Nerve issues in the top of the foot

[Christina Lea]

Hi Everyone,

I’m curious if anyone has experienced a compressed/irritated nerve on the top of their foot before?

In the last 2 weeks I’ve been experiencing numbness in one of my toes, and an electrical sensation in the top of my foot.

When I palpate it there’s a specific spot that, even when lightly brushed, shoots downwards long the top of the foot into the numb toe. The exact spot it slightly lateral to where my laces sit, around the ankle crease.

I don’t lace particularly tightly, but I’m thinking the ongoing pressure has irritated it.

I’ve got upcoming appointments to see a doctors and also podiatrist, but would love to hears if anyone’s experienced something similar

 

[sisinka]

Hi Everyone,

I’m curious if anyone has experienced a compressed/irritated nerve on the top of their foot before?

In the last 2 weeks I’ve been experiencing numbness in one of my toes, and an electrical sensation in the top of my foot.

When I palpate it there’s a specific spot that, even when lightly brushed, shoots downwards long the top of the foot into the numb toe. The exact spot it slightly lateral to where my laces sit, around the ankle crease.

I don’t lace particularly tightly, but I’m thinking the ongoing pressure has irritated it.

I’ve got upcoming appointments to see a doctors and also podiatrist, but would love to hears if anyone’s experienced something similar

Hi Christina!

From description above, it looks like your problem comes from lacing or from the pressure of laces on the top of your foot.

It can be caused because this action 1) pressure the nerve / nerves or 2) pressure soft tissues which can swollen – so they start to pressure the nerve.

More info would be needed.
- is it one foot or both feet?
- does the numbness disappear slowly / fast when you put off the skates / or it stays for bigger part of the day?
- does numbness starts immediately while wearing boots or it happens during some movements only?
- is any part of the foot swollen?
- do you have some abnormal type of foot – flat / high arch / hallus valgus….or some toes deformities? Callus, bunion, ganglion?
One foot is more abnormal than the other (more flat / higher arch) – is it the foot with the numbness?
- did you have some fractures / tendon injuries / inflammation of the foot before?
- your boots – are new?
- did you have a longer break from skating before the trouble started?
- did you wear some new shoes off ice which are more tight around the top of the foot?
- did you exercise or walk more in past weeks before tre trouble started (overusing feet in comparison with previous months)?
- if your have diabetes, hypothyroidism – you can be more prone for tendon / nerves damage.
And so on…

Pain on the top of the foot can be also caused by hypertonia of some muscles – short or long toe extensors, musculus tibialis anterior, interossei muscles.

If yout would pressure posterior tibial nerve in tarsal tunnel (behind the medial malleolus), it could also lead the numbness. But in this case you wouldn’t cause numbness while pressuring the top of your foot.

In my opinion you should change boots into some other which don‘t cause such troubles. If you don’t want to, you can probably try ticker socks – maybe it could reduce the pressure (but you need enough space in boot and you will not feel the toe pick properly).

 

[High Carbon]

Super helpful information from @sisinka !! Yes have your boot fit looked at by a skilled technician. If the boots weren't properly molded to your foot it can put pressure on very undesirable places. Boots can also be punched out in sensitive areas to alleviate pressure. Skates should be easy and comfortable to wear and you shouldn't have to fight your equipment! If your skates were heat molded and punched in the appropriate areas then absolutely look into new skates and/or a different brand. But always take your skates to a knowledgeable tech who can make sure they're properly fitted to your foot.

 

[Christina Lea]

Wow, thank you for such a generous response @sisinka. These are all great questions. And thank you also for your input @highcarbon. I'm really appreciative.

It's only one foot. I haven't skated since noticing the issue and the numbness is yet to have dissipated. The nerve shooting sensation is definitely new, but I'm not sure how long I was experiencing the numbness prior to noticing it. It's very subtle, as it's only superficial numbness in one toe.

There are no visible abnormalities with my foot - swelling ect. I'm a healthy 36yo F, with no other health problems, gait abnormalities or existing foot issues. However, I have an old, minor motorbike injury to that foot. There's existing scar tissue close to the area I'm experiencing the nerve twinges, so perhaps it's an aggravating factor.

I'm going to have an ultrasound and pediatrist consult this week, hopefully that will shed some light.

I'm relatively new to skating and I have been skating multiple days per week, for more than an hour at a time for the last couple of months. And these are relatively new boots. However, they're not uncomfortable at all.

