediately. Don't make me come over there! Sorry, there I go sounding like your momma again.

 

[Matt M.]

Okay momma TJ, I'm smelling

Okay momma TJ, I'm smelling what you're stepping in, lol. But really, if it comes back I'll revisit the doctor. Even though I eat my 1+ apples a day, I'll still do it.

 

[Barefoot TJ]

Okay then!

Okay then!

 

[Matt M.]

Just wanted to update, and I

Just wanted to update, and I have noticed another symptom.

I have reached the end of the maximum (10 day) period for taking NSAIDs, so I won't be taking them anymore. I don't really know what to say about the pain. I've just been staying off it whether I can tell if it hurts or not (I haven't been running either). The injury hasn't healed yet, and it's sort of hard to tell if it's getting better or not. I guess I'd have to say that healing progress has been minimal and very slow so far. I think it's been about 4 weeks now since it was first injured.

But I have noticed another symptom. When I move my thumb over the affected metatarsal (2nd on the right foot) I can feel the metatarsal shift around. It is painful, and it's also lower than the other metatarsals. Isn't that a dropped metatarsal? The 4th metatarsal on the left foot also has a "lower" feeling, but it doesn't hurt or shift around like the other one does. Maybe it's because at the time that I first noticed the 4th metatarsal doing this I stopped running because of the 2nd metatarsal hurting.

It seems like I have gotten this condition a lot (3+) times since I have begun barefoot running. What is going on with this?