Training for the London Marathon

Nov 22, 2011

• Malen asked The Guru for the following Physiotherapy Advice:

  I am training for the London Marathon. After a number of weeks of training, I have developed a pain on the top of my foot. There isn't any swelling, but when I flex my toes I get an aching paid on the top of my foot just above my big toe. I rested for two weeks, once I started running again the problem has started again.

  I am hoping to pick up training in the next few weeks, but fear I am only going to make my injury worse. Not sure whether to seek advice from a physiotherapist or a podiatrist.

  Would appreciated any help and advice you could give

  Thanks

• The Six Physio Guru responded:

  Hi Malen

  If you put your fingers lightly on the sore bit of your foot and then wiggle your toes around do you feel or hear any bumping or grinding under your fingers? Are the shoes the correct size and width? Are they new shoes? Do you have any aches and pains elsewhere?

  Let me know

  The Guru

  Six Physio

• Malen responded:

  Hi Guru

  Yes when I press on the pain and wiggle my toes I can feel a grinding under my fingers. Especially after I have just come back from a run, when the pain is worse. I think my shoes are OK. They are about 6 months old, and I was given advice on which pair would suit my running style etc as they made me run on a running machine before buying any trainers. However the pain does increase when I put my shoes on.

  After rest for a few days the pain goes away, but does then reoccur once I start exercise again.

  Thanks for your help

  Malen

• The Six Physio Guru responded:

  Hi Malen

  Sorry for the delay!

  It sounds as if you've got a kind of tenosynovitis....big words, small(ish) meaning. Basically the tendons in your toes (which go from the muscles to the bones) are surrounded by a sheath for protection. The crackling/grinding your feeling is fluid sitting around the tendon inside the sheath.

  It generally happens because either your shoes don't/didn't fit (laces too tight, not enough space etc) or your teos are being forced to move differently due to your shoes.

  You can have your tendon shealth jabbed (under ultrasound guidanace) - definately a last option or you can modify what you're doing. I'd go for ice and calf stretches and try running in your old/different shoes for a shorter distance. See what that does and get back to me.

  The Guru

  Six Physio

1 Comment

• Responded:

  Dec 04, 2011

  Surprisingly well-written and infmorative for a free online article.