Help Chronic foot pain in Runner

So here it goes. My story starts back in September 2018, although it seems like forever ago I know many have been suffering longer. let me start by saying I am a runner, at my prime I am running 40 miles a week, September 2018 I completed and PRed in the Erie Marathon. I had no pain during the race. The next day I was stupid and went for a run, I put on older shoes and initially felt like the shoes felt tight but didn't think much of it and went out on a 7 mile run. I developed some left foot pain between my 3rd and 4th toes. I continued to run for a few days, really not taking days off, I know stupid. A week or so later I decided to get help. I saw a podiatrist to felt it was a stress fracture, I was placed in a cast shoe and set up for a bone scan to confirm. a week later I had the bone scan that was essentially normal, I followed up with the podiatrist who then diagnosed me with a neuroma, I had a steroid injection that did not really help, at this time I started to develop similar pain in the opposite foot. I took more time off from running, I saw a chiropractor who diagnosed me with a peroneal tendonitis, I saw him for 4 visits and was given exercises, stretches which did not improve my pain. with frustration and no real answers I started to run again. the pain was bearable and would come and go. I believe it was at this time I discovered TMS and felt like I fit the personality to a T. I essentially ignored the pain, read Dr. Sarno's healing back pain and felt like I was somewhat progressing. fast forward to February, I did a 9 mile race, had pain but manageable. 2 weeks later I did a 5 mile race and had extreme pain the first half mile, I finished the race and at the end had a swollen and bruised foot in between the 2 toes where my previous pain had initiated. I lost hope in TMS, I had multiple xrays, saw a new doctor an orthopedist who thought it was a neuroma, had another steroid injection, wore pads in my shoes, switched to wider shoes and even wore a boot for 6 weeks. the pain would wax and wain but never completely resolved. I got an MRI in april that showed edema in the interosseous muscles of my foot between the 2 toes. my ortho doctor recommended not running for an extended amount of time. I did not run for 7 months, I still exercised, mostly biking and swimming. after months of some improvement I finally set a date to start running again in September of 2019. my pain had mostly resolved. I started using the elliptical 2 weeks before running to trying to get my muscles back to running shape, in this time my foot pain increased. I still decided to start running again. I slowly ran, making sure to do low mileage and not run every day. my pain was there but did not get worse. I ran the same 9 mile race 2 days ago and had my usual pain, scared I might take my shoe off and seeing bruising I had some relief that there was no swelling or bruising. but my pain was worse. I really believe I have TMS but I am having a hard time fully committing to the diagnosis, is it coincidence that I injured the same area in February, did it get injured from weakening the muscles from the steroid injection? Does the edema on the MRI mean anything, can TMS cause edema on an MRI. I am frustrated and want to be pain free. side note, I have a history of anxiety and depression essentially my whole life. I had school phobia as a child and the September my pain started was the same time my son started kindergarten. I dont know if this is a connection or again coincidence. I would appreciate any advice.

 

Hi Katrice I’m sure other more informed will reply however from my perspective having had TMS you have depression/anxiety. You have had all the medical work done and it’s not really conclusive or giving you a diagnosis. My advice is to slow down tackle the anxiety and depression for as long as it takes. Once done this will relieve your symptoms of pain.
It’s unconscious anger/worry etc that’s causing your brain to give you pain to keep your mind off these issues causing your general anxiety.
You lol find all the ideas to relax meditate in this site.
Good luck but I’m certain it’s TMS as I was exactly the same but with different presenting symptoms. I did not see my anxieties till I broke down. Spent a long time recovering slowly though

 

I too have had a long history with feet problems. I also self identify as TMS personality and have seen issues like anxiety and fear increase when obsessing on my feet problems. So it's good for you to have knowledge of TMS therapy and understand mind/body connections. That said, the fact that you damaged/injured your feet after a long run and then continued to feel pain as you tried to push through it tells me your feet problems are likely physical. This is backed up the fact that your pain mostly resolved as you shifted to different, less impact forms of exercise. Once you tried running again, the pain returned tells me the injury didn't fully heal or might be chronic for you as you go through life. Running is really hard on feet and knees and multiple other joints. As our bodies age, all of this takes it's toll on us. I'd back off on the running again and get back to less physical forms of exercise and try not to obsess on your feet issues. At some point in the future, try again, but come back very slowly and naturally.

 

Thank you for the reply, however I see it differently. based on many other things I have ready about TMS, chronic pain, and per Dr. Sarno, even the biggest bone in your body heals after 6 weeks. I also have noted that the area of pain will often change in my left foot. occasionally I will have similar pain in my right foot.
You see running is a huge aspect of my life, and I think my unconscious mind knows that, and the fear of being injured or not being able to run has caused it to develop this pain.

I appreciate your opinion

 

Hi Kaitrice85,

I encourage you to follow your gut on this. In my understanding, the time you rested the foot is enough to heal physical problems. I am not a physician though!

On this I am unsure, by the way.

I doubt one injection will cause enough damage to weaken muscles to the point of causing injury.

