Capsulitis and Foot Pain

My feet are still not functional after a month of rest. I do, however, finally have more precise answers. The second specialist I saw diagnosed me with severe capsulitis, especially in the second metatarsophalangeal joint. Theories abound about how it happened. The main thing now is getting it fixed so I can first walk, then hike, then run again.

The pain of capsulitis is like nothing I’ve ever felt. Through all the years of spinal issues, chronic pain, and other health problems, nothing compares to capsulitis. My right foot is now the worst, although it started out opposite. Luckily, the pain is starting to localize a bit and is primarily focused on the joint capsule of the second metatarsophalangeal joint.

Through many sleep-deprived nights (I’m an insomniac anyway, but the nighttime pain in my feet has been unbearable), I’ve done a ton of research on capsulitis. There are a ton of theories out there, and as is often true with health-related information, a lot of the theories directly contradict each other. One example is in footwear. Many podiatric and orthopedic websites (and doctors) swear by a rocker sole for a shoe, while some decry traditional shoes as part of the problem. As with all things, it’s best for me if I gather information and opinions and then form my own plan.

Shoes for Capsulitis

Since I already run in zero-drop, wide-toebox shoes, I’m definitely a believer in natural foot motion and foot strength. I think it’s possible that my capsulitis developed from walking in more traditional footwear: i.e., the kind with toe spring and a major heel-toe height differential. For those who’re clueless like I was, “toe spring” is the amount of upward turn in the toe are of the shoe. If you think about it, that really is an unnatural, weird position for the human foot, which is meant to be flat on the ground when standing.

Debilitation of Foot Pain

The pain, swelling, and dysfunction in my feet go so bad that capsulitis landed me in a wheelchair. It was almost surreal to be pushed around the park in a wheelchair because of foot pain. The fresh air and change of scenery was great, but it was unbelievably frustrating to be in a chair for what seems like a ridiculous reason. The capsules that’re causing this misery are tiny, but holy crap are they sensitive. 

Solutions for Capsulitis

metatarsal pad for capsulitis
The red-pink, pacman-like outline is for the custom metatarsal pad my doctor made to treat my capsulitis. He used a cutout at the top to give extra room for my swollen joint capsule.

One of my coworkers helped me tape custom-cut (courtesy of a wonderful podiatrist), firm felt metatarsal pads into the metatarsal arch area. By elevating and supporting the metatarsals, plus wearing flat, zero-drop shoes, some of the pressure is taken off the capsulitis. I’m able to hobble-walk with a borrowed rollator, which isn’t awesome, but it’s a hell of a lot better than being in a wheelchair due to foot pain.

capsulitis pain runner
Capsulitis is extremely painful. I’m using a rollator so I can get some upper body and core workouts done while I can’t walk or run.

I’ve been good about doing upper body and core workouts throughout this nightmare, but it’s demoralizing and depressing to be unable to walk, run, or hike. A major trip was postponed and I began to reach a scary level of depression and hopelessness. Throwing everything at capsulitis—ice baths, epsom salt baths, CBD oil, ibuprofen—and getting no results was crushing. My auto-immune specialist called in a prescription for a Medrol dose pack. Steroids aren’t necessarily standard treatment for capsulitis, but I was desperate and he was quite worried about the raging, long-lasting inflammation. I’m on day three of the steroids. They’ve made me a bit more emotional, they’re slowly helping clear up the agony of capsulitis. 

One thing I’ve become conscious of is my toe position. It seems that for some time, I’ve been walking with my toes bundled together. I think I’ve been running that way, too, but I’m not sure. I have no idea why that’s happening, other than weak intrinsic foot muscles and tight extensors in my feet. I found a website with a wealth of information about all things feet, and I highly recommend checking it out if you’re suffering from capsulitis or any other foot malady. There are a ton of informative videos available for free, especially on common complaints such as plantar fasciitis. Click here to get to the the video library of all things foot-related. 

