Bruised bone - big toe :(

[dozydoo]

Hi,

nearly 2 months ago i tripped up and slammed my right foot hard down back to the ground - since then i've been experiencing tenderness when bearing weight on my right foot - by the big toe/ball of foot. Xrays 3 weeks after the incident came back clear and the doctor said that i had a bone bruise. I still have tenderness which seems to feell like it's going away only to flare up again - i've been swimming to try and rest this as much as poss but i'm getting frustrated with it now. Can you help?

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[pudding_bowl]

That sort of injury can cause sprains to midfoot ligaments (a lisfranc type injury) or possibly flair up and cause a mortons neuroma type pain. What your doing in terms of swimming is good to help rest. the problem with MT-T or MT-P joint sprains is that you can't rest them because you have to walk, and hense they can flair up and down as per the amount of usage.
There are other different possible causes of your pain than boney issues - i'v mentioned 2 possibilities (although mortons neuroma is quite the stretch really), So you should get a physio or podiatrist referral to clarify and diagnose so that you can get appropriate advice. You may require a biomechanical assessment so ask to see a physio with a knowledge of that etc.
Good luck

[dozydoo]

Hi,

Many thanks for your reply. I'm going to see my physio about this on Monday of next week. See what he thinks....just getting frustrated with it now. Today when I walk on it i can feel the tenderness actually in the big toe joint (underneath).

[dozydoo]

Just a thought - do you think this could be sesamoditis, metarsalargia or hallug rigidus?

[pudding_bowl]

sesamoditis - possibly
metarsalargia - it's a generic term for pain of metatarsal origin in the area your getting it so definatly could be
hallux rigidus - less likely or you would have noticed the loss of motion associated with it.

[dozydoo]

Hi Pudding bowl - went to see my physio last night - he said he thinks it's something called...hallux flexus (something beginning with d) - he pressed in the bottom of my foot by the ball of the foot and it was very tender...and bended my big toe back and forth....he said i had full range in my joint and should have no problem getting back to running.....i'm a bit hesitant though.

[pudding_bowl]

hallux flexus is hammer toe - google it and you'll see the pics? is that wat your toe looks like?

[dozydoo]

Hi - i've googled the pics....my big toe isn't that prominent (bending like a hammer)- physio says that after the trip my muscles would have spasmed to naturally protect the joints and that's what's causing the tightness....and the tenderness when pushing off....don't really know what to think now to be honest.

[pudding_bowl]

Yup doctors are fun like that! Work with your physio and keep us posted. If your doc says go for a run, be hesitant but give it a go. Why not? you can blame your doc if it gets worse, go back and make em feel bad. or you'll get better and high 5's all round.

[dozydoo]

Hullo,

Yep it was my physio who said go for the run...docs predictably said to rest.....i think i trust my physio more....but feel a bit strange running on it if still doesn't feel right....lord knows!!! will give it a go on Thurs and see how i get on and report back.

Thanks for your help!!

[dozydoo]

Hi - quick update - i've bought some pads from boots which have an adhesive back to them so you can cut them to size and apply them to wherever you need to on the foot (my case bof). This seems to be helping but i can still feel tenderness when i have that padding applied - is that normal? I suppose that feeling won't go away until completely healed...anyhow i'm hoping that the cushioning is helping anyhow.....reckon it's metarsalagia from reading other sites including google.

[pudding_bowl]

Do you wear heels? - those will make you feel worse. Best to be in a supportive shoe. Look into the Metatarsel dome orthotic for metatarsalgia.
Howd you go with your run?

[dozydoo]

Hi,

I don't wear heels. I wear flat boots or trainers without support - i used to wear orthotics but they didn't agree with me...

I ran for 10mins - didn't make it better or worse.

Today i stretched my toe - just to get some flexibility but it feels tender again now...so not sure what i've done there.

[dozydoo]

Pudding bowl - forgot to ask what you think about ultralieve ultrasound devices?

