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Severe burning pain in outside edge of foot

post #1 of 15
Thread Starter 

I've been having the same problem as KDriscoll (recent post) for 3 years (Ken I know how you feel).

 

The pain starts as an ache in the instep and radiates to the outer edge of the foot, where it feels like severe burning/pain, about half way between my toes and heel. It also becomes so bad after 5-10 minutes of skiing that I have to stop and take off my boot, after a few minutes it's fine and the process starts again.

 

I've seen sports physios, podiatrists, had arch supports, ankle supports, full orthotics, heal lifters, personalised heat moulded ski boot orthotics and nothing has worked. I too have Head boots as I was told that they are simply a better, more comfortable fit for a wider foot.

 

I do have medium pronation on both feet (flat feet) and ended up seeing an ankle and foot surgeon (2010-11). Since then have had nerve conduction studies, x-rays, MRIs, ultra-sounds scans and Steroid shots and when none of these worked, in March '11 finally had Surgery; a Tarsal Tunnel Decompression in my right (worst foot).

 

The surgery site is healed now and went to a indoor snow centre a few days ago, full of excitement as the ski season is fast approaching here in Europe......and AARGGHHH......It's still the same incredible pain in the outside edge of my foot....

 

I have also read that if Boot fit problems occur as the foot is forced to pronate (flatten) causing pressure of the foot against the boot shell. Typically this pressure occurs at the base of the little toe. Also, because the foot is flexible, the muscles and tendons of the foot are "fighting back" to resist the pronatory movement (flattening of the arch) causing aching in the arch and mid-foot.

 

Apart from the obvious, give up skiing which is not going to happen, I'm at a total loss as to what to do now....CAN ANYONE HELP PLEASE?????

 

Thanks......

 

Pete, UK

post #2 of 15
A tight instep would cause toe numbers 1, 2, 3 and the inside of the 4th toe to go knumb-not your problem. (Some instep work to give you more room can't hurt.) I beleive your are compressing your sural nerve. This is the nerve that comes down the outside of the leg, wraps around behind your outside ankle and across the side of your foot going toward the fourth n fifth toes. It innervates the outside of the fourth toe and the fifth toe. The sural nevre can get compress by the liners C or L pad hidden in the liner. Most often times the bottom tip of the C or L pad is to blame. A few times I've seen the problem caused by the front edge of the lateral (outside) forefoot pad. Jeffrey Rich C. Ped http://www.usorthoticcenter.com

CUSTOM BOOT FITTING SERVICES AND CUSTOM ORTHOTICS -- AMERICA'S BEST BOOTFITTERS

Jeff's US Orthotic Center specializes in Orthotics and Stance...

Reply
post #3 of 15
In addition to Jeff's points above, how is your ankle joint flexibility (with your foot pointing straight ahead, rather than turned out. Pronation naturally causes the foot to abduct (turn outwards Charlie Chaplin stylee) if you then contain the foot into a ski boot and then force it to be parallel on a pair of skis then there can be a tendency for that foot to load up the lateral border and give that burning point

If the ankle joint ROM is also limited (I am sure we are seeing more and more people like this every year) then the following can happen, as you flex forward, the heel lifts inside the boot, this causes the instep to jam into the top of the boot and the load to go through the ball of the foot, if the foot is still trying to pronate then the outside edge of the ball of the foot gets the full force....feels a bit like the boot is drilling a hole through the side of your foot, nothing feels wide enough!

Chances are that your foot is not ultra wide, just that the biomechanics are conspiring against your comfort in ski boots
post #4 of 15

Magwich,

 

Your list of possible solutions you have tried to alleviate the problem is very extensive and must be frustrating considering you still have the problem. My take on your problem my be more basic than what you have done, however, sometimes going back to the basics may help?

 

Your list included:  I've seen sports physios, podiatrists, had arch supports, ankle supports, full orthotics, heal lifters, personalized heat moulded ski boot orthotics and nothing has worked. I too have Head boots as I was told that they are simply a better, more comfortable fit for a wider foot.

 

One thing I did not see in your list was if a professional boot fitter has done any shell or liner modifications to your boot? Or if a boot fitter has measured the width of your foot?  If so, how wide is your foot in mm?  This is good information to know.  You mentioned the head boot being more comfortable for a wide foot, which is probably true, however, it still comes down to how wide your foot really is compared to the width of the boot.  For example, if the Head boot will fit (x) mm wide feet, and your foot is (x) mm + 3mm then your foot is 3mm wider than the recommended width for that boot and may need stretching.  Also, Jeff mentioned the instep height, which could be part of your issue as well, if that was the case, stretching and or modifying the liner, boot board etc would be part of the solution.

 

Keep at it and good luck,

 

Don

post #5 of 15

do you get the same pain, with the boots on, and NOT skiing?  as in standing around in them?  or does this ONLY happen when you start to slide around?

 

If you rent boots, does this happen with all sizes of boots?  can you go up, or down one size and it still happens?  just as bad, or just as fast?

 

do you get this in any other sports, activities, etc?

post #6 of 15
Thread Starter 

Hi Jeff,

Thanks for the advice.....are modifications to the boot liner C & L pads simple or would a new liner be required?

post #7 of 15
Thread Starter 

CEM,

Thanks for the reply and strangely, I have never tried looking at the range of movement in my ankles.

