Why do my feet hurt? Metatarsal tales

[C clearly]

I am focusing these days on keeping up or increasing my regular walking - whether for health in general or for another Camino. On another thread, I was struck by the following comment, which I think many of us can identify with.

My feet will just quit while the rest of me is good to go.

I've had some foot issues over the years and want to encourage others to try to get to the root (or foot) of the matter. Some problems can be helped.

Is the pain something you need to "walk through" or is it something that will get worse with over-use? Over the past 10 years, I've had problems with both feet, that persisted for weeks or months and took the pleasure out of walking more than 5 or 10 km. "Walking through" them was not helping.

1. Pain in ball of foot at base of big toe - Resolved after I got my first custom orthotics.
2. Metatarsal pain - Turned out to be a stress fracture which was confirmed by a bone scan. (It's otherwise often hard to diagnose.) Resting with virtually no walking and soft house shoes cured it in 7 weeks.
3. Pain at the top of my foot on the inside of my arch - Resolved with new orthotics with different arch support.
4. Pain on top of base of middle 2 toes - Resolved by changing to shoes with a soft flexible top (Brooks Ghost 13).
5. Pain on top at base of 2 different toes - An x-ray revealed no evidence of injury/fracture, but some arthritis. This is my current challenge, and seems to be much improved with new orthotics with metatarsal pads, which I didn't have before. The fellow added the pads for both feet, though, and created a new pain in the left foot while relieving the pain in the right foot in a week of testing. Now I have the metatarsal pad in only one foot.

I find it amazing that 1 or 2 mm of extra support here or there can make such a difference. With the new orthotics, I walked 70 km last week in comfort. It seems that I have very mobile metatarsals and the joints scrunch together (my non-medical description) if not carefully supported for long walks.

All of these problems are things that many people suffer in silence all the time. They stop trying to walk so far or so much, or they accept the pain as an inevitable consequence of aging. Sometimes there IS no solution, but I have been lucky to be able to manage these issues.

I suspect that orthotics are over-sold, but for me they have proved essential. The problem is that you will never know unless you try them and you have a helpful professional, and custom orthotics are very expensive. Mine are covered by my extended health insurance - I doubt that I would have spent the money in the first place, but now I know they are worth it to me.

One other point - I always used to go barefoot or socks-only inside. Now I love my Hoka Recovery Slides and wear them constantly around the house. They provide cushioning and a sort of arch support.

Here's another good thread on foot problems beyond metatarsal issues.

 

[Carolethecatlover]

I am focusing these days on keeping up or increasing my regular walking - whether for health in general or for another Camino. On another thread, I was struck by the following comment, which I think many of us can identify with.

I've had some foot issues over the years and want to encourage others to try to get to the root (or foot) of the matter. Some problems can be helped.

Is the pain something you need to "walk through" or is it something that will get worse with over-use? Over the past 10 years, I've had problems with both feet, that persisted for weeks or months and took the pleasure out of walking more than 5 or 10 km. "Walking through" them was not helping.

1. Pain in ball of foot at base of big toe - Resolved after I got my first custom orthotics.
2. Metatarsal pain - Turned out to be a stress fracture which was confirmed by a bone scan. (It's otherwise often hard to diagnose.) Resting with virtually no walking and soft house shoes cured it in 7 weeks.
3. Pain at the top of my foot on the inside of my arch - Resolved with new orthotics with different arch support.
4. Pain on top of base of middle 2 toes - Resolved by changing to shoes with a soft flexible top (Brooks Ghost 13).
5. Pain on top at base of 2 different toes - An x-ray revealed no evidence of injury/fracture, but some arthritis. This is my current challenge, and seems to be much improved with new orthotics with metatarsal pads, which I didn't have before. The fellow added the pads for both feet, though, and created a new pain in the left foot while relieving the pain in the right foot in a week of testing. Now I have the metatarsal pad in only one foot.

I find it amazing that 1 or 2 mm of extra support here or there can make such a difference. With the new orthotics, I walked 70 km last week in comfort. It seems that I have very mobile metatarsals and the joints scrunch together (my non-medical description) if not carefully supported for long walks.

All of these problems are things that many people suffer in silence all the time. They stop trying to walk so far or so much, or they accept the pain as an inevitable consequence of aging. Sometimes there IS no solution, but I have been lucky to be able to manage these issues.

I suspect that orthotics are over-sold, but for me they have proved essential. The problem is that you will never know unless you try them and you have a helpful professional, and custom orthotics are very expensive. Mine are covered by my extended health insurance - I doubt that I would have spent the money in the first place, but now I know they are worth it to me.

One other point - I always used to go barefoot or socks-only inside. Now I love my Hoka Recovery Slides and wear them constantly around the house. They provide cushioning and a sort of arch support.

Here's another good thread on foot problems beyond metatarsal issues.

I have very mobile metatarsals and the joints scrunch together (my non-medical description) This is Morton's Neuroma. The nerves are scrunched and become inflamed. You do realize that the padding will break down over the 300+ kms you walk. Buy 'Chiropodist's Felt' and cut it to size and replace as it is squashed down from time to time. I suspect stress fractures are a lot more common than known. They glow in an ultrasound. Keep walking!

