How can I avoid toe tendon pain when hill running?

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 montyjohn 06 May 2022

I've never been much of a runner, but I've been picking up hill running recently. I'm quite enjoying it, but also using it as a way to train for an upcoming mountaineering trip.

I recently bought some brooks cascadia 16 trail running shoes and after a couple of short (2 mile) hill runs in them I've noticed a problem.

The tendons under my middle toes, where they join the foot have mild pain.

This is a problem as I need to continue to get fit but really can't afford it to turn into an injury and my goal deadline looming.

I'm not wearing inserts, but normally need to as I have mild flat feet. Not noticed a problem with my arches.

The shoes are otherwise perfect, and would really rather not buy a different pair, at least not without understand what the problem is.

Has anybody got any experience of this and know what, if anything can be done to prevent this type of injury?

 morpcat 06 May 2022
In reply to montyjohn:

Were you running before without pain, or have you just started running? 

Is the pain linked to hill running? If you run on the flat, do you get the same problems? Is it worse when going up or down hills?

Is the pain linked to the new shoes? If you run in different shoes (or no shoes), do you still get the same problems?

Are there any stresses on your feet? Is the shoe tight on the left/right side (compressing the base of the toes)? Are you curling and pulling your toes in because your foot feels insecure (even mildly)? Has your running technique changed at all (e.g. landing more on forefoot)?

OP montyjohn 06 May 2022
In reply to morpcat:

I'll try and answer what I can.

I believe it's related to the new shoes. I vaguely recall having a small problem in the same area with the old shoes but it was minor. Going back to the old shoes isn't an option as they are rubbish and gave me blisters among other problems.

Only my right foot is affected however. Left feels perfect.

I've only been doing hill running. I haven't been running on flat so cant comment on any differences.

I don't notice the pain when running.I ran on Monday, felt a bit of pain after. it healed. I then ran yesterday, and it's worse today. The pain is so far only noticeable later in the day after the run, and the day after my run. Whilst walking around today, if I curl my toes, the pain goes away.

The new shoes feel great. Like running on fluffy clouds. Not tight anywhere. Don't feel insecure and don't do anything weirs with my toes that I'm aware of. I have been making an effort to keep the laces tight. This may be a mistake.

Only change recently is running on steeper inclines than before. I want to run less on tarmac and more in the woods (which happen to be steeper near me).

 morpcat 06 May 2022
In reply to montyjohn:

Try some runs on the flat and see if you can eliminate between it being the shoes or the inclines causing the problem.

Given that the pain is occuring after a run and fades after 24-48h it could be that it's just some muscles that haven't been stressed in the past needing to adjust to the new activity. However, it being worse on the second run rather than better is not a good sign. I obviously can't tell how much or what type of pain you're feeling, so I can really only say to use some judgment here to stay on the safe side of training. If you think it's close to becoming a lasting injury and you're in danger of pushing it too far, first try dialing back the pace and doing some more relaxed runs to build up the miles and give your body time to adjust.

Post edited at 12:32
 Cobra_Head 06 May 2022
In reply to montyjohn:

Only run downhill.

OP montyjohn 09 May 2022
In reply to montyjohn:

I solved the mystery.

My new fairly expensive running shoes have appear to have given me Mortons Neuroma which is a life long nerve condition.

A bit annoyed with it really, never had a problem before I bought these shoes. They felt super comfortable and I had no clues that there was anything weird going on with the ball of my foot when wearing them.

In reply to montyjohn:

I would go and see a physio before making that diagnosis yourself especially as you don't describe numbness or tingling.

Running in the hills is hard on the feet and legs and particularly if you have had the protection of boots in the past. When I started, I kept our local physio going for a while. I too came from a mountaineering background and was running for training, but now I love it and when work isn't interfering too much my main sport.

OP montyjohn 09 May 2022
In reply to SouthernSteve:

> When I started, I kept our local physio going for a while

Haha, I'm sure he loved his new conservatory.

I am extremely confident however what it is. It couldn't be a clearer match.

  • Feeling of a hard ball at the base of the toes.
  • Foot clicks when compressed form the sides
  • I have been getting a numb and tingling feeling, on and off.
  • Pain varies from stabbing, burning to a dull pain depending on it's mood.
  • It's exactly in the correct place.
  • I do suffer from flat feet so higher risk of it.
  • I can fully bend my toes without making the pain worse. So unlikely to be tendon or skeletal.
  • The big one, and this was amazing, was I learnt how to massage it (good old youtube). You basically spread the inflammation to where there is space between your bones and after 1 minute 90% of the pain was gone and i was pretty much walking normal again. Wish I had figured it out earlier. I've never know such an improvement from something so simple. It does slowly return as i walk around, but pop my shoe off, another massage and it's better again. Weird thing.

I was walking around the house last night, wearing all my different shoes, with different insole configurations, and found that the trail running shoes rapidly bring the pain back whilst my hiking boots and others don't. So that's a plus.

I know it's store policy, but I'm going to ask Brooks for a refund. I'm sure they are fine for other people but on occasion it just doesn't work out.

So I'm doing the exercises (which also are helping) and the massages, I'm going to slowly build up my walking distance along with special inserts and if I can't manage this  condition I'll see a physio to figure out what else can be done.

 morpcat 09 May 2022
In reply to montyjohn:

Oh! My wife has that, and I didn't even think that might be the cause here. You can get shaped insoles specifically for Morton's. Not sure how comfy they'd be to run in though.

In reply to montyjohn:

Opinions will differ on how to train for mountaineering, so I expect a mixed reception here, but I believe running uphill, while it may work, isn't necessarily the best way to train for mountaineering. Given that it is causing you pain my advice would be to STOP NOW,  Injury ≠ Progress. And try another form of training that may be comparably good for your goal that doesn't cause you pain.

Oh and if you ever develop an injury like plantar fasciitis, which I hope you don't... you won't be having a lot of fun and it can be a slow healing process which can really mess with any trips you may have planned

May I suggest you post a fresh thread on best way to train for mountaineering that doesn't involve running up hills (because that is a whole thread/topic in itself).

OP montyjohn 09 May 2022
In reply to CantClimbTom:

> STOP NOW,  Injury ≠ Progress

I have done this. To be honest with the pain I've had over the weekend I had little choice in the matter.

> Oh and if you ever develop an injury like plantar fasciitis

I've had this about 10 years ago. Very painful and lasted a very long time. Fortunately I responded well to inserts and never had a significant problem since.

> May I suggest you post a fresh thread on best way to train for mountaineering that doesn't involve running up hills

Good shout. FYI, my plan is to go on lots of short hikes initially (just completed a 2 mile one today over lunch) and couple that with box step ups for a while (which I won't find particularly fun). I may well avoid running all together as i just can't risk an injury this close to my trip.

In reply to montyjohn:

Without straying too far into the stuff I said should be in a different thread. My tip for now will be ankle weights that are a heavier than whatever boots you plan to wear and then the next tip is football socks to avoid/reduce ankle weights rubbing your ankles. Sorry but ankle weights are going to make box step ups even less fun.

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