Ahhh I have had the same
Ahhh I have had the same pain in the base of the 5th metatarsal. Without the ability to examine your gait and your foot I will do my best to sort this out for you over a few posts back and forth. here goes...
first thing that's interesting about your story is that you have the same pain on both sides in the same place. What that tells us is that the same forces are acting on both feet in the same manner. So one thing I was thinking was that you had said that your vote where did not fit anymore after you started barefoot running. That I find to be very interesting because that happened to me as well. Let me tell you this story because my story sounds like the same story as yours.
Last year when I started barefoot running my shoe size was an 8.5 - 9.0 depending on the style. After barefoot running a notice that my shoe size went from the 8 1/2 to a 9.0 to a 9.5 - 10 in just four months. that only that but the footwear that I used before started to compress my feet from the sides primarily. The first symptom I started feeling was this squeezing and occasional stiffness and pain in the base of my fifth metatarsal. it wasn't going away in fact it was getting worse and I notice that I was wearing the same shoes in my rotation, a pair that was a small size 9.
Then I made a really stupid mistake when I was asked to go to a formal affair and the only formal footwear I had to go with my talks was the large 8/2” nine. After that night my left foot locked up and I had known the pain in the base of my fist metatarsal butt also in the anterior aspect of my sub talar joint on the plantar aspect of my foot.
At that point I realized exactly what was causing the pain in my fifth metatarsal. It was the fact that my footwear was not wide enough in the toolbox, not for my running shoes which I don't wear but for my casual and dress shoes that I wear in the office. but you might want to do is examine the footwear that you have been wearing in the last few months this way. Put the shoes on that you have been wearing one pair at a time close your eyes and try to visualize if you have pressure from the footwear being too narrow in the toolbox compressing your fifth metatarsal medially. That might be able to solve at least the cause of the problem for you. Next we have to determine how to treat it so that you can get on with your running.
What I have found is that inflammation both silent and painful, can be traced to wear and tear–stress and strain, caused from theabnormal movement patterns, specifically a locking or reduced joint play or spring in a joint that should be moving. this lack of joint play or locking of the joint is caused by a weakness in the muscle which supplies the movement of some area of that joint.
so what you can do is you can take your thumb and find the exact area of pain, flatten the pad of the thumb out in the area of pain and applied the pressure to the area of the base of the fifth metatarsal down to the bone and hold that pressure until you feel the pain in the area began to subside. For instance if the pain is a 10 out of 10, hold the pressure and you will feel the pain subside for about 10 to an eight after it plateaus for a while. Usually it'll plateau at another level like an eight or seven until it just melts away to five roof for. Then it plateaus at that level and then melts away down to a one or two were sometimes it goes all the way down to just pressure. The key is to hold that point until you feel nothing but pressure and not letting up on the pressure and so you feel just pressure and no pain whatsoever not even a minimal amount of pressure pain.
Essentially what you're doing is you're working with thr muscle spindle, golgi or myotactic reflex to essentially trick the brain into thinking that everything is okay. What the brain will do is that it will release the muscle spasm in the involved muscles that is compressing the joint and allow the joint to move more freely the way it was designed to move. You can do this in all areas of your foot and ankle knee hit back back shoulder to wrist. All you have to do is have a basic understanding of the anatomy and where the muscles are in the application is the same. There are many names for this kind of hands-on self-help application from Nemo technique, active release, bodywork, deep tissue work, spindle cell reflex work, who cares, just put the pressure on the painful area and hold it until the pain goes away. That's it
Now the next thing I recommend for you to do is to do a maneuver which I named after Anthony Field, the front man from the Wiggles kids entertainment group. it's called the foot wiggle test. what you do is you grabbed the fifth metatarsal at the distal aspect or edits and a new stabilize the midfoot with the other hand and you simply wiggle the fifth metatarsal back-and-forth to check the movement of the joint where the pain is at the base of the fifth metatarsal.
