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hil
03-09-2009, 09:37 PM
I have had pain in my mid inner right foot area (around the area of the talus / navicular bones) for almost 2 years which is severely limiting my doing exercise but as yet no one has been able to work out what is actually wrong so any light you could shed would be much appreciated. Sorry if it is a bit long winded.
It began in April 2 years ago. I have always been very active, I used to rock climb, cycle and run regularly. I had also recently taken up salsa dancing. I went on a salsa weekend and danced more than ever previously and my foot was fine but when I went for a run the following weekend I began experiencing pain on the inner aspect of my foot (about an inch forward and down from the medial maleolus) which stopped me from being able to run.
The pain got gradually worse over the next 2 weeks, stopping me from dancing or exercising, and eventually getting to the point where it was very difficult to weight bear. It was also very tendor to touch and a small hard lump appeared.
I saw a podiatrist privately who had no idea what it was but suggested I saw a podiatric surgeon (who I paid to see but he also did not know what it was). She also noticed I have very flat feet, so I have been wearing arch-supporting insoles since then. My GP thought it was an exostosis because of the small hard lump and referred me for an x-ray which showed a small exostosis but this was then thought to be incidental to the pain. I was referred to the sports medicine department of the local hospital. The doctors there have not been able to work out what is wrong with my foot despite 2 MRI scans (which have apparently shown no abnormality). They gave me a steroid injection about a year ago which just made it hurt more for a few days then back to normal. So I am still none the wiser as to what is wrong after 2 years and seeing several specialists. It is variable and has had periods of feeling a lot better, so I have gone back to dancing and doing yoga, and have managed a couple of very short runs, but it always gets bad again. It is really getting me down as I have relied on exercise for stress release for many years and this is stopping me from being able to do that. When it is at it's worst my foot feels very unstable and I am unable to push off the ball of my foot when walking, so have to walk in a strange way! When it is at its best it still feels slightly strange, and starts to hurt after walking for a while. Driving is also a problem sometimes, especially on long journeys, it sometimes feels tingly / numb, possibly from the vibration of the car. I have quite poor circulation and often have cold hands and feet. It generally feels worse / stiffer when it is cold.
The small hard lump which appeared initially comes and goes, and is sometimes slightly larger and less well defined. The pain is usually in the spot I mentioned previously but sometimes spreads to other areas locally in the foot, on the inner aspect.
Thank you for reading all of that, I hope it makes sense. Any thoughts or advice would be greatly appreciated. Even if there is no cure for it after such a long time I would like to have an idea of what it could be.

Heidi
03-10-2009, 10:51 AM
Hi,

I can see that this is quite a complex problem. Pain on the inside of the foot, in the area you describe can be caused by a number of things, from stress fractures, to tib posterior tendinopathy, to tarsal tunnel syndrome. However, none of these commonly present with a hard lump. Saying that it is still worth looking into them.

I would also suggest a full biomechancial analysis if you have not already had this done. This should include your posture and movement patterns for the whole body. This is often overlooked, especially by Doctors, consultants etc.

Its good that you have your insoles as I am sure your foot position has contributed to the problem. Do you find they help at all?

hil
03-11-2009, 04:13 PM
Hi Heidi,
Thank you for your reply. I actually saw the sports medicine physio again yesterday and I suggested to him that it might be a stress fracture as my symptoms seem so similar to those of a stress fracture, but he believes the MRI scans I have had done would have shown this up if it was the case. Do you think they would, or in your opinion would x-ray be better for showing this? He also said that after nearly 2 years it would have healed, but as I have continued to exercise as much as I have been able to I'm not sure it would have healed. He now thinks that it could be the exostosis that was originally seen on x ray that could be causing the problem and has referred me for a steroid injection under ultrasound, but I am not very keen on this as the last steroid injection just caused a lot of pain for a few days then just back to how it was before.
I have not heard of the other 2 possible problems you mentioned but I will have a look in to them. I am trying to get myself referred to an orthopaedic surgeon who specialises in feet to get another opinion.
I am not sure who would carry out the full biochemical analysis you suggested, or what that actually involves, could you let me know?
Yes I do find that the insoles help, my foot definitely hurts more when I haven't got them in my shoes. But also shoes with good cushioning seem to be better than those with little / no cushioning. Do you have any other footwear suggestions?
Thank you again for your advice and opinion, it is very much appreciated,
Hilary

Heidi
03-11-2009, 04:57 PM
MRI's do usually show up fractures, although occaisionally they can be missed. But for now at least I would follow your physio's advice until you can see the ortho.

Biomechanical assessments can be carried out by several different people. Try a specialist running shop or a podiatrist. It basically involves walking and running on a treadmill which has a video camera set-up behind you to film the way your feet and lower legs move.

I know that some sweat shops have these:

http://www.sweatshop.co.uk/storefinder.cfm

Click on the shop closest to you and under services if it saus video gait analysis or motion analysis then they do it.