October 8, 2013

Why I Skipped My Long Run This Weekend

by Anne Mauney, MPH, RD

73 comments

So… I skipped my long run this weekend, guys. After the past couple really long runs, I’ve been having some irritation in my right outer foot. Nothing serious, it just felt like it was bruised almost, and would go away a couple days later, no problem. But on Sunday night, when Matt and I were back from our 1 year anniversary trip and setting out to do a long run (he wanted to join me since we have the Tough Mudder coming up in a week and a half), it was NOT feeling okay. I think our really hilly 20 mile bike ride on Saturday must’ve irritated it further. I stopped a quarter mile into the run and told Matt to go on without me. Blah.

Here’s where it hurts:

IMG_4530

I’m 99% sure it’s not my shoes, although I think I’ll start tying them more loosely. I wear the Brooks Ravennas and have been wearing and loving them for a year now, and never had any problems through multiple half marathons in the spring. I honestly think I’m just getting to that point in training where things are started to get irritated from all the mileage.

This was a step down week for my Richmond marathon training, so after doing 19 miles two weekends ago and 20 miles last weekend, this past weekend was going to be a “short” 12 miler. (I know, so ridiculous that 12 miles now is on the “shorter” side of long runs.)

My foot was bugging me a little after the 20 miler last weekend, but I did 5 milers on both Tuesday and Thursday and about 3 miles (+ some boot camp moves) on Friday morning with Matt, no problem, so I think it must have been the bike ride and all the pressure on my foot from going up so many really steep hills that irritated it again.

So – any advice? My foot feels 100% fine to walk on, and again, it doesn’t feel like anything serious, just like some bruising and tenderness, but at this point in training I’m really cautious about overdoing it. I got in a nice swim yesterday morning as my workout, and today I skipped my scheduled morning run and will probably do kickboxing or something instead. Tomorrow is a yoga day. That brings me to Thursday – I think I’ll try to run that morning and see how it goes, and assess the long run situation from there. I’m supposed to do another 20 miler this weekend – eek! Fingers crossed my foot is fine by then. I’m planning to ice it some this week, too, in case that helps.

Would love any input you guys have! Has anyone dealt with anything similar?