 

[henrythedog]

Over a quarter of the bones in the human body are in your feet: 52/206, along with 60 joints and over 200 muscles, tendons and ligaments.

A physio friend of mine describes feet as a complex bag of problems held in shape by the contents competing to fail.

I’ve had episodes of debilitating plantar fasciitis over the years, the last of which terminated my CdMadrid in 2019. That was only relieved, at Tincatinkers advice, by liberal applications of orujo taken internally.

Significant weight-loss last year may now have resolved it.

 

[Camino Chrissy]

One other point - I always used to go barefoot or socks-only inside. Now I love my Hoka Recovery Slides and wear them constantly around the house. They provide cushioning and a sort of arch support.

@C clearly, I'm wondering if the Hoka's would be good evening/shower shoes on the camino. Are they lightweight?

 

[henrythedog]

@C clearly, I'm wondering if the Hoka's would be good evening/shower shoes on the camino. Are they lightweight?

A fraction under 300g. I looked at them but stuck with my Birkenstock EVAs.

 

[Camino Chrissy]

A fraction under 300g. I looked at them but stuck with my Birkenstock EVAs.

Disappointing for me. I've posted elsewhere that Birkenstocks hurt my flatish feet as they have such stiff high arches that do not work for me...ouch!

 

[C clearly]

This is Morton's Neuroma. The nerves are scrunched and become inflamed.

No. I expect these conditions could exist together, and confuse the diagnosis, but I don't have Morton's Neuroma. The nerves are not affected - no "pebble in my shoe" or tingling toes. My pain is from the bones being scrunched together at the joints - more on top than the bottom.

I suspect stress fractures are a lot more common than known.

Yes. I even rested my feet for 8 weeks (no recreational walking) in case it was. But the discomfort came back.

I'm wondering if the Hoka's would be good evening/shower shoes on the camino. Are they lightweight?

@henrythedog is correct. My pair of women's size 7s weighs 272 g and I think they are less bulky than Crocs. But yes, I would take them on the Camino if I didn't have another similar no-name pair that I've had for 10 years, that are perfect and weigh only 175g. I've been looking for ages for a replacement and only found the Hokas that have been acceptable to my fussy feet (aka "they who must be obeyed"). Now I can save the old ones for the Camino.

I would love to find something less bulky, but comfort is the only thing that counts. The Hokas don't dig into the top of my foot, and they stay effortlessly in place when I walk.

a complex bag of problems held in shape by the contents competing to fail.

Walking for an hour or two barefoot on squishy sand flats in the summer just about put me on crutches the next day. My husband thought it was very therapeutic for his feet.

 

[blueskywa]

my fussy feet (aka "they who must be obeyed")

and don't we know it!!!

 

[Kevin Malinak]

You sparked a memory...
I had a strange pain in both feet for the last 3/4 of the Camino...
It was in the back area of both heels.
It didn't bother me during the day, just at night, got so bad that I had to put something under the lower legs to lift my feet (heels) from pressing on the bed.
Worst was trying to sleep on my back, but also bothered me on my side.
Anyone know what the fix/prevention would be?
Blessings, -kevin-

 

[David61]

Over a quarter of the bones in the human body are in your feet: 52/206, along with 60 joints and over 200 muscles, tendons and ligaments.

A physio friend of mine describes feet as a complex bag of problems held in shape by the contents competing to fail.

I’ve had episodes of debilitating plantar fasciitis over the years, the last of which terminated my CdMadrid in 2019. That was only relieved, at Tincatinkers advice, by liberal applications of orujo taken internally.

Significant weight-loss last year may now have resolved it.

Do dogs get PF? If so, front or back paws? All 4?

 

[henrythedog]

Do dogs get PF? If so, front or back paws? All 4?

Yes

All four.

Plantars Fasciitis for Dogs · PetMassage™ Training and Research Institute

Full Title: Author: Date of Publication: PDF: Research Paper Text:

petmassage.com

 

[David61]

Yes

All four.

Plantars Fasciitis for Dogs · PetMassage™ Training and Research Institute

Full Title: Author: Date of Publication: PDF: Research Paper Text:

petmassage.com

Paw dogs!! My two feet suffer so much. Cobbles and crazy paving! Thank you Spain!

 

[KimR]

@C clearly, I'm wondering if the Hoka's would be good evening/shower shoes on the camino. Are they lightweight?

I’ve used recovery slides as my 2nd pair on my Caminos. Walking around town .Very lightweight. Can wear with socks. A treat for my weary feet. My wet feet did slide a bit in the slide So not as ideal for showers or walking in the rain. Only downside is that they are bulky but can be hung on the outside of your pack.

 

[C clearly]

I had a strange pain...
It didn't bother me during the day, just at night,

I often have strange pains that bother me more at night than in the day. Maybe it is part of the whole mysterious healing process. In the middle of the night, I'll think "I'll never be able to walk as planned tomorrow" and then in the morning I am fine!

 

[Thebee6]

@C clearly, I'm wondering if the Hoka's would be good evening/shower shoes on the camino. Are they lightweight?