These items are supportive for TMS diagnosis. You've had improvement, which is progress, even though not perfect.

We have the Structured Education Program at the Wiki which is free and very helpful, by the way.

Andy

 

Kaitrice, I'm sorry that you are having to deal with this lingering issue. I have battled TMS for over five years now and can tell you that there are no exact answers and the fight is ongoing but controllable. In Sanro's writing he indicates the pain/discomfort is often associated with learned behaviors, therefore since running is a huge part of your life it makes since that this foot pain would happen while running because it takes your attention and your mind away from the real issues. I have had several lingering issues and once I convince myself that the discomfort is from TMS the pain will move to another location within weeks.

I would honestly try journaling, meditation, and if possible therapy. For the six-seven months I did therapy I was almost completely pain free and wish that I had the resources to continue it. Just saying things out loud can relieve both you mind and body.

Best of luck!

 

Unfortunately this a very fragile view of the body that will not help the original poster. As a fellow runner I hate hearing that doom and gloom diagnosis that running "wears down the ligaments".

 

I agree with you grapefruit. I appreciate your comment in this thread.

 

Have you tried visualization techniques like Steve Ozanich suggests? Visualizing your foot as pain-free? Or concentrating on a pain-free body part? When I run I sometimes get a niggling knee ache at exactly the 4km mark and I have found that the degree to which I can concentrate on the other knee, which feels great, telling my brain "this is how a knee should feel when running", I am able to push through the pain and by the 5k mark it is gone. I have also found this sometimes works for runners cramp too.

 

Kaitrice85, my heart goes out to you. I have foot pain too, though it started in a different way. In one of the many books I've read (I think it was Sarno), someone said that foot pain can take a little longer to cure because it's hard to really accept (in your gut) that it's TMS. And my personal experience is that other TMS symptoms have been easier to treat (I've cured 17 distinct symptoms so far) but this foot pain has been more stubborn. Sometimes I get soooo down about it. But I'm making progress, even if it's slower than I want. I'm not going to give up, I'm going to cure it and get to live decades free from false pain. I think you will too! For me, being on a slower path of recovery has meant that I need to stay immersed in the literature over time. Reading one book never would have worked for me...reading a variety of authors (and using Gordon's recovery program on this website) has helped me stay focused and (mostly) positive. Maybe this would help you too? Also, my other symptoms each vanished rapidly, but one-at-a-time over a period of about 8 months (so far). So who knows...maybe tomorrow's the day, for you or me or both of us!


But what I want to say to you more than anything is that I don't think you were stupid. You called yourself stupid a few times in your post and I feel that way sometimes too. But I think that pushing yourself so hard was just what you were taught to do by a society that encourages us to expect too much of ourselves. Deep down, maybe you thought it was the right thing to do--maybe that it made you stronger? Of course looking back with what you know now, you would have handled things differently. But if you think back, were you maybe making the best decisions you could based on how you understood things at the time?

 

Hi Katrice,
I can answer both as a runner for 43 years and as a sufferer of many foot pains over the decades. I would urge you to go with your gut (that it is TMS) as someone suggested, because I have seen that is is, has been, many, many times for me! I have had TMS in nearly every body part at one time, but as for foot, there has been neuroma many times. Plantar Fasciatis many times, achilles pain, top of foot pain. Only once in 43 yrs of running have I every had a real foot injury and that was a metatarsal stress fracture about 4 years ago. Everything else was harmless TMS.

By the way, the person above who said "running is really hard on feet, knees and other joints" is vastly uninformed! Not true! Using myself as an example, I am 65 and after several decades of running tens of thousands of miles, my knees are excellent. My feet, my hips, great. The idea that running is bad for you is an old-fashioned prejudice that has no evidence. The only people who might harm themselves are those with very bad structure, eg, knock-knees, very overweight, or bad running form, espec foot strike. Even the kind of shoes or lack of shoes is pretty much irrelevant. I run with a pair of shoes that have over 1800 miles on them and they are my favorites. I run in all kinds of shoes or no shoes and it makes no difference. (caution: I had to work up to this over time; don't go out and try this without lots of time and prep!).

It sounds like you have already taken the medical route without relief. Since it seems to be a dead end, which does not surprise me, why not gently and gradually try something different? As Sarno says, wait until you are confident that it is TMS before you challenge it. But when you are, start to very gradually challenge the symptoms. Run 100 yards one day. A little more each day. If ever you feel you have pushed it further than your nervous system will allow, back off. That's okay, no hurry. Continue day after day, week after week, not despairing on the down days. The only requirement is to keep at it. Give yourself pep talks; reward yourself when you have met your goals. Keep at it. Good luck.

 

It is so great to hear from veteran runners re: TMS and running. I plan to be still running regularly at your age! I also find it very encouraging to see all the older runners at races too.

Another inspiring thing I like to do sometimes is look up youtube videos of the senior olympics or centenarian runners. If people in their 80s, 90s and even over 100 can run pain-free anybody can.