Sore feet

[Christopher *]

Several years ago I experience serious pain and swelling in the balls of my feet at the end of a 2,600 mile thru hike. In retrospect, I suspect a plantar plate injury (tendons under the toes). I was lucky that it just seemed to resolve itself when my hike was over.

Recently however a similar pain has returned. It is not at the intensity I felt several years ago, but I want to try and get ahead of it if possible. I presently hike around 75 miles a week in PA, where the trails are typically very rocky. I wear either Altra Lone Peaks or LaSportiva Wildcats with a thin Darn Tough mesh running sock.

My questions:

First, are there better footwear choices I should be making to protect the balls of my feet? I have tried Superfeet, but the plastic plate terminates right at the ball of my foot, and seems to make matters worse. Are there better inserts, socks or shoes I should consider?

Second, are there specific stretches or exercises I can do to prevent a plantar plate injury? My google-fu yield only ways to tape my toes.

I tried the search function here, but most relevant results seem out of date. I know there are a lot of people who get a lot of trail time here, as well as experts like Jen, so I figured I’d ask the question out loud.

Thanks in advance!

[Christopher *]

Ugh.

I meant for this to go in general, not gear.

Sorry Ken!

[D M]

I grew up in PA so I know the terrain. First I would go see a good podiatrist to rule out other causes like nerve damage or neuromas. These suggestions on changing your footwear are probably not what you want to hear, but I have lots of experience with sore feet ( I also put a lot of strain on the ball of my foot and wear out smart feet there like crazy), and PF.  This is if you want to continue to train. You probably need to switch to a harder sole/shoe/boot for at least a time span that will allow your feet to heal. I went with Danner boots, lighter models, which take some time to soften, but once done fit like a glove. Really any shoe/boot that will give you more protection will do. Remember it’s only temporary. If your feet are wide Keen work styles and the widest Danner EE lasts are best, (call them) the military styles and one hiking boot. The Keens will require replacement sooner as they go soft and loose support after about 700 miles. Danners last forever (practically) and if the soreness rears it’s head again they will be there for you all broken in. And being winter now it might not be so bad. My next suggestion is to focus a ton on stretching, doing the PF stretches religiously, use ice when you return from walking and massage and possibly your favorite vitamin I (aspirin, ibuprofen) to relieve inflammation or turmeric or other natural things that reduce inflammation. Rolling your calves with a hard foam roller may also help as it alleviates tightness in the whole bottom of the feet. My third suggestion is to reduce your milage for a while to accelerate healing, especially if you are going to get used to using different shoes. All of these things greatly helped me after my first and the following years of over 2,000 miles on the PCT and the CDT. It’s no fun but you must treat it like an injury, otherwise you set yourself up for a lifetime of problems. After healing, gradually go back to the shoes you prefer. I did the above in the course of four years of thru hiking and now am healed (along with some physical therapy) and thru hikes are so much more enjoyable as I know what to do when those first little twinges start and they get less and less each year. Just some friendly advice, YMMV.

[matthew k]

I have found Sole insoles to be superior to Superfeet for me because the stiff portion goes under the ball of my foot.

[Bob Shuff]

I get custom orthotics every year that I meet my deductible – so every year as of late.  The have new scanning and manufacturing methods every year.  Not that long ago they would make a mold in  doctors office.  Now I relax my feet and they wave an iPad with a camera/scanner attached to it in front of my feet.

I asked my doc for some extra padding,  specifically for hiking.  I was also thinking of getting some new boots.  I’ve been using Hoka One One and now New Balance max cushioned trail up to now.

The custom orthotics give you much greater range and options in what shoes will fit.  They just have to have removable insoles of about the same height as your orthotivs.

[Christopher *]

Thanks for the tips! For the past few years my employment situation has allowed me to keep up a good weekly mileage, and I would hate to have to stop cold and squander the time while it is mine.

I figured I might need to start working in a stiffer soled shoe/boot for recovery. I’ll check out the Danners. I appreciate the insight regarding PF stretches … for some reason I wasn’t connecting the dots to look for PF specific stretches to alleviate pain as far forward as the ball of my foot.

I will also check out Sole inserts … I’m encouraged to hear the plastic extends further than in the Superfeet models.

I’m also happy to hear a podiatrist visit may not be terribly complicated, although I should admit I am deathly doctor-phobic and probably won’t go unless my feet are literally falling off … even then I would probably debate the need.

Thanks again!

