why does my foot go numb when running
As a runner, you expect the occasional aches and pains like muscle soreness and blisters. But a foot that goes numb when youБre running is a strange sensation. You are undoubtedly used to the feeling of your foot Бfalling asleepБ when you sit cross-legged on the floor too long. But when that numbness and tingling develops while youБre running, you may be alarmed. Fear not: Foot numbness while running is not uncommon, and most of the time, itБs easily remedied. Foot numbness is most often caused by a compressed nerve. The nerves that cause sensation in your foot and ankle can get trapped between bones or soft tissue. Because the nerve is compressed, itБs unable to send the correct signals to your brain from your skin and soft tissue. Nerve compression can make your foot feel like itБs on Бpins and needles,Б or it can make your foot completely lose sensation. The feeling sometimes makes you want to take off your shoe and rub your foot. It's usually localized to one part of your foot, often your toes; occasionally, your entire foot may feel numb. Nerves in the foot can become compressed for many reasons, including:
Poorly fitting shoes. Shoes that are too tight, which donБt have enough room in the toe box, or are laced too tight can cause the nerves in the foot to become compressed. Thick socks may be another culprit. Trauma. An injury that causes the tissue in the foot to swell, or causes direct damage to a nerve, can lead to foot numbness. Increasing your running mileage suddenly can cause trauma to your feet; likewise, improper running form may cause damage that in turn can lead to foot numbness.
Foot structure. If your feet are flat, or if the sole of your foot is overly flexible, you are more likely to compress the nerves of your foot when you run. Scar tissue. Occasionally, a nerve that is repeatedly compressed becomes thickened and develops scar tissue. This is called a neuroma; the most common neuroma is between the second and third base of the toes, and is called a MortonБs neuroma. Foot numbness, especially heel and base of the foot numbness, may also be caused by compression of the sciatic nerve, a large nerve that runs from the spine down the back of the leg. This nerve may be compressed by a herniated/slipped disk, or by muscles that overlie the nerve. There are steps that you can take to prevent or alleviate your foot numbness: Buy larger shoes, and make sure that thereБs adequate room in the toe box at the front so that you can wiggle your toes freely. Buy shoes with a stiffer sole; shoes with a pliable sole can cause swelling and trauma to the ball of your foot, where the nerves to the toes pass through the bones. DonБt lace your shoes as tightly. Loosen the laces on your shoes to relieve any pressure points on your foot. Try wearing thinner socks, which take up less room in your shoe. Pay attention to your running form. Avoid БslappingБ or БpoundingБ your feet on the ground as you run. DonБt suddenly increase the duration or distance of your run. This may lead to trauma. If these steps donБt alleviate your foot numbness, a trip to a foot and ankle specialist, orthopedic surgeon or sports medicine doctor may be in order.
The specialist will ask about your medical history, to rule out any diseases that may be causing your foot numbness. He may obtain X-rays and examine your foot to try to identify the source of the nerve compression. He may prescribe special shoe inserts, anti-inflammatory medications, or special exercises. Occasionally, more severe cases of foot numbness, including numbness caused by a neuroma, may need treatment with injections to the nerve, or with surgery. Although foot numbness while running is uncomfortable, it is often easily remedied by relieving pressure on the compressed nerves. Simple remedies such as buying larger shoes, lacing your shoes less snugly, paying attention to your running form and making increases in running time or distance gradually may be enough to keep foot numbness from occurring. If self-help fails, a physician may try other treatments to relieve the discomfort. Foot numbness is a not-so-common but worrisome symptom that sometimes develops while running. An unusual tingling or pins-and-needles feeling to the skin not only annoys but introduces fear into an otherwise blissful run. The runner's toes tingle and feel numb, and the numbness can progress along the top or bottom of the foot and occasionally into the ankle. Although the runner need not stop, a reassuring trip to the doctor may be in order. Foot numbness most often implies nerve compression. The specific area of foot numbness will indicate the most likely compression site.
Numbness to the adjacent sides of two toes suggests a problem between the toes. The most commonly affected site is the outside of the third toe and the inside of the fourth toe. Known as a Morton's neuroma, the nerve slowly develops a thickened coat of scar tissue. Numbness while running develops from pounding the pavement, cramming the forefoot into a narrow shoe, or crowding the forefoot by the gradual, almost imperceptible swelling. The runner can try simple measures to reduce the pressure. These include choosing a shoe with ample toe space and using a pad in the shoe placed under the forefoot. This can gently spread the offending bones apart. Next, a cortisone injection may help give relief. If all conservative efforts fail, surgery relieves the pain that often accompanies the numbness. The toes, however, may remain permanently numb. Numbness to the entire bottom of the foot or just half of the bottom of the foot occurs when a nerve is compressed at the ankle. The inside of the ankle is known as the tarsal tunnel. Coursing through this tunnel are three tendons, an artery, veins and the tibial nerve. Similar to the better-known carpal tunnel syndrome at the wrist, the nerve can become compressed, causing tarsal tunnel syndrome. The numbness, and sometimes pain, is initially aggravated by running and weight-bearing activities. Eventually, the symptoms can progress to resting pain or numbness. A search for a "space occupying lesion" in the tunnel is prudent.
This could be a small cyst, bony spur or unusual muscle anatomy. I have seen benign fatty masses also cause compression. Very often, no specific offending mass is found. More commonly, the simple mechanical compression caused by a shoe or excessive foot motion narrows the tunnel space and irritates the nerve. Again, nonsurgical efforts include a period of rest to reduce swelling, attempts to control the excessive motion with an in-shoe orthotic and cortisone injections into the tunnel. Surgical release is limited to those cases recalcitrant to the mechanical treatments. Fortunately, surgery is needed much less frequently than with carpal tunnel syndrome. This syndrome can occur on one foot or it may affect both feet simultaneously. Compression of the nerves traversing the front of the ankle or top of the foot causes numbness on top of the foot. Most often this is caused by overtightening the shoelaces. People with high arches are particularly vulnerable to this problem. Simply loosening the shoelaces, using a modified lacing technique or applying some padding under the shoe tongue may help reduce these symptoms. Finally, foot numbness can indicate a medical condition. See your physician for persistent numbness that is not resolved by these simple maneuvers. Dr. Stephen M. Simons is co-director of South Bend Primary Care Sports Medicine Fellowship, associate director of Saint Joseph Medical Center Family Practice Residency and clinical assistant professor of Family Medicine -- Indiana University School of Medicine.
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