- anne

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73 comments
  • So sorry about your foot! I'm interested to know about your training plan. In another post you described doing 19, 20, this missed stepback, and then a couple more runs in the 20 range? Most plans for less experienced marathoners I've seen only have 2 20-ish milers. Just curious. :D Sending you super power healing thoughts! ps. I ran my first on Sunday and it was the best day of my life. I have no doubt yours will be too!
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    • Hi Shauna, you can read more about my training plan in this post: http://www.fannetasticfood.com/2013/07/17/marathon-training-plan-injury-prevention-nutrition/. Congrats on your race - that's awesome! :)
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  • Sounds like peroneal tendonitis. I struggle with the same thing - starts feeling like a bad bruise and can get to the point where my foot feels broken. It comes from tightness in your lower calf/soleus. Google the 'peroneal tendon' and you can see where it runs down your leg. I've also had luck with KT tape. Rest and lots of rolling is what helps me when it flares up! Good luck!
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    • This sounds exactly like what I have - I ran a half marathon a few weeks ago and felt totally fine, just regular muscle soreness in my thighs, but then a few days later it felt like my foot was bruised and very tender to walk on. I actually went for x-rays because it felt like something was broken. How long do you usually let it rest for when it flares up?
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      • I've never had anything like this happen (before I've always dealt with knee stuff), so I'm not sure how long I'll rest - we'll see!
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    • I went through a bout of peroneal tendonitis in 2011 while training for my first marathon. That area that you are pointing to is where the tendon starts (attaches) and it goes up the side of your ankle and along the side of your calf. You might even feel pain at other areas along the tendon. icing helped a ton. I ended up with accupuncture/pressure which ultimately healed me. And now anytime I feel the slightest signal of discomfort I massage my leg just below the knee on the outside of my calf and roll that outer leg from the ankle to the knee with a frozen bottle of water. Be careful with kickboxing....being on the balls of your feet for an hour long class might tighten that tendon and make it ache. But exercise in general is good because blood flow is very important for tendons to heal. Good luck. And of course this is only my personal experience but I agree with sarah above=)
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      • Thank you for the advice! And I thought better about kickboxing for the reason you noted and ended up sticking with yoga today instead!
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  • Hi Anne! I think you're right that at this point in your training your body is just a bit tired after all the mileage. I'm running Chicago next weekend (!) and have dealt with aches and pains like that before, in addition to a more serious IT band issue. I think the best things to do are rest, ice (freeze a water bottle and roll your foot on it - a good way to actually ice the part of the foot that's sore), and stretch. I like this stretch (http://www.uofmhealth.org/health-library/zm2222) for a good calf and foot stretch. You seem SO on top of your training so I think a few rest days will do wonders and you'll be back on track! Good luck!
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  • Be careful in case it is a stress fracture. I had 2 during my half marathon training and it starts that way. Ice rest and elevate!
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  • I wear the same shoes and have been feeling pain in the same location! I have been wearing Ravenna's for over a year and I started to feel this pain right after I replaced them (my third pair). I iced, dropped my milage, and continued to cross train. It went away after about 2 weeks.
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  • Hi Anne! I'm around the same point in marathon training and am having problem with the opposite side of my foot after wearing Brooks PureFlows. I've resorted to aquajogging for this week after a I had to race this weekend Vibrams (luckily no pain when I where the fivefingers). Both a change of shoes and cross-training seem like good options, although I wouldn't recommend a lot of running in Vibrams if you're not used to them. Good luck & hope we both get better ;)
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  • Hey Anne. Something similar happened to me towards the end of my last half marathon training. It ended up being that my hips were way out of allignment which was causing some crazy nerve pain (kind of like a pinched nerve) and manifesting all the way down at my foot. I would have bet good money it was a stress fracture. I went to my very trusted chiropractor and after 2 adjustments, a few days of rest and some gentle yoga focusing on my hips it was like nothing ever happened. So, if you have a really good chiro (ideally trained in sports medicine) I would start there! A $40 office visit was well worth getting me back to training after only a few days
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  • Hey Anne! I got pain in the exact same spot but on my left foot after running MCM last year. I didn't have any foot pain before that and all throughout training (most of my pain during training was in my hips), but that marathon did something to my foot. I took a few weeks off from running and it healed on its own. I was terrified it was a fracture so I was careful not to push it. Perhaps you should start your taper early? You're definitely ready endurance wise you just have to stay healthy until the big day. Best wishes!!!