[D M]

Yea, I know how you feel, I didn’t go to a doctor until I had such pain I thought I’d broken my foot. But then I found a sports doctor that is also a physical therapist and he’s worth his weight in gold. :-) We did do custom orthotics ( collapsed arch and PF ) and that helped for about eight months, then my feet got so strong they changed again so I was able to use over the counter smart feet again. Hope you feel better soon!

[matthew k]

I’ve been suffering from PF since last spring. It’s finally improving and I think it’s foam rolling that has finally given me relief. My $.02 is get on the roller ASAP!

[Andrew Srna]

Just my opinion, but i would try ditching the superfeet, go with a standard neutral insole, and a slightly thicker sock. Or buy a pair of Lunas and wonder why simple things take so long to realize.

[Rich G]

I had some similar problems after hiking the Standing Stone Trail last spring.  I had blisters under the calluses on the balls of my feet and some pain from  probable neuromas.  I found Saucony Xodus trail runners to be a good shoe because of the Vibram sole.  I also use stick on pads to help heal the worst problem areas.

 

[Christopher *]

A foam roller actually officially made my Christmas list last night! I tried rolling out the offending foot with my dogs tennis ball, and it felt WAY too good … so I think it’s on the right track, although my dog thinks otherwise.

I’ll have to check out the Xodus. I might be wrong, but I’m thinking it might be good to have a stiffer shoe to rotate in every once in a while for recovery. I don’t think going in a direction like the Luna’s would help, particularly considering I’m in Rocksylvania … but again I could be wrong.

On another note I had not heard of the Standing Stone trail, so thanks for a lead! Its a bit too far for my daily hikes, but looks good for a weekend trip!

[Mark]

You really need to visit a professional, as if you chase the wrong problem (PF or bruising from the trail) it will have consequences.

I did a search on the shoes you are using, the Wildcats seem to have a 12mm heel-toe drop, for me that’s a massive drop, you’re effectively walking in high (ish) heels, i’m not surprised the balls of your feet are taking a pounding.

On the other side though the Lone Peaks are 0mm drop

 

If you find the pain is from the pounding you’re getting from the trail then a chance of shoes is a easy fix, different shoes will offer various solutions, less heel-toe drop, rock plates or more cushioning will all help.

 

If the pain is from a PF injury then it’s a bit more difficult to fix, one thing i’ve found is that if i tighten my footwear too tight i get PF flaring up, by keeping my laces fairly loose this pain goes away.

The effect is pretty much immediate for me, i’ll be running and start to feel my PF hurting, i’ll stop loosen my laces and not have the same pain again.

Might be worth a try if your podiatrist diagnosis is PF

[Rich G]

The Standing Stone Trail has awesome vistas inter-spaced with some rather dull connections.  The two endpoints were the highlights along with the 1000 Steps area.  The camping options are not great in many areas.

[Bob Shuff]

One note of caution.  The first podiatrist I saw, recommended surgery for PF.  I heard him tell the girl in the next exam room exactly the same thing, and mention it for a third patient to a nurse in the hallway, over the course of 10 minutes.  He said stretches were of little lasting value.  I luckily got a second opinion. I hope his other patients did the same.

The  doctor I saw next has been my podiatrist for 10 years.  His prescription was active recovery, including some rest and stretches, ice and ibuprofen when needed, and orthotics.

It’s tough to break a healthy routine, but there are other exercises you can do while taking it down a notch on your feet.  Core training is never a bad idea.  If course do as I say…

[Don Burton]

I’ve worn Xodus’s in the past and still love them but switched to Altra Olympus after starting to suffer from PF. I’ll still wear the Xodus is I know there will be a lot of scrambling though.

The Olympus combined with stretching and foam rolling has pretty much eliminated my PF. I’ll feel it flare up a little if I’ve been hiking a lot and get lazy and don’t stretch. Mainly, stretching out my calves in various ways takes care of it. Tight calves pulling on those tendons reek havoc.

Good luck

[Christopher *]

I wanted to say thanks again for the tips, but my reply keeps disappearing! One more time.

Thanks for all the tips!

The calf stretches seem to be moving in the right direction. I hadn’t even noticed they were getting tight, but now I’m being more present of mind.

I also appreciate the tip on adjusting my lacing. I’ve been focused on really locking-in my heel and mid-foot, and that might be part of my problem. I can’t believe I didn’t consider it!

I’ve looked at the Olympus and may give them a shot once my current pair of Lone Peaks gets retired.

