Pain and soreness to the inner top portion on my right foot.

by Maeve Mc.
(Westchester, Ny)

About 2 years ago I managed to cut the top of my right foot (cuneiform area). It was deep enough to have to get about 6 or 7 stitches in the shape of a backwards "L". I never got an X Ray at the hospital. They just sewed me up and that was it. Just recently the side of the same foot had become very sore and painful. I have to mention that I am also severely flat footed. It could be that I just started working a new job as a waitress and I am always on my feet. My shoes are cheap too. My foot is noticeably swollen. It causes me to limp. Worse as the shift goes on. I try to massage my the area but it is so painful and sore. I think it is the bone that is painful to the touch. Looking at diagrams of the foot I think the wound is on the top of my cuneiform but the pain is on the side of my metatarsals-1. I don't even know if the injury has anything to do with my swollen and painful foot. Please tell me what to do. I don't have health insurance but am almost at the point where I might just have to go to the ER.

RESPONSE

Hi Maeve,

Since two years passed from the time you cut open your foot and the onset of pain in that area, I am inclined to think one thing has nothing to do with the other. If the cut had damaged a tendon or ligament, you would have had pain from the beginning.
I do not know how you cut yourself but if you had dropped a heavy object on the foot and had chipped the bone, that too would have been an issue early on.
Typically when people are flat-footed and wear cheap shoes (your words) and have to be on their feet for long periods of time such as being a waitress, in many instances they "over-stretch" the tendons of the tibialis posterior tendon and sometimes the tibialis anterior tendon as well. You can go back to the anatomy pictures and see where these tendons attach into the foot. It sounds like the area you are complaining about.
This occurs because if you are flat-footed, these two tendons over work in an effort to try and support your arch. So working long hours on your feet in cheap shoes will strain these tendons and cause pain in the upper inside part of the foot.
So what can you do? The simplest way to "fix" this problem (making the assumption that my diagnosis is correct) is to add a good pair of arch supports to your shoes. This will elevate the arch and thus relieve the strain on the two tendons I just mentioned.
In the world of arch supports, they are not all created equal. If you are going to buy a pair in a drugstore or supermarket, you have to look for a pair that actually supports the arch. Most of these store bought arches try to "cushion" the foot, but do little to support the foot. For your particular problem, you are looking for support and no so much cushioning. If they do not actually support your foot and you cannot feel your arch being lifted then they will be a waste of money.
So long for a pair that is rigid in the arch area, it will usually be made of plastic rather some sort of cushioning device.
If you cannot find anything in a store, then consider the Redithotics that we sell on this site. They are very supportive and do not take up too much space in your shoes. Getting a good pair of orthotics may just eliminate your problem and save you a trip to the doctor.
BTW, if push comes to shove and you need to seek medical care, do not bother with an emergency room. Chances are they will be clueless as to what is going on. You would be better served seeing a foot specialist.

Marc Mitnick DPM
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