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  • Missed long runs definitely happen along the way sometimes. It's nice that it was just a step back week and sounds like you handled it the smart way by resting instead of making things worse. I had something similar while training for one of my marathons. I had an x-ray to rule out a stress fracture and then the doctor just suggested a few days of real rest, lots of ice and taking 2 Aleve in the AM and 2 more in the PM - apparently that's equivalent to prescription strength pain meds. I don't know if that's actually true, but is what he told me. Hope your foot feels better quickly!
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  • I just bought those shoes!! Do you ever use KT tape? I get top of foot pain not side of foot but I have become a KT tape junkie :) I hope it feels better soon!
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    • I have a sample of KT tape from a conference but haven't tried it - I think I will now!
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  • Hi ladies, It sounds like the remedies are sounding good. I'm of the belief as well that it may be the mileage. A running friend of mine periodically reminds me to follow the 10% rule: increase your weekly total mileage no more than 10% as this can elevate the risk of injury. Also, as it's noted already, the RICE acronym is an excellent remedy: rest, ice, compression, elevation. Speaking of which, I suggest trying some compression sleeves for your long runs if you never have. I've found them to be very beneficial and not merely create a placebo effect. Best wishes as your training continues. -Austin
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    • I'm a big fan of compression sleeves already - agreed! Thanks!
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  • Oh no! I'm so sorry and hope that it gets better soon! I can definitely relate- something similar happened while I was training for my first half marathon. It ended up with me in a boot and orthotics. Not encouraging, I know, but it looks like the people above have some good advice. Try that or seeing an orthopedist or podiatrist if it doesn't clear up. Best of luck!
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  • Did you get new shoes and not break them in? Or need new shoes? Try those foot rollers, they are awesome. Also, ice and rest a little! Maybe a CEP foot compression sleeve for a little "hug for your foot"? Good luck on your marathon!
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    • No, I got these shoes in June/July, so it's not that. I'll try a foot roller, though! I have compression sleeves and love them, but right now compression socks are pressing weirdly on my outer foot so that doesn't seem to help...
      Reply
  • I had issues with knee pain, and I found that I was able to finish my marathon so long as I didn't overdo it on training. I ran about twice a week, and wouldn't recommend it....but it got me over the finish line, so I was happy!
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  • i'd bet minor tendonitis or some sort of cuboid syndrome http://www.sportsrehabexpert.com/public/500.cfm. no matter what it is, ice, rest, and perhaps some taping? will probably help. get better!
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  • I have a feeling it's the mileage and perhaps biking irritated it. I agree with others that a good calf stretch makes a huge difference in many cases. I have one of those calf stretchers and that's helped me immensely. (That and "drawing" the alphabet with my foot) Also soaking in ice water has helped me with foot pain. I haven't had outer foot pain before, but when I had inner lower leg pain I added some superfeet insoles to my shoes and the pain went away after a few runs. You might see if that helps any ... my boyfriend was at the outdoor retailer show in Salt Lake City and apparently the superfeet work not to support arches, but to actually support bones back by the heel that spread apart when you run? I don't know but I guess that can cause some foot paint too. I hope your feet start feeling better soon!
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    • Superfeet are Great!
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  • If you're biking a lot, you might want to consider investing in bike shoes and clipless pedals. They have a lot of advantages, but the main one for you is that by connecting your feet to the pedals, it allows you to pull up on the pedal on the back stroke so that you're pushing down less on hills to go the same speed, thus saving the bottom of your feet some work/pressure. I have Shimano PD-R540 pedals. You can pedal with normal shoes on the clipless pedals and you can also remove the pedals and put back on normal pedals in 10-15 minutes depending on how tightly they're on.
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    • At this point, I'm not biking enough that it would be a worthwhile investment - but I'll keep that in mind for the future for sure!
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  • I had peroneal tendonitis and that is exactly what it felt like for me. I went to a podiatrist but nothing he did really helped. I went to my chiropractor. He loosened things up for me and told me to stretch my calves really well and ease back into running. Read up on stretching your outer calf area (it is a hard place to stretch). He also had me use my knuckle to massage around my outer ankle area. It really helped tremendously.
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    • Very interesting - thank you for the tips!
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  • Sorry to hear about the foot issue. In the long run, if you think it is biking causing the issue, maybe get fitted for bike shoes and get clip-in pedals. Make sure the bike shop looks at your cleat position. In the short term, go see a physical therapist ASAP. They have a lot of tools at their disposal to speed the recovery process. I went to one for a hip issue, and they were very aggressive about treating it, to the point that I didn't even have to miss a single run. Sport and Spinal Physical Therapy in Foggy Bottom - just go. They're amazing.
