No feeling in big toes

[Richard Nisley]

Two weeks ago, myself and five others did a week+ bushwhacking trip from a whistle-stop train drop off near Sherman, AK to the headwaters of Chunilna Creek. The climb from the Susitna River to the tundra involved many steep ascents and descents in which letting go of an alder could result in up to a 1,000’ fall. Four of the six people, including myself, lost feeling in their big toes during the trip and three weeks later our toes are still numb. My worst numbness is on the outside half of my big toes.

I wore my same trail runners and had the same pack weight (35 lbs including 9 day's consumables, packrafting, and fishing equipment) that I have carried for comparable length trips on established trails in CA without any foot problems. All four of us wore different brands of footwear in combination with liner socks and heavy wool hiking socks.

Has anyone lost feeling in their toes while bushwhacking in very steep terrain? If so, how long did it take before your toes stopped being numb? What caused this problem and how can it be treated?

[cary bertoncini]

shoes too small

only times i've had any at all similar experiences were with shoes too small for my right foot (right is 1/2 size larger than left)

[Bob Gross]

"What caused this problem and how can it be treated?"

Incorrect lacing of the boots. My boots fit fine when I am on level ground. But then when I hit serious downhills, my toes will hit against the boot front unless I change the lacing to force the foot more to the back.

On some boots, you can lace for different tightness in the lower lacing or in the upper lacing. In other boots, the lacing tightness will redistribute to prevent this.

–B.G.–

[drowning in spam]

There are lacing techniques to get different zones of tightness in boots.

[Javan Dempsey]

I've had this effect happen to me, one time it took almost a year for the feeling in the left side of my right big toe to return.

I've never been sure what it's related to, but I have found that teaching myself to do toe-rotations helps to avoid this. It's hard to learn to independently move each toe, but it's rewarding, and good for the brain.

It feels related to circulation to me, but I'm just guessing.

[Roger Caffin]

Hi Richard

I have had it once or twice in the past – with small leather boots and small joggers.

I think your feet swelled up a bit on day 2 or 3 and started hitting the front and front-sides of your shoes on the down-hill. A lack of feeling probably means the nerves have been damaged a bit, which is caused by repeated compression or impact.

Physio on the feet – you can do it yourself every morning, and imho a size larger & wider shoes are needed. Try some Darn Tough Vermont Full Boot Socks with them.

Cheers

[Konrad .]

I agree with everything Roger posted. I lost feeling in my big toe after a strenuous 2 day mountaineering trip. It only became normal after 1 month. I remember after the first night, I freaked out and did a bunch of research online. Everything I read says that the feeling will come back…as for how long it'll take…who knows? But rest assured, it seems pretty normal.

[. .]

Good evening Richard,

A couple of questions are in order so that we can eliminate other causes:

1) What were the temperatures and weather like on the trip?

2) Did your feet dry out well every night or did they remain cold/wet for extended periods of time?

3) When you press on or wiggle your toe, is there any tactile sensation, or is it numb "to the bone."

4) Can you perform a capillary refill test for us: When you press into your toe and hold it for a moment, does it go white and then return to pink shortly thereafter?

5) What is the skin like compared to your other toes and the rest of your foot, as far as the color, temperature, and moisture go?

(My wife has had something similar happen while skiing for extended periods. In addition, she had white "spots" appear on her lovely toes where the blood seemed to refuse to visit for a couple of weeks thereafter, but they eventually returned to normal.

I pray that your feet feel better.

[josh wagner]

have you been to your doctor about this?

[Brian Johnson]

I have had mine go numb for 1 to 6 months after a big trip. Fortunately, they have always returned to normal. Most likely cause is some kind of compression from your footwear – could be caused by hiking at higher elevation than you are accustomed, longer distances, heavier loads, more brutal terrain, etc. I had to find shoes/boots with a larger toe box, and although I travel with much lighter loads than I used to, before a major trip I still train the same way I did 20 years ago – I'll work up to carrying 60 lbs for 10-12 miles. If I can survive that with no blisters or numbness I'm ready.

Also, I have read that B12 supplementation is helpful in repairing the nerves, but I have not tried this before. But, if it ever happens again, I will. In some circles this is called "Christmas Toe". You go on a summer or early fall hike and can't feel your toes until Xmas. In my case, this has been fairly accurate.

[Brad Groves]

An assenting voice:

Shoes were too small. They've been fine before because you were on more level trails, not jamming your feet on treacherous down-hills for chunks of the trail. I've had shoes and boots that fit great on normal trails, but the first time I wore them on steeper descents my toes would get beat up. The slope and foot placement contribute to forward sliding.

Can be exacerbated by lace control… I've had footwear that didn't really control the foot well that worsened (or created) problems with shoe length. Need to be able to look the foot into place, but without putting too much pressure on the top of the foot…

[Richard Nisley]

Aaron,

1. The temperatures averaged about 45F with frequent showers both days and nights (thermometer on my climbing watch was accurate if I took it off my wrist). On evening above tree line you could see your breath but there was no frost in the AM.

2. My feet were both dry and warm all of the time. I wore silk weight polyester long johns under WPB Kokatat Tempest dry pants (required for the planned packrafting segments after the long bushwhack). For my liner socks, I wore a thin liner sock comprised of 17% coated silver (odor control). My main socks were Darn Tough Vermont trekking socks. Although I carried an extra pair of Darn Tough Vermont socks to sleep in, my feet were never wet or cold enough to switch or add socks. My feet never felt cold even when sleeping or when getting dressed in the morning.

3. When I press or wiggle my toes there is no tactile sensation on the side or bottom outside half (numb to the bone).

4. When I perform a capillary refill test it does go white and then returns to pink shortly thereafter.

5. The skin on the two damaged toes is a darker red than the other toes on my feet. The tissue feels as if it is blistered and calloused internally rather than externally.

