Why Do My Feet Go Numb When I Run?

Runners frequently complain of numbness in their feet while running.  This could be due to a number of reasons.  The most common reason for numbness is improper sneakers that may not be sized correctly.  Other reasons may be that the sneakers are laced to tightly. Lastly the patient may have a disease such as diabetes and a neurological issue has begun in the feet. 

The first way of treating numbness in the foot and ankle of a runner would be to be evaluated by a specialist. A podiatrist can take a look at your shoe gear and see if it is a proper fit. It is very important that your foot fits correctly inside the shoe. It’s also important to evaluate the way that a patient walks. We also feel the bony prominences of the foot in the sneaker to make sure that the patient fits correctly into the shoe/sneaker.  In our practice we have a shoe store where we will measure the foot correctly and recommend a choice of sneakers and footwear depending on athletic ability and deformity of the foot. 

The next possible problem that we encounter is shoelaces that are too tight. This is easily treated but there are some sneakers that cause moderate irritation on the top of the foot. This is because of where the shoelaces enter at what is called the eyelets.  The eyelets are the metal circular openings on each side of the shoe where the laces weave through.  Sometimes just changing the style of shoe where the eyelets are can achieve comfort for the patient. 

Lastly if there is numbness, burning, or pins and needles, the runner may have a secondary neuropathy.  Neuropathy is typically caused by diabetes, but can also be drug or alcohol related.  Neuropathy is extremely important to be evaluated for. It can cause a permanent loss of sensation that occurs in the foot and can be extremely painful.  The first step would be to see a foot specialist who can evaluate the problem effectively. In our practice we can effectively diagnose if a patient has neuropathy with a skin biopsy.  This is a very definitive test that we rely on to diagnose this problem. There are a multitude of treatments to treat this problem including medication, physical therapy, and pain management with a take home therapy treatment. 

So in review, numbness or tingling sensations noted in a runner can be caused by several factors. The most popular being shoe gear, which can easily be evaluated.  In our practice we routinely measure and evaluate patients for proper shoes and/or sneaker. Lastly, do not run long periods with numbness. It is a sign that something is happening to your foot and ankle and should be addressed by a foot specialist.

Running is Killing My Nails! What Can I Do?

Running is a great sport for cardiovascular strength, stamina and health, but the reality is it can cause a lot of harm to the feet.  When we walk, the big toe extends and helps to hold up the arch.  A myriad of nail problems can occur in the runner. When we run we accentuate the pull of the big toe in a shoe and can increase stress.

As a podiatrist one of the most common problems I see is a blood clot, or hematoma, under the nail.  This problem is very common because of the trauma to the nail when it hits the top of the shoe. If the hematoma is covering greater than 75%, I will elect to remove the nail entirety.  The reason for this being that if the nail has greater than 75% blood, the nail will de-roof at some point anyways. Our worry is that pus will develop under the nail. Trauma caused by running often results in infected nails, also known as paronychia. This is a collection of pus under the nail often seen on the sides of the nail, but it can occur anywhere. Sometimes trauma will cause the nail to grow in irregular ways. The way it grows will cause infections.  Treatment is aimed at getting rid of the infection. Typically what we will do is numb the toe with anesthesia and remove the side of the nail that is causing the infection and write a prescription for an antibiotic.  Soaking instructions are provided to the patient to facilitate proper healing. We try to remove the entire margin of the nail permanently, so that the patient does not have a chronically ingrown infected nail.  Treatment for runners who want to be on their feet and exercising daily is taken into consideration, so that painful conditions don’t recur and cause any slowdown in runners’ ability to exercise.

Thick discolored nails, which is a sign of fungal infection in the nail bed, is also very common in runners.  Onychomycosis, or nail fungus is a caused due to injury in many athletes.  Runners can get nail fungus from their shoes and sneakers being too narrow or not having enough depth. Treatment options are multiple for nail fungus.  The most common approach for nail fungus is topical medication that kills the fungus by penetrating the nail.  Other options are removing the nail and having a new one grow back. A topical antifungal cream is applied until a new one grows back. Other avenues for treatment are oral antifungals, but the risk of liver damage is high and I question the true effectiveness.  One option that is available, but rarely use, is total and permanent removal of the nail.  One of the more popular trends for fungal nails is laser treatment that kills the nail fungus where the nail begins to grow.

For runners the most important evaluation for preventative measures is addressing shoe issues. Crowding of the toes, foot, and ankle can cause a multitude of problems in the running population.  Evaluation by a podiatrist can determine what type of shoe gear a patient will need according to their running style, stride and endurance.  Many of the above nail conditions can be treated effectively with proper sneakers.  For runners with nail fungus, not only does the shoe need evaluation, but also it is important for the foot specialist to treat the cross infection from shoe to the foot.