pain in left top of foot after walking

by Elizabeth
(Illinois)

I began having pain in the top left hand side of my left foot after walking, mid way between the base of toes and ankle a few months ago. The only thing I can think of where I might have injured my foot was by running over our driveway in a pair of clogs (Walmart version of crocs) when one of my children was screaming for help in the barn and I didn't know what had happened. I remember thinking, ow, these rocks sure hurt as I ran, but I kept going to see what was the matter with my boy. I am 48, have had 8 children, and don't normally run in these shoes,(or run much at all) they were just quick to slip on. Prior to this, I have walked regularly 2 miles a day, but now after 1/2 mile, I first will get a funny shooting pain across the top and then if I don't quit walking, a terrible tight, aching pain will make it nearly impossible to put any weight on my foot and I slowly hobble back to my car. After getting home and taking off my shoes and just getting off it for a while, it will go away, or if I stand on my cushy foam mat in front of the sink while I do dishes, it will feel better. I got a new pair of walking shoes to see if this would help. Sometimes I feel like the arches of my feet have suddenly gone flat and at times I will get a burning sensation in the arches of my feet. Some days it won't bother me at all, and I will try and go for a walk, but I never know if that pain will make me stop and hobble home. I do not wear shoes in the house, and it doesn't bother me if I don't wear shoes, but I can't go barefoot everywhere. I want to keep walking, but I can't go the 2 miles unless I break it up in 1/4 to 1/2 mile trips throughout the day.

RESPONSE

Hi Elizabeth,

As in most cases of people writing in to me, it is impossible to give a definitive diagnosis as I do not have the luxury of actually examining you, but I will give you my thoughts on the pain you are experiencing on the top of your foot.
It sounds to me that you are probably correct that this onset of pain is related to the episode of running in flimsy shoes on a gravel driveway in an effort to help your son. What typically happens when you walk, let alone, run on a gravel driveway is that you get abnormal motion in the foot and abnormal motion will in most cases end up causing pain.
What I find interesting in your narrative is the fact that your pain does not occur all the time, but rather when you have walked a certain distance. In other words, it seems to me that your foot does not really bother you unless you put it to the "test". You mention that home, barefoot, and standing on your cushy kitchen mat also make your foot feel better.
Well, typically in conditions like a stress fracture or tendonitis which are probably the two most common causes of pain on top of the foot, the pain will be present, in varying degrees, regardless of your activity. Walking from the bedroom to the bathroom will cause pain, or any short distance for that matter will cause the foot to hurt in those conditions.
So based on the fact that it takes some degree of walking to get the foot to hurt, my first thought would be a ligament problem. A ligament is a leather like band of tissue that attaches bone to bone, in order to hold all the bones in place.
Your running on the gravel driveway may have done some damage to a ligament on the top of your foot, because of all the abnormal twisting the foot underwent, and now when you over work the ligament, the foot starts to hurt.
That would be my first thought. My second thought would be a midtarsal fault which in its simplest terms is a collapse of the arch and thus a jamming of the bones on the top of the foot. This problem usually worsens the more a person walks and may not necessarily be an issue when a person is not doing a lot of walking. The only drawback to this diagnosis is the fact that generally standing barefoot will aggravate the foot because with out any support in the arch (from shoes) the foot will collapse and exacerbate the pain.
Those are the two things that come to mind, but of course, the only way you are going to know for sure is to see a foot specialist and have a complete exam. You state that you have been experiencing your pain for a few months. In general terms, most simple, foot pain will subside in that period of time.
My best advice to you would be if this foot problem is bothersome enough to keep you from doing the things that you would like to do, than it requires medical attention.

see related article....top of foot pain

Marc Mitnick DPM
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