Severe Foot and Lower Leg Pain

Hey all,

Hoping someone out there has perhaps experienced something similar to my problem or can offer some good advice. I am experiencing some significant problems with my feet and lower legs that is making most backpacking and longer hiking trips near impossible.

While descending for significant periods of time or over steep terrain (basically everything here in Colorado), I begin to get severe pain in the ball of my foot (just in front of the arch). If I continue going, it progressively gets worse, spreads somewhat into my toes, and then into my lower leg (starting where on the front of the ankle and radiating up through my anterior tibialis). It gets bad enough that it becomes near impossible to continue descending period, let alone at a reasonable pace. Stopping for a short time and getting the weight off my feet alleviates the issue temporarily, but within a quarter to half mile I will be in severe pain again. This happens worse when wearing my backpacking boots (Oboz Wind River), but still happens with even trail runners (just takes longer to start).

I actually went to a podiatrist to have my feet evaluated and he told me that two little bones in my first metatarsal were protruding or inflamed (sesamoiditis, I believe it is called) and possibly causing my pain. He had custom orthotics made which have significant arch support up to the back of the metatarsals, the idea being to get weight onto the arch and off the metatarsals, I believe. Unfortunately, this doesn't seem to have helped much. Descending the Barr Trail from Barr Camp yesterday in Colorado Springs was one of the more painful experiences of my life, and I believe it is only about 6.5 miles with ~3400 ft elevation loss.

I have a couple theories as to what the issue could be:
1) Boots that fit fine for a while, but as my foot expands, they become too narrow causing my foot to compress (this theory is supported by the fact that my pinky toe started to press into my boot and was very raw by the end of the hike, but also unsupported by the fact that my trail runners are plenty wide feeling, and I still experience the pain),
2) Weak lower leg muscles, particularly the anterior tibialis, causing my forefoot to "slap" the ground, resulting in pain from repeated force on the forefoot. I assume this would require strengthening the anterior tibialis somehow -- as of yet, I am not sure how.
3) Being overweight and not having the lightest gear in the world just dooms me to pain, for the time being (until I lose the weight -- it's slowly going down).

Appreciate any input you all have to offer, as at this point I'm getting rather desperate. I love hiking and backpacking, but foot pain is incredibly debilitating and takes most of the fun out of the trip. Thanks in advance!

Well, I can't comment on the specific problem you're having but I do know that good fitting shoes and arch support is key to preventing pain and keeping your spine lined up as it should be. Crappy or ill fitting shoes are probably one of the leading causes of pain from your feet to your shoulders and neck, even headaches.

Thanks for the tip -- I know it all starts at the feet. I neglected to mention that I have had my feet measured many times (though only at your typical outdoor store... Road Runner Sports, REI, Cabela's, multiple running stores) and no one has ever mentioned needing a wide shoe/boot. I spent a lot of time specifically at REI trying on various boots -- the Oboz fit the best in store, by a long shot, but it seems hard to tell how that translates to the trail.

Some of what you describe sounds as though it could be Morton's neuroma or at least the Morton's neuroma that I had. For me, it was pain that originated between my second and third toes at the rear of the ball of the foot when my forefoot was constricted by a too-tight shoe. The pain would get progressively worse as the day wore on and could get excruciating after a long day. The point of origin of the pain was sore to the touch for several days after an incident. I found that wearing sandals eliminated the problem and that wearing shoes (or boots) that are loose across the forefoot would bring the pain to manageable levels. I have always liked to wear my shoes snugly laced and had to get accustomed to wearing them loose. Try a hike in hiking sandals and see whether they help the problem. If so, you have a place to start. I hike in loose trail runners now, not sandles, and have to be careful with the lacing; I often loosen the lacing for long downhill stretches.

Thanks for the tip. I did try hiking in a pair of Chaco's once and that was the worst pain I have ever felt, but it could have been the way I had them tightened or various other things.

