I have a question reguarding some foot pain I have had in the past and am starting to experience again. The first experience was about a month after the PDX Marathon. I was not running at the time. My feet were so sore, over the entire underside of my feet, I could barely walk. The pain would wake me up at night on occasion. It lasted for two weeks and then was gone as quickly as it had appeared. There was no gradual onset or removal.
My feet have been perfect until recently, I have been running for the last 3 months pretty regularly, about 2 miles several times a week. The weird thing about the pain is that it seems worse when I am lying down, than when I am on my feet. Should I be concerned?

Katie

Katie,

Your description sounds like a transient plantarfascitis but it is important to understand the cause. There are a few different things that could be causing this, if you would give me a little more information about yourself we can trouble shoot what may be happening. Do you have high, low or neutral arch feet? What is your height, weight, and shoe size? Were any other places irritated when your feet hurt? Any problems with blood sugar regulation or personal/family of arthritis? I’ll look for your reply and get back to you ASAP.

Cheers,

Dr. Bryan

Get thyself to a good podiatrist, who can evaluate you for plantar fasciitis and make various recommendations for treatment. I'm just recovering from that and they gave me some exercises and a cortisone shot, and while I was recovering I slowed down my walking regimen and do water aerobics so that I could keep exercising while taking the stress off my feet. My advice -take care of it sooner rather than later - it will only get worse if you ignore the pain!!

Thank you for responding so quickly. I have high arches, but have a neutral stride. I am approx. 5'11'' and weigh 190lbs with size 11 shoes. I have lost about 10 lbs over the last year and am trying to get down to around 170lbs. I have a larger frame.
THe pain I had was not generalized in my heal, but was evenly distributed on the bottom of my feet. There was no pain anywhere else.

I do need to eat every few hours to feel alert. My eating is well balanced, lots of fruits and veggies, but I find that it is difficult to balance carbs and protein. I need more protein than some, but if I eat too much I find I get horrible headaches. My mom has a difficult time absorbing B 12. She has had a part of her thyroid removed and has to give herself B 12 shots. Arthritis is limited on my mom's side of the family, but my dad's side has problems with their joints, specifically their knees. I have been taking glucosamine for a year and this along with lower body strengthening has helped to rid me of any knee pain.

I hope this information helps. As of right now, my feet are feeling pretty good, but any advise would be very helpful.

Katie.

Thank you Aimee!

Katie,

Congratulations on the weight loss! When the plantarfascia pain is even on both feet it points more toward a metabolic/chemical cause that a strictly mechanical one. Being large framed with size 11 feet at 170 will feel great. If you could let me know a few more things it would help me direct you toward a fix. If you push firmly into the flat part of your tibia in the front mid shaft area for 20 seconds does it leave a dent or pitting where your finger was? It is good to check this at different times of the day to see if your legs are swelling. I’m guessing, so please let me know, you have large calf muscle groups. If you do we need to talk about how to super stretch them. People with large calf muscles usually have to use weight machines or very long holding times of 2-3 minutes to get the tissue to fully release and allow proper venous and lymphatic return circulation. Our bodies are great at getting blood to the feet but if the calf tissue is restricted swelling and micro-fibrosis occurs with in the feet and calves. This is most likely why your feet hurt when lying down. If you could get back to me on the presence of pitting or not and if you have well developed calf muscles I can go over how to stretch and make a recommendation on the protein intake times.

Cheers,

Dr. Bryan

I checked my tibia, and there WAS indentation/ pitting. I do get slight swelling in my ankles after I run, and at the end of the day when I have been on my feet all day. I do have poor circulation in my hands and feet. I find it strange though being only 28yrs old. When my body is comfortable temperature wise, my fingers may feel a little numb and sometimes my toes can turn purple, normally only my big toe and the toe next to them, the shade of purple being a little darker on my right foot. When I notice this I typically go for a hot foot soak to bring back the circulation...socks don't seem to do the trick.I did fracture my right ankle about six years ago. It does stiffen up with weather changes. I never recieved PT after getting my cast off. I was told I didn't need it.

As for my calves, I don't think they are large, although they are long, no cankle (: I can see a little difinition, I'm sure there will be more when the weight comes off. I do get calf cramps frequently so I try to get enough water and potassium, although this doesn't always seem to help.

Katie

Dr. Bryan here is the information you requested. I would really like get a hold of some good stretches and protien intake.

Thank you, Katie

Katie,

Sorry for the long time to reply time. There are a number of ways to gauge protein intake; USRDA for adults is 60 grams per day. On the sports medicine side I recommend 1 to 1.5 grams of protein per kilogram of body weight. For 170 pounds this would be 77 to 115 grams per day, the lower number for inactive and the higher number for very active exercise levels. If you can target 40 to 50 percent of your daily protein in the morning it will digest better and be available during the day when metabolism is higher.

The other process I think is happening for you is Raynaud’s Phenomena, in short it is a condition that affects circulation in areas far from the heart, feet and hands. If yo do a google search there is a lot of information on it and some helpful recommendations, some of which you are already doing.

Underneath leg swelling and cool extremities can be an imbalanced blood sugar problem and having a fasting or random glucose check can be helpful to identify this if it is happening. Please let me know if you have any more questions or I can be of further help. Good luck in training>

Cheers,

Dr. Bryan