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Replace our shoes to avoid toe capsulitis.

I run between 20 and 30 miles a week, and have been doing so for several years. Lately I have an uncomfortable pain on the bottom of my foot at the base of the second and third toes. It pulls my toes into a curl. I can run through it, but it's unpleasant and I'd like to figure out what it is. I don't have a blister or bruise, and there is little if any swelling. There's no overall foot pain--the pain is localized to that one spot and it's now always there and has been for about one month. It worsens when I run. I don't think it's due to poor shoe fit, because I've tried several different pairs, plus I've never encountered this before in my prior years of running.

"Pulling force" pain between two toes in the ball of the foot is typically associated with a chronically inflamed joint, a.k.a. capsulitis. The structure that holds the joint synovial fluid is called the joint capsule. This can become inflamed and hurt with increased pressure, as when pushing off while walking. This explains why running makes the pain more severe. As your shoe padding breaks down over time, more pressure winds up on the foot with each stride. Be sure to replace your shoes every 300 to 500 miles to ensure adequate support. Alternating two pairs of shoes can make them last longer. In addition, you may ice the area and/or try anti-inflammatory medication. If these strategies don't help, see a doctor who can take x-rays and fit you for an orthotic. Note that a neuroma (inflamed nerve) can occur in the same area, but it is usually described as a shooting pain and is associated with toe numbness. In any case, treatment of a neuroma is essentially the same.

Jeff Saleman Austin, TX

Bradley Wadington, DPM, FACFAS Hendersonville, NC
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Title Annotation:THE CLINIC
Author:Saleman, Jeff; Wadington, Bradley
Publication:Running & FitNews
Article Type:Brief article
Geographic Code:1USA
Date:Jul 1, 2011
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Next Article:Recovering runners, rest means rest.

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