Metatarsal pain and nothing has worked so far. Any thoughts?

[Pat AKA mustski]

I am not expecting bootfitting advice here. I am trying to gather information that might help at my next bootfitting. I have noticed lately, that I have developed a tendency to both curl my toes and lift my toes. I have found that if I force myself to focus on keeping pressure on my big toe at turn initiation, I can ski longer before the pain kicks in. I never have pain except while skiing and have experienced the same pain in Tecnica Diablos (25), Dalbello Kryzmas(25), and Dalbello Chakras (24) when I sized down at the suggestion of a bootfitter. In the smaller boot, I had the same symptoms but aggravated by circulation issues.

I have tried heel lifts which made it worse. I'm wondering if I should experiment with a gas pedal and see if that helps. Spring conditions are a good time for experimenting.

Any thoughts about the weird toe thing I'm doing?

 

[Chris Geib]

Number 1 culprit is not enough width. Is there room enough or do you have too much squeeze on the met heads?

Greater ramp angle can set it off for me. I would experiment with the gas pedal; shim under the binding so it is reversible.

How is your range of dorsiflexion relative to where the boot holds you? Is the ball of foot loaded more then the heel? Do you have spoilers behind your calves? If so, experiment with less.

Experiment with the heel lift again after flattening the delta.

Have you tried a neuroma pad behind the met heads? ...sometimes takes some experimenting to find the right location left/right & front/back.

Do you have or have you tried a transverse arch in the footbed? I think your toe thing might attempt to simulate this... And maybe that relieves some squeeze pressure. [edit: related, is your footbed flat in the forefoot or does it combined with the overlaps of liner on the edges create a depression/valley to the middle?]

Good luck!

 

[Pat AKA mustski]

Room in the toe box- check
Met pad - if this is the same thing as a neuroma bump - check

Are the balls of my feet loaded more than my heels? Yes? Possibly? The Kryzma has a very upright stance and there are no shims anywhere. However, when molding the intuition liners 4 years ago, I did have heel lifts in the boot which I since threw away.

Footbed is instaprint and does have a Valley in the forefoot.

Can you explain transverse arch more? I am not sure what that is.

 

[Tricia]

How much ankle range of motion do you have?

 

[Pat AKA mustski]

I'm not sure how to describe how much... but I feel like I can close pretty well and one bootfitter told me it was fine and another said it was too limited. Both have great reputations. My guess is that at the beginning of the season I was a lot tighter and looser by the end of the season.

 

[Chris Geib]

In simple terms a transverse arch would be across the foot from the 1st to 5th met head when looking at your feet from directly in front.

If you have a valley under foot when viewed from this perspective that is created by the liner construction, then that would be the opposite. A valley like this can cause compression on the nerve. Different things to try with footbed if that exists:
Get it flat
Flat with a neuroma bump
Flat with a neuroma bump & cutout under neuroma in front of bump
Building a transverse arch
Mix'n match..

Some say a transverse arch is the the key to life, while others believe it a myth... if it stops your neuroma from lighting up it aint a myth!


If you bias towards weight on the forefoot instead of being able to stand neutral with equal pressure along the bottom of your foot, then that could make it worse. I would try to sort that with your boot fitter and get the geometry figured so your ramp, delta, forward lean & net-forward lean pan out to fit you just right...

 

[Pat AKA mustski]

@Chris Geib Thanks. All of that makes a lot of sense. I plan to start fresh next fall with new boots. These have about 200 days on them and are starting to pack out. I have super narrow feet so there isn't much allowance for pack in my liners. I've suffered through 4 seasons of pain of varying degrees. My plan is to figure out as much as I can about what I am doing so I can communicate well with the boot fitter. My next step is to take a private lesson and see what an instructor wants to fix.

 

[cem]

commonly metatarsal pain comes from loading of the area, either through lack of support (footbeds not doing their job) or lack of flexibility at the ankle joint to as you flex you force load the area

the toe lifting/ curling is often habitual in an effort to try and grip onto the boot if there is too much space in the toe box, this may have come from an old boot or even form the days when you were learning to ski and using rental but it may just be down to needing to relax and "stand on your feet"

your boot fitter should eb able to carry out a full assessment of your biomechanics and ROM at the key joints and can then set you up in the most appropriate boot for your needs, i think your plan to have a lesson is a good one, it could be one little thing in technique which is causing the blockage /tension and if you can free that up you might find out the boots were never really the issue

good luck getting sorted

 

[Pat AKA mustski]

Thanks. The toe curling/lifting is a new thing this season. The liners are starting to pack out so it may be a response to more room than usual. I may also have lost flexibility- getting older kind of sucks that way! Either way, I think I need a lesson to eliminate any poor form issues that might be causing uneven load. The pain has been a problem on and off for at least 8 yrs and solid the last 4. I am just trying to sort out my thoughts before I buy new boots. 3rd time's a charm, right?

 

[PTskier]

Consider a trip to a podiatrist. What cgeib says may take some pro adjustments. About curling your toes--don't. Get boots that fit right, get the adjustments needed for comfort, then ski with the muscles in your feet relaxed. You'll ski better.

