Foot injury - need help diagnosing

That's a strange one. I recently struggled with a combination of plantar fasciitis and a stone bruise. I would have said you had the former.

When in doubt, ice it! Some would say that ice will only help in an early swelling phase, but I think its uses go beyond that. So start with that: get a couple of soft ice packs and apply them several times a day for 15 minutes. Just set the painful part on the pad and let the cold sink in.

It's possible that a precription anti inflammatory like Mobic (meloxicam) could help. I'm suggesting this NOT because it's the obvious treatment, but because in struggling with my own injuries I've learned that the obvious treatment isn't always the right one. So keep trying stuff.

Thanks for the response. Have tried a lot of things and running out of ideas.

I thought maybe it could be a nerve problem but I don't have any tingling / sudden burning. Really only if a stretch or put weight on it.

My left it band and hip have been a bit tight (the issue is on my left foot) so maybe there is some linkage there that I am missing.

I foam roll or stretch my whole chain a couple times a day.

I tried the tarsal tunnel test and doesn't seem to be that.

I've been taking aleve for a 6 weeks. Maybe will try a stronger prescription ones.

I use a combo of ice after I walk and heating pad to warm it up in the morning.

I pretty much walk only in soft sandals and comfortable sneakers. Have tried a few different kinds of insoles and doesn't seem to work.

I'm running thin on ideas. Have never gotten a cortisone shot but wondering if this is the next step.

The location you have described sounds exactly where I have plantar fasciitis

I thought it was that but the pain isn't worse in the morning. Hasn't gotten any better with complete rest. Hurts to walk (let alone run). And most importantly the MRI I got the other day shows a normal plantar fascia. I don't have enough experience to know if plantar fasciitis of this severity has to show up on the MRI

I had this exact injury in January and it was incredibly frustrating. Mine wasn't worse upon getting out of bed in the morning, etc. either, but the location was just where the posterior tib tendon and plantar fascia meet, just where you described. What worked for me was seeing a good PT and having it Grastoned, along with dry needling along the inside of my calf. I had trigger points in my calf and along the posterior tib. I rolled out, massaged, and gently stretched my calves and it finally went away. It took a good 6 weeks before I could run comfortably. I took off a total of 8 weeks just to be safe and I'm glad I did. I pool ran in the meanwhile.

I'm the opposite of most, as wearing a flatter, more flexible shoe helped me more than wearing stiff, higher heel-to-toe drop shoes most recommend. Maybe that's because I often walk around barefoot... not sure. All I know is that I wanted this injury gone and fast.

I had been going to a PT but stopped because the pain was getting worse and I wanted to get it properly diagnosed (I had been assuming posterior tib / PF).

I have been googling a lot tonight and wondering if it could be Baxter's nerve entrapment. Seems to fit given the pain is similar to PF but isn't worse in the morning and doesn't seem to respond well to PF treatment.

Hill_runner84 wrote:

I had been going to a PT but stopped because the pain was getting worse and I wanted to get it properly diagnosed (I had been assuming posterior tib / PF).

I have been googling a lot tonight and wondering if it could be Baxter's nerve entrapment. Seems to fit given the pain is similar to PF but isn't worse in the morning and doesn't seem to respond well to PF treatment.

I'd suggest seeing a good podiatrist and see if s/he can give you a diagnostic cortisone shot into the Baxter nerve and see if that is your issue. That was a thought with my injury too, as it did take a few more treatments to respond than we thought it would take. I swear my body heard "cortisone" and decided it would feel all sorts of better. It's worth a try if PT is making it worse.

Thanks. This injury sucks -- gives me hope that you got over it.

I'm going to focus on trying to figure out if it is Baxter's or rule it out. The only other thing I can think of after ruling out PF & stress fracture is either a nerve injury or a muscle strain to my quadratus plantae or other muscle / tendon, but would have thought this would have healed naturally with rest by now.

Yah I've had a pretty similar problem in both my heels recently. The trainers said that it was only achilles bursitis (shows how much they know), and my doctor said that it most likely wasn't PF, but it sure as hell feels like it (I had PF when I was younger). It doesn't hurt in the morning and all that other BS that comes along with PF, but that dull aching pain is still there, giving me flashbacks.

Giving an update here. This injury didn't get better with complete rest except for 2.5 months. A couple weeks ago I noticed that walking barefoot hurt a bit less that wearing normal shoes of any kind / any orthodic, so I got the Merrell Trail Glove 4 shoes and that seemed to reduce the pain in my foot when just walking around but then the pain would come back if I walked in regular shoes.

I saw a good neurologist today at a legit teaching hospital and he did an ultrasound of my tibial nerve. No damage but he did diagnose me with Baxter's neuropathy based on pain and ruling out whatever else it could be -- hard to see the nerves in the feet even with ultrasound.

He gave me a few ankle and foot mobility stretches to do and recommended a cortisone shot if didn't get better with a month or so of this.

In the meantime it seems like mimimal shoes seem to help, so to the poster above who said that low drop, flexible shoes helped the most -- this seems to apply to me as well. Still not sure exactly what I have / what caused it but I am hopefully making some progress.