Foot pain and shoes

[ATbound]

I realize that the topic of shoes has been covered extensively. I apologize if this turns into another shoe thread, it is not my intent. I am hoping it will take more of a health direction.

I began the AT in 2008, had light weight trail runners that fit perfectly and never gave me a single blister. I thought I had found the perfect shoe for me.

Unfortunately I began to experience extreme foot pain. It got to the point where I was taking large doses of Vit I just to get through the day. When I got to Damascus, VA I naturally headed into the gear shop and explained my foot problems. They took one look at my shoes and told me that my shoes didn't have enough support. At that point in my hike I decided to return home and let me feet heal, which took the remainder of the summer. I never got the pain diagnosed, but I believe it was plantar fasciitis.

I would love to hear from people who have experienced extreme foot pain or know people who did and what shoes or insoles they found were more supportive and prevented pain or eased their pain. I am also wondering if there are places that I can get my gait looked at (pronate, suppinate, ect...) for free. Any ideas?

I am beginning a thru hike of the PCT this coming year (2010) and am worried about my feet. I would like to take the necessary steps now to prevent more foot pain and so begins my search for better foot wear. Thanks for your help!

[zeus307]

I to suffer from PF! It sucks!! Time, a frozen bottle to poll your foot on and an anti-inflamitory from your doctor. Also new and good insoles helped me. I am doing better but getting started first thing in the morning is not fun!! It sucks!! Make sure you have good supports and insoles!!! Good luck!!

[garlic08]

What's your pack weight?

[Spokes]

Prior to thru-hiking this year I ran my share of marathons and ultras so I'm familiar with PF. No fun! The Straussberg Sock always helped me during bouts with PF. It's an inexpensive and effective solution that's been medically evaluated extensively.

For hiking boot/shoe supports, SuperFeet have always been kind to me. I get blue or green and size them based on "volume" fit. You'll be amazed at how much difference a millimeter makes in fit and feel.

Finally, be sure to size SuperFeet based on the proper fit of the heel cup NOT the stated size range! I've seen way too many Outfitters just grab a box of SuperFeet based on shoe size and not take the time to properly fit the heel cup (You'll find proper sizing instructions in every box).

Good luck on your journey finding the best footwear!

[XCskiNYC]

Some of the running shoe retailers in NYC such as Paragon videotape your gait while you run on a treadmill. Then they view the video playback of your moving feet and analyze whether you pronate or whatever your feet may do. Of course, the level of accuracy in interpreting your gait will be limited to how well the shoe sales person is trained in analyzing these kinds of videos. But it is free. You may have something similar at a local running shoe seller.

If you have recurring foot pain from hiking you might try a foot doctor or maybe a sports medicine doctor. Sorry I couldn't offer a less expensive suggestion.

[ATbound]

My pack weight on the AT was 30, it will likely be the same on the PCT with all the extra water we have to carry in the desert. My base weight has gone down from the AT, so there is improvement.

I got Superfeet on the AT at Neel's Gap, they fitted them properly to my heels.

I wish I had the money to see a foot doctor or pay to have my gait evaluated, but as a grad student, it is just not to be.

Keep the suggestions coming people! There's bound to be some other great ideas floating around. Thanks for the thoughts so far.

[modiyooch]

is it your heel or the front of the foot? I'm currently dealing with capsulitis, also from backpacking but not as serious as pf.

[garlic08]

I never had to deal with PF, but I had severe Achilles tendonitis issues until I got my base pack weight below 15 lbs. Only then was I able to consider a PCT thru as my first long hike. And I didn't consider using trail runners until my pack was that light, either.

[JuleighGee]

I grew up playing competitve soccer, and one day, all the sudden my feet were killing me. I basically had to limp off the field. Come to find out, I had PF. I tried PT, ice, anti IF, and other crazy exercises, ect you name it...and I can tell you the two things that have worked for me.

1) yoga (ashtanga)
2) custom made insoles

Yoga really helped because it really stretched my muscles. You just dont realize how many muscles you have in your feet until they are inflammed. Most yoga studios have a free or walk-in class a couple of times a week, might be worth a try.

As for the custom made insoles, I still wear them to this day, I am on my 2nd pair in 10 years, which really isn't too bad considering. Shop around for the best price, perhaps ask your family to pitch in for a christmas/holiday gift. Probably not the ideal gift, but when you can hike or run long distances and you're feet don't hurt, it is completly worth it. Just an idea.

[Dogwood]

I apologize if this turns into another shoe thread, it is not my intent. I am hoping it will take more of a health direction.