A key point is that 4 of the six group members have this toe numbness although we each wore different sock and shoe combinations. I recall that during some of the very steep bushwhack section climbs I felt my curled into the hillside to prevent a slide into the creek below. My Five Ten Runamack (28 oz per pair) shoes have climbing rubber on the bottom (Five Ten's S1). On many climbs less than 1/3 of the shoe was in contact with the face of the ravines.

[Richard Nisley]

Josh,

I haven't seen my Internal Medicine doctor about this problem. I can still walk OK and so I had planned on giving it some more time (30 days) before seeing a foot specialist.

I had thought that with the off trail travel and long distances done by many of the forum members, this group might have more relevant experience regarding the cause and cure versus a foot doctor not familiar with the sport.

[James Lantz]

I had the same thing happen to me last Labor Day weekend on my GSMNP AT thru hike. It occurred on the last day of the trip during a rapid, steep 8 mile downhill stretch. My shoes didn't seem too tight but there was a lot of shock to the feet on that descent.
When there was no improvement after a month, I saw my Podiatrist & he prescribed a prescription supplement called Metanx. I noticed gradual improvement almost immediately & within 2 months the sensation had returned to normal. I am a physician & practice Internal Medicine. The symptoms are due to an injury to a branch of the plantar nerve & the Metanx helps the nerve to recover. Ask your doctor about Metanx. It may or may not help, but it is very safe. I've even seen it help folks with diabetic neuropathy of the feet. Also, it is not necessary to take Metanx for more than 4 months because it will either help or not help in that length of time.

[non yep]

had numb big toes when i had runners too small and also a few times on really long rock climbs, but all times this went away in a month.

also had numb big toes after months of thru hiking and they stayed numb for a few months. and my shoes were not too big then either.

[Henry Blake]

Interestingly, I was just talking to a friend a few days ago about the numbness in his feet.

This is not the cause of Richard's numbness, but could potentially be part of a solution. On the other hand, maybe it's totally unrelated.

My friend is mildly diabetic (controlled with oral pills, not insulin injections). He is 63 and spends all day moving on his feet and in a car driving. He just cut back on the sweets (sugar) he loves a few days ago as he should have been doing all along. He told me he's gotten back alot of the feeling in his toes, apparently as a result of cutting back on the sugar.

[d k]

I've had this before, but the last two trips I did my big toes numb and it is still persisting a month later. I did not get cold feet or have shoes too small, but I think sometimes I tend to let most of my weight and balance point fall on my big toes, rather than the balls of my feet where it should probably be going. I was noticing that I was really digging my big toes into my soles when going downhill. I think I may need to retrain myself to walk or something!

[David Chenault]

Richard, do you think aggressive step kicking with a flexible toebox might have done you in?

[Larry De La Briandais]

Although yours is probably not the same, I have the same problem. Mine is from issues with my sciatic nerve. Ibuprofen (or any anti-inflammatory) makes it better. The numbness in my big toes is less when the sciatic nerve is not bothering me as much, and more when it flares up. probably not an issue for you, but thought I mention it anyway.

[David Olsen]

I had a similar thing happen when road biking with shoes
too small. Full recovery, but as others have mentioned,
it took awhile.

I may be of some relief to know that the others had it too.
IE. you are not likely getting some strange disease of the
nerves etc.

[John Huth]

I had this happen on the outside of my big toes with a new pair of boots. It took about 6 months to subside. I'm assuming it was just swelling in the region that took a long time to go away.

Ice may accelerate the healing, so give that a shot. The good news is that once my books broke in, I didn't have problems with it.

Obviously i should've had the boots originally broken in, but my old pair suddenly had problems delaminating the week before I was scheduled to go out, so I had no real choice but to deal with it.

[Richard Nisley]

Dave,

Yes, that is my tentative conclusion based on some of the forum comments. Only two people in our group didn't loose semi-permanent feeling in their toes. One of those two wore conventional leather hiking boots with stiff soles. All of the rest of us wore various brands of ultra-light footwear that had flexible toe boxes. Climbing the steep canyon walls required semi-step kicks. The repetitive semi-kick step climbing apparently resulted in damage to the toe branch of the medial plantar nerve, as Dr. James Lantz suggested in his forum post. This Wikipedia diagram illustrates the nerve that he referenced.

[Roger Caffin]

> All of the rest of us wore various brands of ultra-light footwear that had flexible
> toe boxes. Climbing the steep canyon walls required semi-step kicks. The
> repetitive semi-kick step climbing apparently resulted in damage to the toe branch
> of the medial plantar nerve

Aha! Oh yes indeed.

My initial thought was that the shoes were the wrong size and that the damage had been done on the DOWNhill, but that was not entirely convincing for FOUR people. At that stage I did not know about the step-kicking on the uphill part.

But step-kicking in UL footwear on the way up – not so good for the toes at all. I would agree whole-heartedly with this diagnosis. One of the limitations.

Cheers – and best wishes for a recovery.

[E C]

My Limmer Lightweights weigh about 1.25lbs each, but I wouldn't wear anything else for backcountry usage or bushwhacking.
Dinosaur footwear does have it's advantages after all!
A speedy recovery to all concerned.

[Jonathan Beitler]

awesome thread, i had the "tingle toes" for 2 months after section hiking the GA-AT, after some time it just went away. I was wearing a pair of Merrell Moab Ventilator Mids (well broken in 75+ miles and i was carrying 43 lbs. After researching solutions it turns out that when i upgraded to more of a boot, a Keen Voyageur MID it never happened again, so i would have to agree that the "softer" shoe may have something to do with cause.

[Author]

Posts