small hard knot discovered on the side of my foot

by Rebecca
(Tulsa,OK)

The knot I found is on the outside of my right foot just below the ankle bone. It is hard an somewhat sore. I have a lot of pain on the top of my foot around my ankle any time I have to walk very far no matter what shoes I have on but wearing heels is out of the question. Even pointing my foot down in the position of wearing heels hurts. So because of this pain I tend to sit and rub this foot and ankle and that when I discovered the knot. I do not know if the pain is related or seperate or if it is something I should see a doctor over. As a bit of history I have always had sharp pains feeling as if the arches of my foot were pulling or stretching. Even as a teenager I had this and was told I had flat feet and that it was because I had Cherokee Indian descent. Could this be why I am having problems?

RESPONSE

Hi Rebecca,

The simplest answer to your question would be if you are having pain in your foot and ankle, to the point that it is affecting your everyday activity, then yes, you should see a doctor. It should be apparent to you that this is not going away on its own.
People who are excessively flat footed can have problems in the area of the ankle. Read my section on ankle pain where I describe that when someone is excessively flat footed it actually ends up causing a mis-alignment of the ankle joint. Over time this will tend to cause pain usually either on the inside of the ankle from an overstretching of the structures on that side or, pain on the outside of ankle from a jamming effect of the fibula jamming into the foot.
This is not to say that you cannot have pain as well on the top of the foot, which ends up being the front of the ankle..
As far as the lump on the outside of your ankle, my "guess" would be a enlargement of the peroneus longus tendon which is a tendon that comes down the side of your leg, to the outside of the ankle and then goes below the lateral malleolus or ankle bone that you feel on the outside.
Because you are excessively flat footed, two things tend to happen. One, the tendon is over worked and two, the tendon is being jammed from the pressure of the ankle bone jamming into the outside of the foot structures.
So, although I think you would get far superior care if you saw an foot specialist in your area, you might consider trying a good arch support first. The purpose of which is to better align the ankle joint by reducing your flat feet (pronation). If you can create better alignment, you might see a reduction in pain.
If you go into a drug store to buy an arch support, make sure you can actually feel it supporting your arch and therefore lift up the foot. Most of the stuff sold in drug stores and supermarkets just cushion, they do not support. Without adequate support, the device will be useless.
If that reduces your pain, then fine; if not see a foot specialist who can actually examine you and make a proper diagnosis.

Marc Mitnick DPM
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