I have metatarsal issues -- insufficient fat pads on the bottoms of my feet, ruptured plantar plates, hammer toes, crunched-up nerves -- and am grappling again with getting the right combination of boots, insoles, orthotics, lacing (different lacing patterns can really help -- Google is good here), socks, etc. I have had plantar fasciitis in the past, too, but no longer do daily massage of the calf and shin muscles make an enormous difference for that. One constant that I hope never to be without: Oofos running recovery sandals. Oofos has several models; I swear by their thongs, which I took with me on the Camino Frances in 2018 and slid onto my feet as soon as I stopped each day. They're a one-piece sandal with a thick, cushy sole and arch support that takes pressure off the metatarsals and positions your weight over your heels and arches. Really supportive, really comfortable, and actually invigorating after a long day on The Way. (Dunking my feet in every cold stream along the way was also key, and a practice I continue on my daily New England walks in all weather.)

 

[C clearly]

They're a one-piece sandal with a thick, cushy sole and arch support that takes pressure off the metatarsals and positions your weight over your heels and arches.

I am extremely attached now to my Hoka recovery sandals - I wear them constantly around the house now. When I remove them and walk on the hard floor, my feet hurt. This is another example of how even the seemingly simple slip-on sandals need to suit your foot. The Oofos hit the wrong place on the top of my foot, but the Hoka are perfect.

On the other hand, the Hoka Bondi 7 was not a match for my feet, for long walks.

 

[SacredSteps]

Coming into this late, so apologies if you have already considered this, but I often have similar pain. On the Appalachian Trail and my first Camino, I developed "stone bruises" or inflamed metatarsalgia. On the AT, there was really nothing at all to do except soak in the stream, wrap it and try to take shorter days. On the Camino, the pharmacies made several suggestions.

In the end, I have fully changed my shoe from a normal to max cushioing model (Altra Olympus for trail and Brooks Beast for road walking). Because neither model has a true flex rock plate, I remove the insole, cut a silicon vegetable cutting board down to match the insole, and place that layer between the sole and insole as a rock plate. At the first sign of any pain, I wear very generic metatarsal / ball of foot padded sleeves that extend from the toe area over the ball of my foot. Between the cushioned shoes, mid-cushion socks and the pads, I haven't had any pain in almost 1,000 miles since.

I know foot pain is terrible and I hope you find something that allows you to enjoy your next Camino. Buen Camino!

 

[gerardcarey]

cause neither model has a true flex rock plate, I remove the insole, cut a silicon vegetable cutting board down to match the insole, and place that layer between the sole and insole as a rock plate.

What a good idea that is.
Thank you very much.
Regards,
Gerard

 

[davebugg]

What a good idea that is.
Thank you very much.
Regards,
Gerard

Here's a bit of additional information on making homemade rock plates/shields from a past post I wrote. It really is a pretty easy fix to a shoe that is otherwise a great fit.
----------------------------------------------------------------------

If the imprint of trail debris, poking at your feet through the outersole of your shoe, is making your feet sore, you may want more shielding. A simple and effective DIY solution is to make a Rock Plate at home. The Rock Plate will slip under your insole, and provide a very effective level of protection without a huge penalty to the 'feel' of the shoe..

Take a thin and flexible plastic, like that found in milk jugs, or a thin plastic cutting board or plastic sheet

Using your insole as a template, mark an outline of the insole onto the plastic. Cut out the outline. Place the cut out into the shoe, under your insole. If needed, use some double surface tape, like carpet tape, to affix your new 'rock plates' to the bottom of the shoes.

If you still find that you need more shielding, add a second pair and see how that works for you.

Increasing the cushioning to the foot is another method of shielding feet from trail debris. Some shoes, like many models of the Hoka One One, build this into some of their shoe models. Aftermarket insole inserts are another way to add such cushioning, which some folks find effective.

Insoles with effective open cell foams and elastic polymers can provide extra cushioning that will also provide some additional support to your foot structures. As the foot slightly sinks into the cushion, it creates an impression that will slightly fill in the void under your arches. This is an example of this type of insert; there are others that can also be effective.

I always take an extra insole with me, not an extra pair of footwear. I find that if my footwear feels good walking, it will be sufficiently comfortable for lounging around after a long day of backpacking or walking Camino. Of course, wearing lightweight trail runners rather than heavier footwear make this option easy.

I designate one insole as my walking insole. That's the one I will. . well. . do all my backpacking and Camino walking with. The extra insole that I take with me, is usually the one that came with the shoe.

The factory insoles are usually very light. When I swap out insoles at the end of the day, and will be walking around the village or town seeing the sights, getting dinner, shopping, etc, the factory insoles are more than sufficient for that walking task. Swapping out insoles allows my walking insoles to air out.

Like shoes, aftermarket insoles are an individual fit-and-feel type of thing. No one can reliably tell someone else that the aftermarket insole they like, will be a good match for another. If shopping for an insert, it can take quite a bit of trial and error to match your feet to a specific insole. There is a reason why so many aftermarket products exist; one type does NOT fit all.

The most valuable thing about such recommendations, are the observations about wear and tear, and quality control. Do they break down quickly? Cost? That sort of thing.