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Toe injury on the trail.

? I am a 57-year-old male runner and recently fell right at the end of an 11-mile trail race. I felt tremendous pain in my left foot for a couple of minutes, and then I was able to hobble the 200 or so meters to the finish. I developed bruising in my big toe (with some blood under the nail) which two weeks later is nearly gone. However, I can sense that I am not able to "toe off" properly when I run. While attempting a few stride-offs recently I was unable to generate much force from the left foot. Can I continue enjoying easy-paced runs and expect the toe to heal itself, or should I take time off in order to allow faster training in the future?

Tony Salinaro, Antioch, CA

A tendon tear or possible fracture needs to be ruled out first. The inability to toe off warrants a detailed examination and radiographs. Unfortunately, I wouldn't recommend any further running until you are evaluated.

Jerry Katz, DPM, Randallstown, MD

My concern with your lack of "toe off" is injury to the flexor tendons, which push down on the big toe. Check the strength of the toe by pushing it down against your hand, then compare it to the right big toe. You can also put the joint through its range of motion (without resistance) and compare that to the other foot. If all is equal without pain, you can gradually return to running at pre-injury intensity. After runs, I would ice the toe for 10 minutes. If these tests reveal that the toe isn't functioning properly, certainly seek medical attention.

Robert Hallivis, DPM, Annandale, VA

Please note that Clinic responses frequently appear as excerpts of longer answers, especially when the inclusion of two full answers would result in redundant information.
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Title Annotation:The Clinic
Author:Hallivis, Robert
Publication:Running & FitNews
Article Type:Brief Article
Date:Sep 1, 2004
Words:301
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