by Paul Stasko, DPM

Dear Doctor:
I have been having pain and swelling in the “front” of the foot. I noticed this after I have been active recently, what should I do?

Dear Reader:
Thank you for your question. I commonly see this in the springtime, especially in active people when the nice weather starts. People like to get active and start moving outside including running, biking, hiking and other activities. After a winter of being inactive or less active, things can occur within foot in response to increased activity. I would first recommend having the foot checked out by a podiatrist/foot and ankle specialist to ensure that the pathology is being treated appropriately. There are a few things that can be contributing to the pain in the foot.

The first thing that I would be most concerned with is a stress fracture of the foot. This can occur in the long bone of the feet (metatarsals), or in the bones to midfoot, and even the heel. Most commonly the forefoot is involved in this type of injury. It is important to have this checked out as early as possible to avoid further injury or fracture.
The soft tissues around the lesser toes can be affected as well. Simple tendonitis or capsulitis (inflammation of a tendon or joint capsule) can occur around the forefoot. Another special structure called the plantar plate can be inflamed or even torn. This can lead to laxity and pain in the lesser toe joints, sometimes leading to a condition called predislocation syndrome. It is important to have this checked out appropriately to ensure no further injury, and that the appropriate steps to healing are taken.

Other structures in the forefoot can cause pain with increased activity as well, including nerves (neuroma), or formation of bursa or cysts that can cause symptoms as well. It is very important to have the foot biomechanically evaluated to ensure that foot structure is not playing a role in pain and discomfort.

Appropriate shoe gear is another factor to consider. The type of sneakers and shoes that someone wears can affect the forefoot depending on padding and stability of the sneaker or shoe. In conclusion, forefoot pain in the springtime and summertime is something to have evaluated. It is important to see a professional for this type of pain to ensure that there is thorough evaluation being performed and the correct steps are being taken to ensure a full recovery and pain free activity!

Thank you once again for your question.

Paul Stasko, DPM, a foot and ankle surgeon earned his medical degree from Des Moines University College of Podiatric Medicine and Surgery and completed his residency training at Geisinger Community Medical Center in Scranton, Pennsylvania. In addition, he completed a Foot and Ankle Fellowship at the Rubin Institute for Advanced Orthopedics, International Center for Limb Lengthening at Sinai Hospital in Baltimore. Dr. Stasko sees patients at Finger Lakes Bone and Joint in Newark and Geneva and performs surgeries at Newark-Wayne Community Hospital.