[pct-l] sore feet

[charliethorpe@worldnet.att.net (Charlie Thorpe)]

Hello Charlie and bj -

Charlie said:

>I had developed a sore spot also (on the side by the base of the big toe,
>just above the ball of the foot). Friends thought it might be a bunion...

bj said:

>...Your post describes a classic bunion... <<followed by a great
>discussion on hiker's bunions>>

I think that I threw you guys a curve!  My soreness "bump" seems to be on
the top of the joint at the base of the big toe, not on the side.  I had
looked at a grisly poster showing a cross-section of a bunion in the
podiatrist's waiting room (who says you have to wait in a HMO?) and had
wondered if that was where I was headed.  If I understood the poddoc right,
the bunion bump is on the side of the toe joint where the dislocated big
toe gets pushed over.

The finger-pointing to show me my problem was done on an x-ray looking at
the toe/foot joint from the side where the bunion bump would have been if I
had one.  I was shown a ledge of bone at the top of the socket(?) that the
toe-bone fits into.  The opinion was that this ledge was built out too far
(toward the toe bone) at the part of the socket closest to the top of my
foot...such that my toe bone bumped into it when it tried to bend straight
back/up.  The protruding ledge kept my toe from bending back as far is it
apparently should be able to.

I just rooted around and found a copy of Gray's Anatomy that one of my kids
left here at the house.  If I am remembering my poddoc discussion right and
if I am reading that most-interesting book correctly, I am talking about
the joint between the head of the right foot's 1st metatarsus and the base
of the 1st phalanges.  The offending "ledge" that is keeping my big toe
from bending up and back as far as it should is on the top of the head of
the 1st metatarsus.

I didn't see all that much difference between how far back my two big toes
would bend, so being the skeptic that I often am, I went around to a couple
dozen friends to see how far their toes would bend back before they hit me.
It does seem that their big toes can bend back a bit more than mine can.
BTW, I also noticed a few opportunities to teach a little "airwashing"
technique...

The soreness that I have been experiencing is generalized over the entire
joint at the base of the big toe...I haven't noticed any specific "hot
spot" like I had on my heel.  I have noticed a VERY direct relationship
between how sore the joint gets and how "low" the ball of my foot is in
relation to the rest of my foot.  Raise the ball, the soreness goes
away...lower the ball, the soreness returns.

I played around with pieces of duct tape on the underside of the
"SuperFeet" insert (right below where the ball of my foot rests).  At first
I built up just the area under the base of my big toe....MAJOR discomfort
from the entire front of my foot.  I then tried building up all the way
across the ball of my foot from one side of the insert to the other.  I
used 1/2 inch wide strips of duct tape and added only one or two (sometimes
overlapping and sometimes side by side) each time.  I would hike for a day
or two between adjustments.

At first, I kept getting better with each adjustment and then my comfort
quit improving as I added more layers of duct tape.  I guessed that I was
doing the build-up too far back, so I started adding the duct tape layers
(each strip still went from side to side) a little farther forward.  After
a while the area around the joint quit hurting, so I covered the little
strips of duct tape with full-width duct tape and quit fussing with it.

At least a couple of times in the next 300+ miles I noticed the pain
starting to come back and I took the insert out to see what was wrong.  In
each case, the whole build-up of duct tape had shifted slightly toward the
back of the insert.  I just repositioned the build-up and the pain went
away over the next few days.

Now that I am back in town, I switch the inserts around as I wear different
shoes.  I have noticed that the pain is starting to come back and the duct
tape seems to be in the same location that had been working in my hiking
boots.  Perhaps I will have to work up a set of inserts for each pair of
shoes or only wear my hiking boots...or better yet, go find an expert who
really knows how to build a good orthotic insert!

I am guessing that my podiatrist was probably right in suggesting that
surgery could possibly relieve the problem.  My head tells me to wait to
see if non-surgical options work out.  My gut feel is that surgery ain't
gonna happen unless the pain gets so bad that it slows me down enough for
the guy with the knife to catch me <g>.

- Charlie II  AT (MEGA'93)
             PCT (Mex@Can'95)
     Chipping away at the CDT



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