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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!

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Escalante Racer Review

Altra Escalante Racer Boston Edition blue and yellow running shoe
Altra Escalante Racer, Boston edition.

I’ve heard several credible rumors that the Altra Intuition is about to be discontinued, and I’m super bummed. I’ve been running in various versions of the Intuition since it was first born several years ago, and while I’ve tried other shoes, the Intuition always works best for me. The Intuition 3.5 is the latest model I’ve worn, which puts me two versions behind the newest, but I LOVE it. I can run a half marathon on mostly pavement without much foot pain, and that says everything. I needed a new pair and looked forward to trying the Intuition 4.5 (skipping Intuition 4 since it’s passe now), but when I went to our local running store, there were almost no sizes in stock. Online searches didn’t help much, either. It was almost impossible to find the Intuition in a (apparently popular?) size 9, especially with my first color choice.

I’ve tried the Altra Escalante, which lots of people love, but it wasn’t for me. The upper was sock-like but too tight for me. I tried the Escalante 1.5 at the local store, and while it fit a little better than the original, I felt unstable on turns. Enter the Escalante Racer. Billed by Altra as a “faster, higher performance version of the Escalante,” I was most interested in their description of the upper. They claim it’s firmer and more supportive when taking corners. I’m not one to fall prey to marketing jazz, but it sounded like the Racer might be a hopeful choice to take the place of my beloved Intuition.

I bought the Boston version of the Escalante Racer because I’ve been to the city three times and loved it. The walkability, the mass transit, the food, the parks, the history— such a cool place. I don’t care much about the looks of my running shoes as long as they perform well, but as soon as I opened the box, I was impressed by the appearance of the Escalante Racer. The Boston version is bright blue with yellow and black accents, including patterned yellow laces. Score one for aesthetics, but my main concern was how they’d feel on a run. I touched the upper and noticed a huge difference between the Racer and the regular Escalante. There didn’t seem to be any stretch at all in the Racer’s upper, and the toe box looked roomier. I put on my favorite socks and sat down to try on the Escalante Racer.

Running in the Escalante Racer

The first thing I noticed was how difficult it was to put the shoe on. I felt like one of Cindarella’s stepsisters. But once I pulled the laces extremely loose, I finally got the shoes on my feet. The difference between the Racer and the plain Escalante was massive and evident immediately. My feet didn’t feel constricted at all in the Racer, but they felt reasonably supported when I walked around a sharp corner in my house. Convinced they were a potentially awesome option, I took a chance immediately and went for a run.

The first run in my new Escalante Racers was 6 miles. With the Intuition, I could always take a new pair out of the box and run any distance in perfect comfort. The Racer’s sole felt a little stiff, which was surprising since the sole uses segmented rubber with significant gaps between each piece. I ran on hard dirt, weedy grass, asphalt, and concrete— pretty much every surface I ever run on except sand. 

By the second mile, I noticed increased comfort. The cushioning was definitely less than the Intuition (it’s a different shoe, so that wasn’t shocking), but as my run progressed, the comfort of the Racer increased. The stiffness lessened or I got used to it, but either way, I was fine with the sole. The mesh upper was highly breathable, which is super important since I live in Florida. I can definitely see my socks through the shoe, so by breathable, I guess I mean full of holes. Most importantly though, my feet felt secure on corners, even at fairly high speeds. 

As for basics, I have mostly great things to report. The laces stayed tied (super basic, I know, but I’ve definitely experienced lace problems with some shoes), the Racer was true to size, and the colorway was as advertised. The only surprise was how difficult it is to get the shoe on and off, but a little patience for extra lace-loosening isn’t a big deal.

I wish so, so much that Altra wouldn’t discontinue the Intuition. Since they are, though, I’ve found a solid backup plan in the Escalante Racer. I haven’t tried the Racer on anything longer than 6.5 miles yet, but so far, so good. As usual with Altra shoes, I love the zero drop, roominess, and comfort. I’m not sure anything will ever be as awesome as the Intuition, but I really like the Escalante Racer and feel hopeful that future versions will be even better. I’m a longtime Altra fan, and I can now add the Racer to my list of why I love Altra shoes. Foot-shaped, zero drop, Boston-themed– what’s not to love?