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Forefoot pain from martial arts

Discussion in 'General Issues and Discussion Forum' started by NIKO, May 31, 2011.

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  1. NIKO

    NIKO Member


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    Dear everyone,
    for the past six months, I have been exercising barefoot. This have involved a lot of forefoot work as I am undertaking martial arts and boxing. For the past week or so, I am experiencing symptoms sub left fourth MTPJ. I have treated this in my patients before however, am wondering if you all have had common experiences either yourselves of with patients.

    Particluarly:
    the pain is sub left third/fourth region.
    it is now presenting continuously, more aching in nature
    nil night pain
    cannot isolate the exact area of pain, a throbbing of sorts.
    particulary prominent after exercise, during exercise it settles somewhat or I become unsettled and do not feel it!

    I have considered using some padding to offload the area, using mat shoes and so on.
    Any ideas, thoughts, comments? The wish is to not have to stop exericising. While clearly this may be a case of physician heal thyself, I turn it over to you.

    Regards
    NIKO
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Niko! - I replied to your email :)

    Try some strapping to hold the toe slightly plantarflexed to restrict dorsiflexion (think plantar plate problemo). All see these other martial arts threads - there may be something in them.
     
  3. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Niko

    Try using the cheapest diagnostic instrument you own. Your finger.

    Palpate the point of maximum tenderness. Where is it *exactly* you are pressing.

    Are you palpating;
    * the metatarsal head/plantar capsule
    * then slightly distal to this - the plantar plate - particularly closer to the attachement to the base of the proximal phalanx
    * now move even more distal then across medially and laterally to the common digital nerve proper (ie neuroma territory)

    What is that hurts? Bone, ligament/plantar plate, or nerve?

    Identify the structure, then offload.

    If you are doing martial arts, use compressed felt padding taped onto the foot in teh appropriate spot to offload or accomodate the tissue under stress.

    Or take up swimming.:eek:

    LL
     
  4. Berms

    Berms Active Member

    Good advice LL..... always helpful to know exactly what anatomical structures are involved before attempting to treat it.

    Not sure that swimming is a good idea either :D you still have to push off from each end of the pool with your forefoot doing most of the work.

    Berms.
     
  5. Possible problem there. If the martial arts involve kicking the toes will need to be retracted or they'll sort of break off.

    In which case the optimal treatment might be to stop kicking stuff. Lay off impact training for a while.
     
  6. Fraoch

    Fraoch Active Member

    Hey Niko,
    Seem to remember having the exact same problems when I was doing karate whilst at Pod School some 20 years back. Tried padding (caused slipping and falls) and strapping (ditto and felt bloody annoying). Lisfranc says it best, identify structure and treat accordingly. Also follow other advice. Give it a good break or try something different. I did six years of karate in two year intervals. Every time the forefoot pain came back, gave up up for a while, got back into the sport only to have problem reoccur. These days I hula hoop. No foot pain. Good luck.
     
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