 

Given your ideas, I have just tried dropping into a ski position and my left foot stays planted to the spot with reasonable movement. However, as I squat there is slightly less movement in my right ankle and as I get lower in the squat, my foot moves outward (ie kinda rotates out from the heel (clockwise), albeit my big toe shifts by 10mm or so, but certainly towards the Chaplin style you mention.

 

I can see how you say this loads the outside and causes the burning pain.

 

Assuming this is down to biomechanical structure, can I assume this is not going to change, given any intervention?

 

Thanks again.....

 

Pete (UK)

 

post #8 of 15
Pete

You can stretch calf muscles if it is just them that are tight, infect all skiers should but mist sit at a desk 50 weeks of the year and then put their boots on and go...where are you based? In case you hadn't noticed I am in the uk, even if you are at the tigger end of e country I may be able to suggest someone that might be able to help you

The key comes with finding the boot, insole and stretch plan that works for you, most physios can tell you about the stretching, podiatrists the foot but neither of them tend to be great with ski boots...I did have a long discussion with an American DPM about ski boots and he was under the impression that no boot fitter knew what they were doing and he was the only person in the world who could sort people in ski boots....interesting chap NOT!!
post #9 of 15
Thread Starter 

Don,

Your comments also make sense, as it kinda sounds like the "Square Peg / Round Hole Scenario"!!!!

 

I have measured my foot (in socks) and at the widest point it is 110mm; I also measured the external width of the boot at roughly the same point and this is only 115mm. Given the width of the shell material itself and the liner, I think you may be on to something here.

 

Essentially, my foot must be crammed in there. I hadn't given it any thought as I always felt that there was something wrong with my ankle/foot. I assume, I'd be best placed in get a boot fitter in France when I go for New Years, as I have not heard of specific "Boot fitters" here. I know our local ski shop do stretch boots, but think just asking a shop assistant is not the right way to go; a more considered and measured approach by someone experienced may be far better. I'll research this in more detail.

 

With regards to the instep height adjustments, is this something a boot fitter will aslo be able to remedy?

 

Thanks very much for your help.

 

Pete (UK)

post #10 of 15
Thread Starter 

Hi Mntlion,

Just wearing the boots and not skiing, I get a mild sensation of the same, but say 5% of the real thing.

 

I do get the pain, though to a lesser extent when jogging, say 20%, but it's safe to say its at its worst in ski boots.

 

I don't generally hire, but had considered hiring ski boots in resort for a day, one size up to see if the extra space would help.

 

Thanks

 

Pete (UK)

post #11 of 15
Thread Starter 

Hi CEM

Yes, that's me, 50 desk weeks / 2 ski weeks a year....boots in the loft in between.....

 

I am currently trying out some calf stretch excercises leading up to my first ski trip on New Years Eve....one thing the surgeon and podiatrist commented on, was that I had large calf muscles, so assume that they could be part of the problem?

 

We do have a couple of ski shops here in Brighton one chain and one independent, but don't think either have a specific "Boot Fitter". It is quite clear this needs to be done by someone who can bring the whole plan together, in a considered, measured and experienced way, if it's to work. I was advised by a local in Switzerland a few years ago, when having similar boot problems 9not these boots), that I should've purchased in resort, as they grew up in the sport and know what's what!

 

That said, ideally I'd like to resolve this before I get there, so any advice, recommendations for boot fitters you may know, would be gratefully received.

 

Thanks

 

Pete

post #12 of 15
Pete, closet person I can think of would be Anja at snow lab in knock hatch

If not I am a couple of hours north in bicester oxfordshire, we work only by appointment so please do not make the drive without calling first, currently booked about 10 days ahead mid week and 4 weeks ahead for weekends

If you do what to wait till you get to resort, which resort are you going to?


Oh yes and a large calf muscle could push you forward and exaggerate the issue
post #13 of 15
Thread Starter 

Hi CEM,

Knock hatch is only 30 minutes from here, however, I have just visited your website and dropped my contact details on there as Bicester is not too far to visit if needed. Please give me a call when you pick up the message.

 

Thanks

 

Pete

post #14 of 15

Pete,

 

      I'll bet your quads burn!!!  Large calf's will push your knees forward and any extension at the ankle/knee will push your foot forward in the boot more than someone with a smaller calf in the same boot.  If your knees are too far forward you will sit back trying to get off of the front to the ski, you will then be riding the back of the ski, with your toes being driven up into the toe box where the boot is narrower, ouch!  This may be the reason for the discomfort.

 

     I suggest you go see CEM, he can flair the boot cuff to the rear to accommodate those large calf's, which "may" alleviate the other issues you mentioned.

 

mike

post #15 of 15
Thread Starter 

Hi MikeTSC

Yes indeed, quads certainly do burn and from what you've said, I can see why .....

 

I have made contact with CEM, as I think a boot fitting is now ESSENTIAL!

 

The one good thing to come out of this forum (first one I've ever done), is that many heads coming together to collectively look at problem are so much better than one or two. Moreover, I think finally after three years of this issue, that I've finally found someone that knows BOTH feet and ski boots professionally.

 

Though we may not be able to medically resolve the biomechanical issue, we can at least make the correct equipment adjustments to minimise the problem.

 

Thanks for your input

 

Pete

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