I have heard of the Thousand Steps, I just didn’t realize the name of the associated trail network. Definitely on the list for a weekend!

Thanks again.

[Scott Nelson]

I had pain in the ball of my foot that I tried for too long to endure. Finally, I went to a podiatrist and he saw on an X-ray that I had broken small bones in the ball called a sesamoid.  They act as small pulleys to gain leverage in the tendons to push off with your big toe.  With lots of rest and Ibuprofen the cracks healed.  A sesamoid pad that adhered to my foot helped, too.  Surgery sometimes is needed.  Mine were caused by overuse.

I wish I had gone to the podiatrist sooner. I’ve since moved on with him fixing my ingrown toenails permanently in 10 minutes after years of pain and infections.  But that’s another story…

[tom lakner]

Hiya,

Had the same problem years ago , and found a pair of Dr. Scholls gel inserts. Problem was sol-ved.I’ve used them as my default with  the Lone Peaks. This fall I got a set of custom orthotics that i’ll try on the pct ,but will be aware of where i can get the dr. scholls.Hi Ed!!

Tom L(Sunte)

 

 

[tom lakner]

Hiya,

Had the same problem years ago , and found a pair of Dr. Scholls gel inserts. Problem was sol-ved.I’ve used them as my default with  the Lone Peaks. This fall I got a set of custom orthotics that i’ll try on the pct ,but will be aware of where i can get the dr. scholls.

The custom orthotics are due to too much kicking into snow on the pct in Oregon. SOBO . Messed up my right ankle badly.Hi Ed!!

 

Tom L(Sunte)

 

 

[Christopher *]

I just wanted to follow up on this thread.

I’ve been taking the time to stretch. I’ve also taken Mark’s sage advice to loosen my lacing and that appears to have been a BIG source of my trouble!

Amazing!

I ran a 12 mile rocky loop yesterday (pictured above) and my feet are feeling fine!

Thanks for the advice!

 

[D M]

That’s great! Happy trails to you! (and your pup!)

 

[Christopher *]

Haha. She is such a ham. She literally photo-bombs every shot I take!

As soon as the phone is out for a pic, fuzz-butt is front and center.

[Mark]

Pheewwwwww, it’s not just me and my odd feet then :)

Amazing how something so simple that 99% of people don’t even think about makes such a difference isn’t it.

[Mark]

One other thing i’ve found.

If i wear the same pair of shoes for most of my running i tend to get various aches, pains and injuries.

With my Hoka’s i tend to get niggly hip and knee pains, with my minimalist shoes it’s various pains with my feet and oddly different knee aches (i say oddly cause it’s not the same areas of pain i get with the Hoka’s).

Found if i wear different shoes each run i don’t seem to get these niggly pains and aches.

My theory is, if i wear 1 pair or style of shoes for so long my body adapts to them, so i start getting weak areas or areas that are stressed more like ligaments or tendons.

As i’m not a doctor i have absolutely no idea if that’s realistic theory, but it’s the only thing that seems to make sense to me.

I’ve got 5 pairs of different running/hiking trail runners i try to rotate through them all so i wear a different pair each run, sometimes this is not possible, maybe i’ll need to wear my Salomon speedcross 3’s for a week or so cause it’d muddy and i need the grip, so real life interjects but generally i find if i rotate my footwear i’m getting noticeably less injuries, aches and pains (beyond the usual ones for a overweight 47 year old stupid enough to try running)

[D M]

Most long distance walkers/hikers find that by the end of the hike (I’m talking PCT or CDT or whatever is over 2,000 miles in one shot) that the best thing for the feet it to have something to switch into and wear as opposed to always wearing the same type so as to mitigate the overuse syndrome many of us get. Some use Crocs, some use sandals, some have another pair of runners. By Cascade Locks many NOBOS had an extra pair of shoes tied to their packs. Not to say there are not folks who have found the holy grail shoe that is the one that is perfect all of the time, because I have seen that also. It’s just my observation that by the end of long hikes people who have gone the distance usually have two pair to rotate. I’m approaching 60, but my brain says I am still 25 so I have to be careful of overuse injuries, so when my feet need a bit of a change up as long as it’s comfortable I will do so. I did one very rocky thru hike, the AZT, half in Chacos and the other in my normal hiking shoes, it really helped my arches and kept the muscles healthier in my legs and feet. Gave my feet some fresh air too!

[Author]

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