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Interior foot pain


Question
Hello,

This past Tuesday morning (1/3/2012) I bent down to put my shoes on and noticed a sharp pain on the inside of my right foot, going from just below my ankle bone (a little towards the rear of my foot) to just at the top of the arch of my foot.  The weird thing is that I only notice the pain when my leg is completely extended, I'm bending over, and my foot is flexed up.  If my foot is pointed straight I don't feel the pain.

Some background on me: I compete in track (sprints) and field events (long jump) and have been actively training/competing for the last year and a half or so.  I had some patellar tendonitis about a year ago, but that is no longer an issue.  

My last practice was on 12/27/2011, took a break for new years, and then went back to practice last night, 1/5/2012.  During the break I went for a light hike, only 1.2 miles, on 1/2/2012, the day before I noticed the pain.  At practice last night while warming up, when doing high kicks to stretch my hamstrings, it felt like that area of my foot was on fire.  However, doing sprints, and plyo's up the bleachers, were completely fine with no pain.  Like I mentioned, it's only when my leg is fully extended and foot is flexed.

The shoes I used on the hike were the same hiking boots I've had for over 2 years, and I've gone on 10+ mile hikes in them with no issues.  I think it might be some kind of tendonitis and iced the area after practice last night.  But same pain this morning if I try to create it manually.  I don't think it's plantar faciitis since there is no pain on the bottom of my foot at all.  Also, I have type 1 diabetes, but I don't think that's a factor either.

Help?  :)

Thanks!
Owen

Answer
I'm sorry to hear you're having pain Owen.  The good news is I think that you're problem will go away in a short period of time.  Since the problem changes according to what position you're in I agree with you that I don't think the diabetes is a factor.  Because of the position that you describe that irritates it and the location of the pain I believe it is a tibial nerve problem.  The tibial nerve is an extension of the sciatic nerve.  This is significant because the sciatic nerve is up near the hip which is stretched when you bend over.  The sciatic nerve becomes the tibial nerve behind the knee and then extends to the foot by going behind your ankle bone.  The position you describe stretches that nerve to the point of irritation.  Try not to go into this position.  Normally problems like this resolve or at least improve within a couple of weeks.

(That being said, if the problem doesn't improve within 2 weeks go see a medical doctor.  You likely know that diabetes can affect nerves, but those are often sensory nerves and this doesn't seem to be a sensory nerve.  There's still things that we don't understand about nerves and diabetes though.  Again, if the problem doesn't improve within 2 weeks see a medical doctor.)


Good luck with track this season!


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