 

[udailey]

I curl my toes too and find I am not skiing as well as the moment I uncurl them. So I try to keep them flat but with room above them it's hard not too curl then again once I stop thinking about it. I've found that putting those toe warmer packs on top of my toes fixes the need to curl. Unsure if this is the cause of your pain but the extra room above your toes is probably why they curl.
Uriah

 

[Pat AKA mustski]

My plan is to start with the podiatrist and go from there. I am waiting until next season to take a lesson and see if anything in my stance needs adjustment. It is possible that I am frontloading. The pain was much worse in spring snow which tends to toss me into the back seat. I am probably overcompensating. The toe thing is weird though. I have never done that before.

Boots will come but, since I have never had comfort in ski boots despite the work of highly recommended fitters, I am not hopeful of a fix there. Besides, it's Bob's turn for boots - I have to wait one more season.

 

[udailey]

Two things to add and probably obvious to you already.
When I bought boots (lange rs130) I bought them from Evo so I could wear them around the house for hours/days and still return them if they didnt work out. During this time I fooled with the fit a lot. Adding and subtracting cereal box cardboard under my heal. I had cut it out to match my footprint. I also used super thin balsa wood. Then I would add or subtract width with more or less layers. Some layers would be trimmed. I stuck the layers together and to the footbed with double sided tape. I finally got it super comfortable.
Anyway, when I added to much height under my arch I experienced metatarsal pain. You have all summer and fall to experiment like this if its something you're willing to do. I also stuck the boots in the oven and then clamp them on.
The best investment I made in fit and warmth was a purchase of zipfit liners. Cheapest I found them was $189 shipped from England. They were much more expensive in the states.

 

[udailey]

http://m.ebay.com/sch/i.html?_nkw=Zipfit&isNewKw=1&_sacat=&cnm=&mfs=&acimp=&_trksid=&sqp=zipfit

Wow! ZIPfits as low as $99 on ebay but plenty at $150. They will ALWAYS resell if you dont like them.

 

[Pat AKA mustski]

Yes. Zip fits are definitely under consideration. For my next set of boots, I plan to start with Corty at Footloose and continue from there. I have had Corty make adjustments to my current boots but I bought them through a bootfitter in LA whose adjustments made things worse. Corky's adjustments didn't solve the problem either so methinks a fresh start will be needed. I like the idea of playing around a bit this summer.

 

[SallyCat]

The best investment I made in fit and warmth was a purchase of zipfit liners

I love my ZipFits, but I have found them to be the opposite of warm. I had to invest in Hotronics to make them tolerable.

@Pat AKA mustski I may be repeating something I said on another forum or mentioned in person, so forgive me if so. I heartily second the recommendation to go to the podiatrist first. I had the same issue and switched from Instaprints to the regular off-the-shelf Sidas "3 feets" and saw improvement in that I could ski for a couple more hours until the pain started. Still not good, though. Finally, the Dr. sent me to PT for my ridiculously tight calf muscles. I had four different exercises to do daily just a few weeks before my trip to Mammoth and I was reasonably diligent.
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Ok, I'll admit, I was a little lax, but I did do them.
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Alright, alright! It was the end of the school year and I was working two jobs; I barely had time to bathe. I stretched once or twice. But when I got to Mammoth I started doing the stretches aggressively before and after skiing every day. Remember that scene in North Dallas Forty where the guys are working out in the gym while drinking beer from cans? That was me in the Stump Alley parking lot.

Anyway, I skied 21 days in a row in June with only a handful of days where I had to take my boots off RIGHT NOW because of met pain. Imagine if I'd actually done what the doctor told me to do?

I guess my point is, see the doc before the bootfitter. It might be something you can correct. And also ask the Dr. about your ski boots. They might could help you figure out in which directions to tinker with fit.

Good luck!

 

[cosmoliu]

Yeah, check in with your favorite neighborhood podiatrist. If the toe curling thing is involuntary, you might be developing hammer toes. But, you should see that every day, not just in ski boots. If you do have hammer toes, you might be loading the metatarsal heads more than nature intended, particularly in the closed environment of ski boots, causing metatarsal discomfort from that standpoint.

 

[Pat AKA mustski]

Thanks everybody. The toe curling is not involuntary in the sense that it is not a reflex of some sort. It seemed to disappear once I focused on it. What I did really become aware of - skiing in groups of mixed abilities - is that standing is the worst. Usually, I ski with my husband and son who are both faster than me. For that reason, I choose to bring up the rear so there is no standing. Once I catch up, off we go. Standing caused me the worst pain of all. I will definitely see a podiatrist, but I believe it's a boot issue. So, here's to starting over again from scratch!

 

[Pat AKA mustski]

Thought I would provide an update. I have been doing foot/metarsal stretches and calf stretches and am starting foot strengthening exercises this week. An interesting thing that I have noticed, while stretching, is that when I shift my weight back to my heels, I lose my balance. That's new. I will talk to the PT guy about that, but I suspect some exercises that focus on balance might help.

 

[Pat AKA mustski]

Update: I did quite a bit of balancing exercises this summer. Also, @SallyCat i took your advice and really worked on calf stretches. I also spent some time in metarsal and ankle stretching. I just skied my first 2 days of the season at Mammoth and these are the first days in my life that my feet have been pain free whike skiing. Fingers crossed it’s not an anomaly!