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  • Hope your foot feels better! It's smart to listen to your body and take it easy for a week, then see how you feel after some rest.
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  • Sorry to hear about your foot pain. I feel like with marathon training there comes aches and pains. Sometimes I ask myself why do I keep signing up for marathons haha. I have been feeling a similar dull pain on the side of my foot while training as well. I have been doing some extra cross training as well and an ice bath for my feet after the long runs and then compression socks, which I know you use. The KT is Great, I would recommend trying that too. Remember to train smart, take the time you need to rest your foot so you can get to race feeling great! Hope to see you at Richmond!
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  • Sorry to hear about your foot! I had some foot pain for awhile this summer. It tied back to tendentious/plantar facetious. Try rolling your foot on a lacrosse or tennis ball to loosen it up. I also agree with all of the calf stretching suggestions. Mine was improved a lot with that. Good luck and don't stress the missed run!
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  • I second the commenter who suggested rolling your foot on a tennis ball - did wonders for my feet when I was marathon training last year!
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  • Definitely agree with the other comments about your peroneal tendon! I had the same exact issue on the same spot on my left foot after my 18 mile run. I had been exaggerating my pronation, thinking it would help with some IT band irritation. It did not, and my podiatrist "grounded" me from running for about 3 weeks after basically telling me I was an idiot. What DID help was a ton of calf stretching and actually getting out a rolling pin (poor man's "stick") and rolling out my calf and hamstring every few hours. Putting my foot in a ziploc bag and dunking it in a bucket of ice water for as long as I could stand it after every run also helped a lot. I know it is not what you'll want to do, but consider giving it another week of rest and doing some water running and swimming in the meantime. I'm sorry you're dealing with this- hope my advice helps :)
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  • I wouldn't worry- missing a long run (during a step back week especially) wont derail your training at all. You have an incredibly strong base. I stress fractured my heel last year after making the wrong decision to run through the slight pain I had... My advice is to wait until you're pain free for your next long run- mine started as a subtle nagging pain and quickly escalated when I didn't rest it. The crutches/boot were not so fun. Neither was the DNS at The Nike Women's Full and CIM! Hope you feel better!
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  • Same thing happened to me and I was told it was over use...too much extensive walking and running without adequate rest in between.
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  • Does it feel like you need to crack your foot but can't?
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    • No, it feels more like a bruise just in that one spot - outer foot.
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  • Awe man sorry you have an nagging injury like that. I have runners knee so I know how that can be, when my knee is bothering me I normally swim. BUT there is also "Yoga for Runners" class up here in MA, not sure if there is one near you but those are always good because they focus on runners injuries!
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  • I'm dealing with the exact same situation except on my left foot. It hurts in the same place and after a 10 miler one morning the pain moved into my ankle and I could barely walk. I'm also running Richmond and our training schedules sound similar. I nixed my 20 miler 2 weekends ago and gave myself a few days of recovery. I ran a half last weekend and everything seemed to feel okay- so I'm resuming cautiously with the training. Not to freak you out, I talked to my brother who is in PT school, he said that is a common location for the start of a stress fracture. Apparently that bone can get weak with the constant pounding so it breaks. I would say rest a few days and proceed with caution.
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  • I'm actually dealing with a very similar foot problem right now. I'm not sure if it's quite the same thing though because mine still kind of hurts when I walk sometimes. The less I'm on it the better it feels though so I'm just trying to take it easy with the hope that it'll go away soon.
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  • I've had that before Anne! Just took a day or two off the normal running schedule, iced at night, and put some inserts into my everyday shoes (not my running shoes) for extra cushion/comfort. Good luck! You'll be good to go on Thursday!
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  • My fiance and I both use Brooks, and we both experienced a similar pain in a different location of our feet. I would strongly suggest that you try another pair of shoes for a few runs to see if it goes away! I loved my Brooks up to that point, but I'm not sure that I would buy another pair after that. I know someone else who runs in Brooks and had the same problem too! And plus, you are running a lot...I'm sure the mileage isn't easy on your body! Sure hope you feel better soon.
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    • That is really interesting, Trixie, because it's also the reason I left Brooks - I had the Ghost 5 and ended up with the exact same kind of foot pain that Anne is describing - same place, felt like a bruise, etc. NOT fun - and everything I read about it indicated some kind of tendonitis. I SO wanted to love the Brooks!!! I ended up going back to Asics 7 months ago (Gel Kayano 19's) and I haven't had a twinge or bit of pain since! I just figured Brooks were not the right shoe for my feet.........