I'm hoping that the symptoms will settle with a couple of weeks of rest and I can proceed back into skating with a bit more vigilance to any aggravating factors. I have bought some gel pads to protect the area that seems sensitised.

Thank you again for your time and advice!
C

 

[MaHa75]

My daughter had the same problem and it did not dissapear without surgery.

 

[sisinka]

....
It's only one foot. I haven't skated since noticing the issue and the numbness is yet to have dissipated. The nerve shooting sensation is definitely new, but I'm not sure how long I was experiencing the numbness prior to noticing it. It's very subtle, as it's only superficial numbness in one toe.

There are no visible abnormalities with my foot - swelling ect. I'm a healthy 36yo F, with no other health problems, gait abnormalities or existing foot issues. However, I have an old, minor motorbike injury to that foot. There's existing scar tissue close to the area I'm experiencing the nerve twinges, so perhaps it's an aggravating factor.

I'm going to have an ultrasound and pediatrist consult this week, hopefully that will shed some light. ....

Thank you. And thank @highcarbon for other ideas.

Simplifying things - scar contains fibrous tissue which is less elastic than kollagen tissue. Even soft tissues under the scar can be contracted (not sure with the right English word for this). Active scar may even pain or cause pain in different regions of body.

That's why good physiotherapists always look for scars and if needed - treat them with pressuring, massaging, stretching etc.

Scar with soft tissue changes may lead to block of joints and bones movements in that area.

Top of the foot is a small area so even small scar can create bigger trouble.

I don't know how long / big is your scar. If it is still painful when you touch it (I guess no)? Or if the area of scar is painful when you palpate into depths (= so you can even feel every single bone with deep palpation).

X-ray will exclude stress fracture or bone abnormalities. Ultrasound will look for some fluid / cyst or swollen tissues. I personally think it will be OK without any pathology.

As to podiatrist - definitely take your skates at the meeting. Plus if he / she has no knowledge about figure skating - explain what kind of movements you are doing - bend knees… ankle joints always in dorzal or plantar flexion… with blades on the ice and bend knees = which means additional pressure for the top of the foot. Show him boots material.

This doesn’t go particularly to your problems, but you may also ask podiatrist to examine what is the pressure you put on both feet. If there is a significant difference between left and right leg, it can mean blocked ankle / knee / hip joint on more pressured leg. Or another cause can be in pelvis area – muscle imbalance or blocked vertebral joints.

I would reccomend one session with physiotherapist to be sure that your foot is OK.

Physiotherapist should examine and if finding some pathology (pain, small / no movement of tissues, hypertonia in muscles, blocked joint) then treat:
- crural and plantar fascias
- crural and plantar muscles, interossei muscles of foot
- Achilles tendon
- head of fibula, ankle and Lisfranc and Chopart joints, movement of each tarsal bones and metatarsal bones, metatarsophalangeal and interphalangeal joints
- free movement of calcaneus
(Without any hesitation take the list of things mentioned above with yourself.)

If you wouldn’t mind I would like to get the feedback from you – how was ultrasound and podiatric visit. As well if you decide for physiotherapeutic treatment.

 

[sisinka]

My daughter had the same problem and it did not dissapear without surgery.

May I ask which nerve was released and on what place of the foot?

Approach must be always individual.

It depends on the foot structure and things mentioned above…on the level of nerve damage (if it is caused by nerve’s pressuring)…on the level of pain…on muscle paresis (when motoric fibres of the nerves are pressured).

Right now Christina’s troubles described above don‘t look like that surgery is needed.

Did your daughter undergo rehabilition before the surgery?

 

[MaHa75]

May I ask which nerve was released and on what place of the foot?

Approach must be always individual.

It depends on the foot structure and things mentioned above…on the level of nerve damage (if it is caused by nerve’s pressuring)…on the level of pain…on muscle paresis (when motoric fibres of the nerves are pressured).

Right now Christina’s troubles described above don‘t look like that surgery is needed.

Did your daughter undergo rehabilition before the surgery?

Yes we did everything possible to avoid surgery for almost 9 month but nothing helped unfortunately.

 

[sisinka]

Yes we did everything possible to avoid surgery for almost 9 month but nothing helped unfortunately.

And is it OK now? No tingling / pain in foot anymore?