Sports Medicine/Bunionette Irritation
Hi Dr. Bob,
I recently went hiking in brand new hiking boots. I only did about 1.3 miles and then I went out once the next week and did 1.4 miles. It looks like the hiking boots aggravated my self diagnosed bunionette. This irritation has happened one other time although when it happened that time I was not exercising regularly so it did not cause much disruption in my life. Currently I am exercising between 2 and 5 times per week. The exercise is a combination of the elliptical, weight lifting (arms only), short (~2 mile) trail runs, and the occasional hike.
The irritation of my bunionette is impacting my exercise and I was curious how long I should wait before I can ease back into my workouts.
So far I have been resting it, wearing shoes with a large toe box, icing it occasionally, taking ibuprofen or naproxen once per day (600mg I think), and I have stopped exercising. The last time I exercised was Friday 5/23 and when I went for a trail run my calf muscles got extremely tight, so much so that I could feel it in my shins. I stopped running because I was worried about injury and walked the rest of the trail and eventually realized that the bunionette was probably causing me to change my stride when I was running.
I have not gone to a podiatrist yet. Is there any advantage to going to a podiatrist at this time? Will they be able to tell me anything other than what I already know? Is there a general guideline for when I can try exercising again? I do not want to go back to soon and reaggravate it and have to start all over again. At this point I notice the irritation even when I do something like roll over in bed but only occasionally when I walk. It is definitely most painful (but still only maybe a 2 or 3) when I get up first thing in the morning.
Any advice would be much appreciated!
Hi Katie- seeing podiatrist soon makes the best sense so you can get proper diagnosis & treatment plan. So-called bunionette usually means "tailors bunion or enlargement of the 5th metatarsal head, usually with its capacity to rub & get irritated in shoes. Might also have inflamed the surrounding tissues. Your initial treatment of backing off running, doing some ice & ibuprophen makes good sense but seeing podiatrist is best. Could be that your foot type & mechanics are the culprit & doc can identify this.
Often, new shoes like your hiking boots can start irritating process. Conservative measures can help- I've had great success with orthotics that can control excessive pronation & rolling of the foot. Physical therapy like ultra sound, possible cortisone inj also possibilities. Don't jump into surgical correction unless orthotics not effective, but if tailors bunion is large enough & non responsive it solves problem. Hope this helps- good luck, Dr. Bob Weil