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      • Tricia, that is so strange...I had the ghost 5 as well. I feel the same as you...I really wanted to love the Brooks, because they felt amazing at first. It seems like they must "break down" faster than other shoes? I used to use Asics, and like you, never had pain!
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        • oh wow! that is bizarre- yes, they did feel amazing at first - I broke them in for 1 month, did fine but then got down to Florida and started running outside more on spring break and that was it - painful knees, feet were hurting and none of that had EVER happened with my Asics. The Ghosts also seemed to run wide, and my foot is not a strict "narrow" but runs narrow, so Asics work so much better for me. What do you run in now? Sounds like we have similar feet!
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          • Wow, my feet must be similar to yours! I have slightly narrow feet as well! I'm actually shopping around for new shoes right now...I loved my Asics Nimbus, but maybe I should try the Gel Kayano!
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  • Hi Anne! Not sure if anyone said this already because I didn't read through all of the comments, but it might be redirected pain from tight hips. I had the same thing in my left foot (exact same spot) after having some left hip issues. The chiropractor was able to help me a lot, along with yoga (lots of hip openers) foam rolling and rest. Once I fixed my hip, the foot pain was gone! Hope this helps :)
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  • Could be a number of things: tendonitis, stress fracture, nerve issues, etc. Many physical therapy/sports medicine clinics offer a free injury consultation that you should think of doing. I work for a physical therapy company and we do it every day of the week and help out a lot of people! Could save you money if it's not a big deal AND could save you further injury if it is! Good luck! I'm starting training for my first marathon in February!
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  • High five for listening to your body!! It's hard not to get so caught up in the plan that you think you "have to" finish every run exactly as listed, or else you won't succeed in your marathon. But when our bodies tell us to make adjustments, we've gotta suck it up! I've never had pain there so I can't help, but I'm crossing my fingers that you feel better soon!
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  • Well done for listening to your body! Hard sometimes! I have/had Morton's neuroma. It started as a niggle sort of bruised like pain in the side of my foot but radiated underneath. Not sure sounds a little similar...google it and see if it sounds the same!
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    • My issue is in the outer edge of my foot, not the ball, so I don't think it's that... hope you are better soon!
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  • I'd say the best thing you can do is what you're doing - stay off of it as much as possible. Ice it and maybe get a foot massage if that would feel good.
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  • the most common running injuries at that spot are peroneal tendonitis, stress fracture of the 5th metatarsal, and a subluxed cuboid bone. I am a physical therapist, and am seeing many runners here in chicago for these injuries right now! don't wait around to get it checked out. many physical therapy clinics will offer free injury screens. find a clinic close to you and have a professional look at it. better safe than sorry, best of luck!
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  • Hi Anne - My brother (lives in DC as well) just hurt the side of his foot during a run club. I'm not sure you have a bone contusion (what he had) but definitely worth it to get it checked out and x-rayed. In Matt's guest blog post on my blog he talks about his podiatrist in DC too: http://marriedandmarathoning.wordpress.com/2013/10/05/matts-guest-blog-the-time-i-was-90-sure-i-broke-my-foot/ He has it wrapped and was told to take a week off from running. Good call to rest it. Is there a visible bruise or it just feels bruised? -Kathleen
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  • I was also going to suggest tendinitis. I use KT tape and it helps immensely. For a while I was afraid I would have to quit running until it healed, but as soon as I used the tape I could run without pain. I had to wear the tape constantly for a week or so, but now I only use it for long runs and races as a preventative measure.
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    • Is there a place online that shares how to use the tape? I'm clueless :)
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      • Here ya go! http://www.kttape.com/wp-content/uploads//KT_Instructions_Peroneal-Tendonitis1.pdf Their website has application instructions for the most common uses. I was using it for posterior tibialis tendonitis and had to google instructions, but it did seem to help (if you can get the tape to stick - follow the instructions EXACTLY regarding stretch/no stretch, and rub the applied tape using the paper backing to heat up the adhesive and get it to bond better.)
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  • I'm so sorry Anne. I've fractured my pelvis two years in a row during marathon training so I know it can be extremely frustrating to get injured after putting so much time in. I'll send good thoughts your way and hope you're healed enough to run!
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  • I had the same pain and initially thought it was peroneal tendinitis. It turned out to be a muscle bruise. My orthopedic doctor said he sees it very rarely, only in runners and it pops up when you run in old shoes. I had done one last 10 mile run in my old shoes and then went that day to buy new shoes. That was enough to do it.