[pudding_bowl]

Will have to give it some time to see how you go with your pads you'v got as will take a while to kick in.

As for ultrasound... get your physio to give it to you - decide wether you like it. The ultraleive is 1Mhz so get them to use 1 not 3. If you find it beneficial then go for it. There is no evidence to back up it's use so I rarely use ultrasound. Alot of people love it and swear by it. But not me

[dozydoo]

Hi Pudding bowl,

Thank you for your reply.

I've just been for a swim.

I've noticed that when i'm standing up and i lift my toes up on my left foot (the sole of the foot still flat on the floor) all toes lift together but when i do this on my right foot (the one with the issue) the big toe is quite stiff and is lower than the others.

Going to take some ibuprofen.

[pudding_bowl]

Has your physio done many mobilisations of the toe? grabbing it and gliding it up and down to help remove the stiffness? its a possible treatment to help with your stiffness.

Would you say that you are getting better or there is no change so far. If your getting better then lets roll with that and just do what you are doing. But if no change then investigate other therapies like mobilisations, and ultrasounds etc.

Won't get to reply much after tomorow as am heading your way for a wedding/holiday of xmas and new years.

[dozydoo]

Hi,

Hope you have a good journey to Britain!!

It's hard to tell if it's getting better - it's very slight improvement. I recall physio did do that on my toe - i did the same exercise with my toe this morning and it's ok again now...(all toes rise up at the same time)

Thanks for your advice.

[pudding_bowl]

So mobilising your toe helps the problem? brilliant, now you can also help yourself as well as your physio input.

[dozydoo]

Thanks Pudding bowl - what exercises do you recommend for toe mobilisation?

Enjoy your trip to england!!

[pudding_bowl]

Do what you did that morning that made all the toes come up together. seems like you were on the right track with that.

Last day at work today - last patient has just been through. I'm off home early to pack. Maybe I'll see you in the streets... but won't recognise you. And I doubt I'm about to ask strangers if they have a sore toe. haha

Have a pleasant christmas.

[dozydoo]

Hi Pudding bowl,

I hope you have had a good Xmas in the UK!!!

I have still got tenderness under my big toe and it's more underneath the toe joint itself now rather than the ball of the foot...I went to physio again today - i don't really think he knows what to do to help me really as he taped it up in order to ease the toe joint and to stretch the fascia but it didn't feel any different and didn't last the day. I think i just need to wait until it heals - just frustrating not knowing what it is.

[pudding_bowl]

Your physio does appear to be doing all the things that I would be doing. I'm unsure I can give much more advice without examining the toe.#
In terms of toe exercises it seems that self mobilising was helpful... continue that. you can try ultrasound, icing, and taping.
Also look into strengthening the toe using rubber band resistance perhaps and stretches following that. - Ask your physio if they feel that will help.
The big toe is supplied by the lower spinal nerves so your physio should clear that area of your back (L5) to assess no spinal component.

Am still in UK till the 19th. Currently in Birmingham with colleagues for NYE party. it's been good so far. visited Bath and Oxford which are beautiful cities.... I can't say the same about Birmingham - I apologise if your a brummy. I also apologise for calling you a brummy if your not.

[dozydoo]

Hi Pudding bowl,

Sounds like you have had a good tour around!!! I'm not a brummy hee hee...i live in Cheshire - about 60 miles away from Brummy land.

Thanks for the advice. I managed to run on it for 30mins today (on the treadmill) - think it aggravates it a bit but not much and still the same tenderness really....if that makes any sense. I've bought some more felt padding today and some surgical tape - so i'm doing a makeshift padding to try and take the pressure off the toe joint - see if that helps any. Since i last reported into you i think i said my big toe was stiff when trying to lift it with my foot flat on the ground but i'm not getting that now...so hopefully this is progress!?!?!?!

I wish you a Happy New Year!!!