The next phase of the plan to heal my capsulitis is more of the same for several more days—rest, elevation, gentle stretching of the extensors, and gentle foot mobility exercises. I’ve never been this sedentary in my whole life, but it’s necessary for now. The core and upper body exercises are keeping me a little bit sane. In a few days, I go back to my auto-immune specialist, and then back to the podiatrist. I’ll be done with steroids by then and really, really hope to feel good enough to declare capsulitis a thing of the past. For now, I’d be over the freakin’ moon if I could just take a few normal, pain-free steps. Capsulitis sucks big time and I never want to go through anything like this again.

UPDATE!

It’s a long, long story, but my problem turned out to be coming from entrapped nerves in the calf musculature. After intense sessions with Graston technique (Rock Blades, scraping, and other names, all pretty much the same thing), my foot pain was drastically diminished. I now keep it away by obsessively rolling my calves with a foam roller, stretching my calves, and wearing calf compression sleeves. It seems it wasn’t ever a foot problem at all, despite multiple doctors saying it was. If you’re having issues with capsulitis or other foot maladies, it’s probably worth getting a good, deep calf massage and seeing if you get results!

8 Replies to “Capsulitis and Foot Pain”

  1. Hello! thanks for info i hope you have gotten over this ? I have daughter athlete whose foot just “blew up” after uphill running sprints- and MRI shows capsulitis of 2nd met but she is having SO much more pain-but only upon weight bear so she is on crutches. She is not painful when off of it. but oddly, the capsulitis is NOT pinpointed it is painful in a larger area, more toward “behind” it forward the arch, towards mid point of sole but not back towards heel. So seems more is involved other than the Capsule -any ideas welcome we are trying it all now too, ice, NSAIDS…rest. also show recommendations appreciated-hoka vs Altra-for when she can walk again.. Good luck and Thank you!

    1. Chris, I’m sorry to hear about your daughter’s foot trouble! I hit rock bottom but was 90% cured by one visit to a sports chiropractor. The bottom line was this– my pain was mostly coming from nerves that were entrapped in tight calf muscles and were signally pain the capsular area of the feet. The chiropractor used Rock Blades (metal massage tools) to deeply massage my calves. He put heating pads on my calves for 10 minutes first, then spent a couple minutes working on the muscles. Relief was instant. As soon as I stood up, I could walk almost pain-free. Since then, every time the pain returns, I either use a stick roller or have a co-worker massage my calves, and it works every time. The area we target is toward the middle/outside of the calf up near the knee. A heating pad and a little massage is all I need now if there’s a flare-up. Best of luck, and hopefully your daughter’s solution will be quick and easy!

    2. I am an avid runner who is going through this now. Haven’t run in almost 2 months. Wore a walking boot for 5 weeks. Bought a pair of hokas and metatarsal pad insole and been wearing those for the last 2 weeks. Also icing the area and stretching calves 2-3 times a day, plus taking Advil. Would say I about 70% better, but what a painful (literally) experience this has been. Hope to start being able to run again by start of the new year …. I will take ‘losing’ 4 months of running time as long as ‘this’ doesn’t come back again – worried about that.

  2. I have been suffering with this for 5 years and in both feet. I have capsulitis in both feet in the second toe. I have constant pain and numbness. I need to sleep with ice packs on my feet to fall asleep, can barely wear shoes and it hurts while walking and not walking. Did the steroid pack work? How did you find your chiropractor? My calves are tight and I had calf spasms nightly prior to this issue developing. I’m worried that next year I will be in a wheelchair. Anything else you can share? I’m desperate.

    1. I’m so sorry you’re miserable. I found my chiropractor through a friend’s referral. He was deeply connected to our local running store, and athletes are often the best resource for finding healing pathways. Many physical therapists are also certified in Graston technique, and some acupuncturists can perform gua sha (all very similar in my understanding). Those treatments plus calf compression sleeves have made a huge difference for me. Best of luck to you.

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