Unfortunately I began to experience extreme foot pain. It got to the point where I was taking large doses of Vit I just to get through the day. - ATbound

Excuse me ATbound, I'm all for taking the proactive approach to health care, but when it gets to this pt., preferably before it gets to this pt., it's time to see a foot specialist and I do not mean a gear specialist. Go make a podiatrist appt! Bring the shoes that you currently wear and, if you can, older shoes that you've experienced foot pain while wearing.

[mudhead]

Also take any worn out shoes you have. They won't laugh if you walk in the door with a garbage bag of shoes.

New Balance web site has a section on foot types. Some good info. Also has a part to determine the pronate or sup... type by looking at old shoes from the rear.

Good luck.

[Spirit Walker]

There are a lot of possibilities, and the best way to find out which is the problem is to see a foot doctor. Between friends and family, we've dealt with a few of them:

Plantar Fascitis can be prevented by stretching. But if this is your problem, don't wait on seeking treatment. If you ignore it too long you may spend years dealing with the issue.

Morton's neuroma is caused by shoes that are too tight in the toe. Treatment starts with new shoes. It can heal itself, with rest, but if left untreated you may end up with surgery (cutting the nerve). Jim had this on the PCT in 2000 and it made his hike a lot more difficult that it should have been.

Capsulitis/metatarsalgia - My husband is currently dealing with this one. A doctor said that the problem was caused by shoes that had too much flexibility. He needs a more rigid last. Cortisone shots helped ease the pain and he threw out his running shoes and is wearing new insoles, but we aren't sure that that will be a long term solution.

One of the side effects of so many hikers switching to light weight shoes is an increase in foot and leg problems. You see a lot of shin splints and stress fractures. Partly that's because people hike much longer miles than they used to. Partly it's because they get less foot support with the lighter shoes. Most people are fine with them, but some folks need more support.

Though you don't have much money, it really might be worthwhile to find out exactly what is going on so you can deal with the problem before you get back on the trail.

[modiyooch]

Capsulitis/metatarsalgia - My husband is currently dealing with this one. A doctor said that the problem was caused by shoes that had too much flexibility. He needs a more rigid last. Cortisone shots helped ease the pain and he threw out his running shoes and is wearing new insoles, but we aren't sure that that will be a long term solution.

I like to hear more of his experience on this one. This is what I am dealing with at the moment. Anti-inflammatories didn't work and I don't want the cortisone shot. At least, not at the moment. I wear sturdy boots while hiking. I think it was more of overuse issue. I'm not throwing out my running shoes because that's the only shoe that I don't feel the pain. He did tell me not to go barefoot. I do have more pain with the sandals or without shoes. My injury definately came from my 250 mile section hike in the Whites and ME. I didn't run for two weeks, but this didn't help so I'm back pounding the pavement.

[sbhikes]

Different foot problems seem to lead people to different solutions. I bought some shoes with good support in 08 and ended up leaving the trail with severe foot pain. I think I had stress fractures in the metatarsals because the shoes were too rigid.

This year I went to a running store and bought some flexible shoes. I do not wear special insoles. I took out the ones that came with and used various layers of soft and flat insoles.

I think that plantar fasciaitis calls for stiffer shoes while my problems seemed to respond well to more flexible shoes.

With my softer, flexible shoes, I was able to finish. My feet would be sore after a 30 mile day, but nothing felt broken. I did get some tendonitis in my heel, but that came with climbing hills. I tried to slow down on hills so I wouldn't pull my heel, but I would forget. I hiked only 1800 miles on my trip this year, though, so I don't know what I would have felt like after 2650.

I also have had morton's neuroma since I was 16. The foot doctor said he could try a cortisone shot or surgery. I was scared of both so I've just dealt with it. My last pair of shoes were a men's 4E width. Heaven. I wear my shoes extra big (like up to 3 sizes) and tie the laces very loose. My feet don't slip around if I wear wool socks. Even thin wool socks don't slip. It's like portable ground for my feet that just happens to be attached by a shoe. If I could walk barefoot, I would.

I would like to see a podiatrist for the tendonitis and for some other strange pain I have. I guess I ought to do it since we pay $14,000 a year for health insurance and I never go to the doctor.

[Plodderman]

I had a problem with PF a few years ago. Tried different shoes, and insert from the Doctor, freezing water in small cups and rubbing my foot with them. Did stretches with a towel in the morning but to no avail. My foot finally healed up because I rested it for a couple of months. Since that time I switch shoes regularly and very rarely buy the same brand two times in a row.

I never had this problem again and have regularly switched shoes. Now I have two pair and rotate them every other hike.

[Jonnycat]

I had a job stocking a few years ago, which entailed getting on a knee and the ball of one foot on concrete floors.

