#769 Intractable dubious metatarsalgia diagnosis - DOC

#769 Intractable dubious metatarsalgia diagnosis

What is the intractable dubious metatarsalgia diagnosis? Well, that’s what we’re talking about today but the Doc On The Run Podcast.



Today’s episode actually comes from one of the YouTube viewers and this was from Casey. He wrote in and he said. “This year I suffered from this problem after switching to zero drop running shoes and I was finally running pain free. The zero drop running shoes made me into a forefoot runner instead of a heel striker. I was doing great but then I started having pain in the ball of my foot from a callus. I then started having this pain and I did exactly what you said to do in this video and it worked great and specifically this video showing how to remove a callus in a specific way with a specific technique.”

He said, “Great information here, everything I was researching kept saying it was metatarsalgia but my pain was different. Thank you for the great video.” My reply to Casey was “Thanks for watching and adding your comments. So glad to hear you’re back to running instead of getting stuck with the intractable dubious metatarsalgia diagnosis.”

When I wrote that, I was thinking about trying to explain what that really means. Metatarsalgia refers to pain in or around the metatarsal bones in your foot. You have five of them. So, if this was your foot and you have the foot bones here. You have your toes all out here. The foot’s basically the same as your toes in that you have metacarpal bones in your hand, those long bones right here. You have tarsal bones at the top of your foot.

If the metatarsals hurt, we call it metatarsalgia. Metatarsalgia is not a diagnosis, but it’s descriptive term but a lot of people use it as a diagnosis. And so, if you start having pain on the bottom of the ball of the foot where the metatarsal are pushing against the ground, somebody call that metatarsalgia, but if what’s happened is you’ve gotten a callus because you’re landing and putting more pressure and friction on the ball of the foot because you’re running as a  forefoot striker or mid foot striker in minimalist shoes, well, that’s normal.

If you get a thick callus, it develops a hard spot that starts to hurt and you push on that spot, you may think it’s metatarsalgia but it could just be a problem with the skin, a thick painful callus that hurts when you step on it. And if you remove that thick piece of skin, that hard callus, the pain goes away.

In that case, you know it has nothing to do with the metatarsal and it’s not metatarsalgia but most of the runners I see, who are calling me for a second opinion after they’ve been told over and over and over they have metatarsalgia and they need to stop running, they don’t calm down if they don’t stop running, they actually have something else like a plantar plate sprain, which is an injury to a ligament, not the metatarsal bone. Or they have a neuroma which is an inflammation of the nerve between the metatarsals and not a problem with the metatarsal or something like Casey’s callus.

If you’ve been told you have metatarsalgia, drive down to your doctor’s office and demand a more specific diagnosis. Tell them you what to know which actual thing is injured and what it’s going to take to get that better so you can get back to running as quickly as possible.

If you haven’t checked it out and you have metatarsalgia, you might want to check out the stress fracture masterclass. You can get it for free at docontherun.com/stressfracturemasterclass.

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