pain in the ball of left foot between ball and 2nd metatarsal, and at bottom of ball (near arch)

by Bailey
(Arcata, Ca, USA)

A few months ago I blindly kicked into a step running up stairs in The dark and since then, ive had minor to serious pain in and around the ball of my left foot. I have difficulty lifting my big toe off the floor, and recently, I've had difficulty curling in downward. I play collegiate level volleyball, and though I can play with the pain, after games, the pain is high and painful walking persists into the next few days. Just recently, after games, the bottom of my foot around the ball is swollen and feels as though I am standing on a wide lump when standing erect. After games, any kind of bending of the big toe or toe region of the left foot hurts badly. Please help, could something be broken?

RESPONSE
Hi Bailey,

Two things come to mind. First, since there was trauma there is always the chance that you broke something, either the base of the toe or the second metatarsal bone. The only way you would know this of course, would be with an x-ray. If there is a fracture there now becomes an issue of time. Since you had the trauma a few months ago, even a simple fracture might become an issue because of the time lapse.
A second and more probable cause of your pain would be capsulitis, or the over stretching of the ligament that attaches the toe bone to the metatarsal bone, particularly on the bottom of the foot.
If you had jammed the second toe backwards enough when you first had the trauma, this could have cause an over stretching of the ligament. You would tend to have a feeling of fullness on the bottom of the foot and of course would be exacerbated during athletic activity.
Since you never really can give the foot the time it needs to rest (by staying off it, or reducing your activity), the foot never has a chance to get better.
Taking capsulitis one step further, there is also the possibility that you may have experienced a plantar plate tear which is an actual tearing of the capsular ligament. Obviously, this is a more severe problem to treat and will require immobilization.
As you can see this problem needs medical attention. Ask your trainer to set you up with a foot specialist, someone who understands all the possible sources of your pain so he or she, by process of elimination can come up with the correct diagnosis and then offer you treatment.

Marc Mitnick DPM
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