Subsequently, that foot has a lot of pain like a PF kind of pain. Sometimes walking barefoot is excruciating.

The solution for me was to get a big old heavy pair of boots with a stiff sole. They work great, and I can hike all I want to in them.

When I get to town and wear anything less stiff, I start getting reminders that I need the support. Oh, if only there were more shoes with stiff soles!

[oso loco]

I like to hear more of his experience on this one. This is what I am dealing with at the moment. Anti-inflammatories didn't work and I don't want the cortisone shot. At least, not at the moment. I wear sturdy boots while hiking. I think it was more of overuse issue. I'm not throwing out my running shoes because that's the only shoe that I don't feel the pain. He did tell me not to go barefoot. I do have more pain with the sandals or without shoes. My injury definately came from my 250 mile section hike in the Whites and ME. I didn't run for two weeks, but this didn't help so I'm back pounding the pavement.

You asked. On the PCT in May and June 09 I had a blood blister on the ball of my right foot - then I tore the meniscus in the right knee. After the surgery, the knee was fine, the blood blister was gone, but the foot (specifically one toe) wouldn't allow me to walk much. While we were in NY in July, my max mileage was about 3 miles. In Aug and Sept, max was about 6 miles. Finally got back to see my surgeon in mid-Oct. Got the cortisone shot and started a recovery program. Program involves sturdy boots, GRADUAL increase in mileage and anti-inflammatories. For the anti-inflammatories - either 4 Advil 3 times a day or 2 Aleve twice a day. DO NOT mix Aleve and Advil - use only one or the other. Gradual mileage increase means start at one (1) mile and increase SLOWLY. Same way I recovered from the knee replacement last year. We did 8 miles today (4 weeks after the cortisone shot). Next week we'll try 10.

I'll let you know if it's still working for me in a couple months.

My suggestion: if you really have capsulitis and want to cure it, then find a good podiatric or orthopedic surgeon, get the shot and follow his/her advice. If you don't want that then your pain isn't anywhere near what I had. If you're running, you'll likely increase the pain and the recovery time.

There are Internet sites that recommend special insoles. Might be worth a try, but you'll still need a podiatrist for that.

[Krewzer]

..... Unfortunately I began to experience extreme foot pain. It got to the point where I was taking large doses of Vit I just to get through the day. When I got to Damascus, VA I naturally headed into the gear shop and explained my foot problems. They took one look at my shoes and told me that my shoes didn't have enough support. At that point in my hike I decided to return home and let me feet heal, which took the remainder of the summer. I never got the pain diagnosed, but I believe it was plantar fasciitis.

I am beginning a thru hike of the PCT this coming year (2010) and am worried about my feet. I would like to take the necessary steps now to prevent more foot pain and so begins my search for better foot wear. Thanks for your help!

Hey ATbound. I had PF for the first time in my life this summer. It put me off the my PCT hike and took about 3 months to get back to normal. I don't really know what caused it, but here are my guesses and thoughts about it.

1. Shoes. It was the first time I used trail runners. I loved them, but am going back to my old Vasque's for long distance hiking.
2. I'm a fan of superfeet, but didn't use them early on because I had the new trail runners. Wouldn't do that again.
3. Too many miles too soon. On the PCT you can start out doing 18-25 miles a day. The solution for me is patience, HYOH and going slower early. How many times have we heard that before?
4. Pack weight was 27-33 pounds. That was great for me and I don't think a factor. Water issues often added an extra 10-12 lbs, but dropped quickly as the day worn on.
5. I ignored early warning signs. It took a week, maybe longer, before things really got bad. But when it did, it got really bad, really quick. Should have taken a Zero day or two at first sign of trouble.
6. I was shocked to find Ibuprofen didn't help at all. Normally it cures all my hiker ailments. I was told by the podiatrist, blood circulation is very poor in tendons, thus it is very difficult to get meds to the area. I was taking 3 and 4 at a time and nothing.
7. Forget the Steroid/Cortizone shot. If it's that bad already, it's not going to get you back on the trail any time soon anyway. I took one in Tahacipi, Ca. Even after a week's rest it still wasn't well enough to continue. BTW. This is the number one most painful shot I've ever taken in my life.
8. Orthotics. I've talked to several hiker friends who have dealt with PF. Most, if not all, recommend Orthotics. I know of two who order directly from discount online source. I haven't looked recently, but I believe the run a couple hundred bucks.
9. Stretches. Next time....more stretches, more often, no fooling. I also am a big fan of Yoga. Wish I'd started it 40 years ago instead of one.

10. And finally, my number one thought on the subject is,
"You're going to love the PCT." Happy Trails.
(Hey Oso, what's hap'nin)