Hi all. 

I made my barefoot running transition in early January and have slowly been adjusting myself to it. About a month ago I started the foundation program and have been been constantly wanted to head out and run - a great feeling :)

After today's long run I realized that an injury I had about a year ago is starting to show up again. I originally got it playing floorball and saw a physiotherapist that essentially told me that she didn't know what it was and just told me to talk it easy for 6 weeks and wear more supporting shoes. It eventually faded away but has now resurfaced. 

After about an hour of today's run I started feeling discomfort on the middle of the "inside" of my foot. After finishing the run I had pain and could hardly put weight on it but 2 hours later everything feels fine. Sorry about the ugly foot image below but it shows the area I mean. 

Does anyone know what this might be and how I best proceed? I'm pretty worried by this as I have two races coming up this month and 2 months to a half marathon I was hoping to be able to run :(

Many thanks!!

Mikael

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I had pain in that area a few years ago when I was in my early stages of transitioning to minimalist shoes.  It was basically one of many symptoms of doing too much too soon. I didn't see my doc for it, but I took a rest from running for a few days and focused on exercising the muscles in the foot by doing "toe yoga" and tiger-walking.

Have a look at images/diagrams on the internet for "digitorum brevis".

Intuitively, I would say there might be a few things at play here.

1. you could be landing too far out in front of you, striking the ground more towards the picky toe or side of your foot.  If so, this could force you to roll in or pronate too much, without getting the stability with your toe first, and cause stress to this area.

2. Or the same result, but stemming from keeping your knee too bent throughout the stance phase.

Try running in place and see if you feel the pain.

Also, do any of the slant board angles cause this area to hurt?

Are you still running with the stability/support shoes the PT suggested?

Eric, I watch my form closely but I paid extra attention today. I think I am not striding long. My ankle does not cross my hamstring and cadence is consistently 21-22/15 seconds. My weekly off day is tomorrow (Monday). On Tuesday, before I go out for my run, I will try some spot running with bare feet and no socks at home. I am guessing that I will not feel pain. So it is something that I am not doing correctly while running. Please see another comment posted by me just now in response to Lori Enlow. thanks for your responses

Good morning (well, it's morning here at least),

Thanks for the input! I really appreciate it. 

I've been running in a pair of Merrell Trail gloves for a bit over 4 months now, until last week without any other problems than some sore muscles in the beginning. The more supportive shoes and soles that was suggested to me last year I only used for maybe two months and I haven't had any problems since then. The strange thing is that the way it was last time (and appears to be now as well) is that it can hurt while exercising but given a day of rest everything feels fine again with no symptoms. I guess that's why it was hard for the physical therapist to help me as well. 

My right foot does point a bit more outward and I know that I'm not hitting the ground with it pointing perfectly forward. I've been struggling with trying to correct this for a couple of years without success but was hoping that it might sort itself out given "proper" running technique and foot/balance training. My cadence is usually at around 90 so I don't think that I'm overstriding but it's hard to tell. 

Running in place feels fine, at least now that I've gotten 24 h rest and no slant board exercises have hurt so far and not today either. 

I'm thinking of giving myself a couple of rest days and then try again with some of the slower/easier runs and see how it feels? 

Thanks again!!!

After spending some time reading, revising my slant board exercises and going for a short HRZ2 run with heightened mindfulness on what I really do with my feet, I'm ready to go with Eric's first suggestion. I do angle my right foot out too much and I seem to be landing close to the outer side of my foot. When paying attention to this and trying to really force my foot to stay more straight it felt better. I've also realized that I've been sloppy with locking my knee during the slant board exercises and once I do that I get a lot of strain on my Gluteus medius (which I assume is the weak spot that causes my foot to "have an angle"). 

I'll focus on the exercises, stay alert on my foot placement during the runs and hope things turn around for the better :)

I have had a similar experience to Mikael. My pain is close to the area pointed to by Mikael in his picture but ONLY on the inside of my left foot. I am almost at the end of Week 2 of the Foundation Program and otherwise have no issues. The pain itself is low intensity and I actually ignore it through the day. However, it is a little worse when  I have sat for a while of I have been lying down. It is quite bad for a few minutes when I first get out of bed in the morning. After I have hobbled around for 5-10 minutes, it goes away. Since it goes away quite readily, I am thinking it is not really an injury but some kind of muscle issue in that area. I have just started icing that area today to see how it responds. I found the following picture on the net showing the anatomy of the foot. My pain is close to the Calcaneus but I am pretty sure that this is not an issue with the bone because it goes away if I start walking. I must add that I feel no discomfort (as yet) while I am running. I am able to comfortable run over an hour at 10K/hour pace.

I am keeping extra close attention to the way my foot lands and it looks fine thus far. Will monitor for some more days and update this post if I discover more.

I have had similar issues as you all with my right foot. I have found that I also tend to reach with that right foot and land on the outer edge more than the Left...so I think there may be some commonalities in what we are doing. I also tend to keep more of a bent knee on the stance leg when running (my cadence is pretty ideal naturally)) It has taken literally months of focus on my foot strike and work to get it to where I am now with pain almost gone. I also experienced the increased pain after periods of rest and easing after 10 min of walking. Foot would hurt at the beginning of my runs, ease or disappear and return mid - late run or cool down. I think patience is key as it takes a long time to solidify the muscle memory to create a permanent change in form. A note of hope...I just finished a 57mi race and the foot did pretty dang good despite the issues and seems to be continuing to improve.
I would also say it is the tendons and fascia that are inflamed due to increased stress...caused by form. With my medical hat on I can say with some expertise that tendons, once inflamed are slow to settle down (stop hurting) even after you have fixed the offending problem (poor form). So don't expect pain to magically resolve as soon as you correct some of those issues. If you are on the right track correcting problems those tendons will settle down slowly. A red flag is increasing pain. If you really feel you have corrected the problem and pain is escalating or not slowly improving week by week then you need to step back and rethink things or have it looked at.
Another question for you guys...are you allowing your heel to come down when u run? This was another cause I had. Letting that heel come down is very important

I believe that I do. I paid very close attention today to my form trying to analyse what was going on a bit more. It had drizzled through the night so my routine trail was damp. I watched the marks that my shoes left behind as I completed the 5 laps and they look like full prints. The heels do land.

As I observed closely, I believe that I am pushing off a little more strongly with my right foot than my left one. Now this may well be because I am 'protecting' my left foot a bit without realising it - will keep an eye on it next couple of weeks. I also consciously (maybe for the first time in my running career) observed my knees as I drove forward. I wanted to see if they are both balanced. Again, I found that my left knee does not drive up as much as my right. This also may be because I am sub-consciously protecting my left foot.

What I can confirm is that both my toes are pointing forward and that my cadence is consistently 21-22/15 seconds.

Thanks for the input and advice. I've been working with trying to get my right foot to point more forward and focus on where I land. I ran 8 km at the beginning of this week (before I was knocked down by a brutal summer cold) and it felt good during most of the run even though I could feel that it would hurt again if I did misstep. 

Regarding the heels, they do come down properly. I missed this in the beginning and noticed how important it was after two weeks or so :)

Just to add to my report from yesterday, my foot did not get any worse after my 95 minute run yesterday. I did feel the pain for a few minutes when I got out of bed this morning, but I think it went away quicker. At least, it has not gotten any worse. Will observe my form closely and report progress. Thanks for all your inputs

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