I've had a number of foot problems over the past 4 or so years. It started with metatarsal pain in my right foot, which kept me from hiking for most of a year as I was waiting for it to get better (which it eventually did; I switched from Spenco insoles to green Superfeet, which may or may not have had anything to do with it, but it was what the podiatrist recommended). Once that got better, I started hiking again only to develop plantar fasciitis in the left foot. This kept me off the trails for the most part for a year or so, but seems to be fine now. I am back to my Spenco insoles. Along the way I've had pain in my hip muscles; I attribute that, and probably the plantar fasciitis as well, to weakened muscles that ended up with me walking with bad form and not noticing it, slapping my feet down and moving my legs with the wrong muscles because the right ones were too weak.

So I guess what I'm trying to say is that all sorts of things can start happening when you are out of shape and try too enthusiastically to get in shape. In my case, it resulted in me having to take a lot more time off to heal, and it's not over yet! But at least I am able to get out there now and do some serious hiking again, albeit not without some aching hips.

Lacing your shoes too tightly can certainly cause pain, I've done that. I think it's kind of instinctive to want to lace hiking boots tightly, but I've learned not to do that. My laces tend to get to tight after taking my shoes off and lacing them up a few times. Now, I almost always loosen the laces all the way down to the toe and adjust them every time I put my hiking boots on (every morning).

I'm from Colorado, and you are the first person I ever met that said there were any downhill stretches on the trails.

First,I would eliminate the easy problems. I'd suggest using trekking poles,as they really help take the strain off the feet. Slide your hands up to rest on top of the poles during the steep downhill stretches. If the trail is rocky take your hands out of the straps so you don't get the pole stuck in a hole, fall and break your wrist.

Secondly, check your socks. Wearing cotton socks will cause the balls of my feet to hurt. I'd recommend a thick wool sock like Smartwool, or a synthetic like Thorlo. You can buy an inexpensive equivalent at Big R's. I think they are called Ralson. They have an R on the top of the ankle.

It's possible your hiking technique is causing the problem. It's counter-intuitive, but if you lean forward a bit when hiking downhill, it puts your center of gravity over your feet and your feet won't slip inside the shoes like they do if you aren't leaning forward. If your feet want to slip out from under you when hiking downhill, then this may be your problem. Trekking poles will give you the confidence to do this.

If these don't work, try a pair of Danner Combat boots. I like this pair. Danner boots. They are more comfortable than bedroom slippers and don't need breaking in. They transfer the forces differently, and they will reduce some of the slippage in your boot. They also prevent twisting of the foot like you get in shoes. I wear these boots all the time except for short hikes. They are also completely water proof so I usually just walk through shallow streams.

Check your pack weight too. You don't have to go ultralight, but it is possible to stay under 30 pounds for a 3 night/4 day trip with relatively inexpensive gear. Even 25 pounds is not out of the question.

I just noticed you were hiking down the Barr Trail. I've never hiked it, but that is downhill. Maybe just avoid trails that have long stretches of downhill. There are many trails up the road a bit by Seven Falls.

Another thing you can try. If your feet start to hurt after 20 minutes then stop for a 5 minute break after 15 minutes. The rule is rest at about 80% of the time it takes for something to hurt.

There is something else I like to do for fun. Walk slowly for about 100 feet (20 paces counting just the left or right foot), stop for a few seconds and look around. We do this when it's hot because it conserves sweat. It's a great way to attract animals if you don't talk. Deer and elk often come over to see if we want to play.

Ill go ahead and state that I have not read this entire thread! I'm just stating that the only time I've ever had extreme foot or lower leg pain which was only once, i was ill fitted for a pair of work shoes! They felt fine but I latter attributed all the pain to them , as soon as I bought a better fitting pair all the pain imediatly residedr

Hahaha! There are downhills in Colorado the same way there are 300 sunny days a year.

I second Gershon's suggestions. Hiking poles (if you don't already use them), lightening the pack, and perhaps a shoe that isn't necessarily a wide, but something wider in the toebox, like a KEEN.

Good luck, I hope you figure it out!