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  • Hi Anne! I'm in sort of the same situation, but with my right ankle. I ran 20 miles two weekends ago and 12 miles last weekend without any problems, but since then my ankle has felt majorly bruised. I was supposed to do another 20 miler on Sunday and then taper for MCM, but I had to stop at 6 miles. I'm planning on just starting my taper early, since I know my body is ready, I just hope the pain goes away before race day. Anyways...I would DEFINITELY try KT tape, it's helped me a lot in the past week. The website, kttape.com, has video tutorials on how to apply it for pretty much any injury, so that's really helpful. Also, ice and rest! I have an appointment at a physical therapist's office tomorrow, and they specialize in running/bicycle/various endurance sport injuries. If you could find a place like that in DC, which I'm sure you could, they would probably know exactly how to treat it. Good luck!
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  • Smart move on skipping your long run! I'm famous for telling my athletes/clients to rest if something feels off or injuried but go out and run myself when I'm having issues. Someday I will actually do what I say! Great advice above from other bloggers above. I've have just about every possible running injury possible except yours. You mentioned you've had problems with knee pain before. Knee pain is caused either by foot or hip issues. So your knee pain may be an early sign that you really had some foot issues. I would suggest (if you continue to have issues with your foot which will obviously progress a bit faster due to the sheer number of miles you are running for marathon training) to see a chiropractor and/or sports med doctor and have your hip alignment checked and also have them check your running gait. I would also guess that you have tight calves (especially the outer calf muscles), which is very common in runners. I swear by graston that my chiropractor does that helps break up muscle/fascia adhesions in my calves. Most chiros or PTs are certified to do this. A golf ball is good at getting into the calf muscles too. I've taped my knee before when my IT band issues were acting up, but after a bit of use the tape really irriated my skin. So keep that in mind in case you have sensitive skin. Best of luck! I'm sure with a bit of rest you'll be back in no time! :-)
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  • Sorry to hear about the foot. Hope you're taking ibuprofen, in addition to the other remedies/treatment.... Touch wood -
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  • I had this exact same problem about a month ago when I was increasing my mileage before a half marathon. Like some other people have noted, mine was related to a very tight calf. I turned several of my runs into easier runs at a slower pace, spent alot of time stretching my calves and rolled my foot over a tennis ball. Just cutting back for a week or two helped immensely! I ran my half pain-free and haven't had the problem since. Good luck!
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  • Sorry to hear about your pain. My husband is going through a similar problem, not with his foot but with his calf. The temporary remedy seems to be scaling back the distance of his long runs and not running as fast during his shorter runs. He's afraid to go to the doctor in fear that he'll be told to not run at all, but scaling back seems to be alleviating some of his pain. Hopefully this will help you as well, as soon enough your body will have rested like it needs to and you'll be ready to tackle the longer distances again!
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  • You've gotten some awesome advice! I've never had any pain there before, but I've dealt with knee and shin pain cropping up while marathon training and have definitely cut back on long runs. For my first and second marathon, I alternated long (16-20) with short (10-12) for most of the cycle, only running 2 or 3 20s total and it really helped to have that extra week of recovery in between. I still managed to finish with a 13 minute pr in the second so I don't think it hurt my fitness at all. But the back to back 19/20 can be tough on your body. Good for you for listening to your body and backing off!
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  • Hi Anne, I had to chime in here. I had the same thing (tendonitis) during my first marathon training season. What helped: roll a golf ball under your foot in the painful area to work out the tendon. Any sort of soup can laid on its side works too. I took 1 week off and rolled daily and I was good to go! Happy training!
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  • You have so much advice already, but here's my two cents worth. You see,I have a similar problem on my right foot. Feels like a bruise, when u put weight on it it hurts. I recommend using a flexible bandage and figure 8 wrap it to the ankle to compress and stabilize the area. Ibuprofen helps, but if u have stomach issues, use Voltaren gel. I use 1/2 inch of the gel and massage it into the area. At night, after I do this, I wrap a heating pad around my foot (like a boot) as well. When the bruised feeling started to go away, I started running again (5miles), but I would come home and ice,elevate and compress right away. It didn't last long- 5 days maybe? One night, I had the brilliant idea of taking a muscle relaxant before bed. The next morning, I was surprised when I got up that my foot didn't hurt anymore. I don't know if that was a coincidence or not, but I was glad it worked! :-) Now, I am back to training for the Honolulu Marathon! BTW, I am also a pharmacist who stands on her feet 12 hours a day!
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  • Hi Anne, I'd recommend visiting a PT to assess what's going on and give you some tips for training and to correct the problem. Good luck and happy training!
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