1. You could feel a freely moving joint
2. You could feel clicking and popping in the joint in some of the different movements do wiggle it in.
3. You could feel it's not freely moving and stiff
4. You might feel that it's completely locked and does not have independent movement in relationship to the bone adjacent to it which it articulates with called the cuboid. http://socalrunnergirl.typepad.com/photos/uncategorized/2007/06/05/footlig1.jpg
You might want to check the opposite side and compare the two and see if there's any differences between the left fifth metatarsal–cuboid movement and the right. what might throw you off as they may both be cracking, stiff and/or locked.
next thing you can do is wiggle this bone back and forth in an attempt to free the movement up in the joint. The only time you should be doing this after you've thoroughly worked on the muscles that are painful surrounding the joint with the deep tissue pressure. Understand, that it's not uncommon for me to spend three hours in a click doing deep tissue work on 1 foot in one treatment. It's not uncommon for to take 9 to 12 hours releasing the 33 joints of the human foot on a very chronically ill patient. So don't feel discouraged if you are working on this painful muscle tendon ligament area of the fifth metatarsal with this deep tissue pressure for sometimes hours at a time. As long as you're feeling some decrease in pain during each application or applications and increase movement during these wiggly treatments than your making progress. The only thing left to do is to win the war by continually treating it until it goes away completely. You can work on this area several hours at a time even if you want to have rapid progress. The only reason why doctors and therapists schedule you for 15 minute incriments at a time is they get paid for proceedures lasting 15 minutes with their codes. Pathetic isnt it?
Its just the way the system works The ony reason why doctors and therapists schedule you 3 days a week like Monday, Wednesday and Friday on non active rehab days is because they are playing golf on Tuesday and Thursday. There is no rationale reason for treating a patient less than daily and no rational reason for treating 15 minutes vs 3 - 4 hours at a time unless the therapist is tired. My clients fly in from out of state and even out of the country for 10 - 12 hour all day sessions for days at a time and fly back and I charge by the hour. You can do it yourself. Its cheaper to do it yourself and you learn more about your body this way
What I recommend is that you spend at least an hour per night before you go to bed on the fifth metatarsal treatment tracing this pain anywhere and everywhere like a vein of gold hitting all parts. Then for sure you should spend at least an hour of treatments on that area working on every spot that hurts around the region before you do your runs. I dont have pain before I run barefoot but still I look for possible areas of "silent" inflammation. That is when you probe around and find a painful muscl
e spasm you did not know you had. Why find out about it when you are 40 miles down the road? Prevention Prevention Prevention Fine Tune! It improves performance of the human spring mechanism to resist impacts and allows you to go longer distances because it improves elastic recoil storage and release in tendons attached to muscles which are at the proper length during push off and landings.
One time I was treating a patient with calf and knee pain cool was three weeks out from the Chicago Marathon. We just got the pain out of her foot and calf and knee four days before the marathon. She was a bit concerned that she might make it through the first 15 or 16 miles and then pull up with this foot, calf and knee pain in the middle of the race wondering what to do now. Someone her husband knows who's serves as a therapist for a football team, NFL, told her that it was wrong to do deep tissue before activity.
That's completely ridiculous.
In fact I made a point to have four hours of time massage on both of my feet prior to running a 10K in Bangkok as a preventive measure to make sure that my spring mechanism of my foot was as pliable as possible to handle the landings of this barefoot run on the solid concrete streets of the Thailand Ministry of health.
So after she said that to me I told her well if you believe that what you can do is take out your cell phone, call your husband and go home after 15 miles of running and call that NFL trainer to see what to do from your living room. She looked at me kind of funny and I said "what you got to loose?" You don't have $50,000 on the line in the race if you hit a certain time. You just want to complete it so pull over to the side find the area of pain with your thumb stick your thumb in it down to the deepest part and hold it there till the pain goes away. Dont rush. After that make sure you've got all the painful areas treated before you begin to run again and tell me what happens.
She came in after the race with her ribbon and her certificate of completion completely excited about her accomplishment. In fact she said that at mile marker 15 sheet pulled up with some tenderness in her knee in the back by the base of the tibialis posterior muscle so she pulled over to the side stuck her thumb in the muscle and treated it for about 10 to 15 minutes So the pain was completely gone.
What happened next was her times in the miles from 15 to 26.2 were faster than the miles from 0 to 15. Go figure. She beat her predicted time only because of the increased efficiency of the stride due to that 15 minute treatment she did at mile marker 15. She would not have hit the mark if she did not do the treatment.
When you feel the pain in the 5th metatarsal, stop and do the treatment until you feel the pain go. Start running again but if you feel the pain again stop and hit it again and a again until you are running pain free. Do not let up. You need to crush this problem and get back to your old self. You cant do that by doing what you are doing Get more agressive with the self help. Be ruthless
This works if you don't give up. It seems simple because it is. So go for it and e-mail me back what you find to be the result.
Don't give up.
Dr James Stoxen DC
www.barefootrunningdoctor.com
