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Capsulitis - Sports Podiatrist Recommendation?
CREATED: 10/12/11 by JHJ20012 REPLIES: 1
JHJ20012's ravatar JHJ20012    JOINED: 2/1/10    POSTS: 197
Capsulitis - Sports Podiatrist Recommendation?
POSTED: 10/12/11 9:12 AM

So, after consulting Dr. Google, I'm self diagnosing with Capsulitis of the second toe (essentially the ligaments at the base of the toe get inflammed and cause pain and if not treated the ligaments can eventually fail and the second toe can drift and ultimately cross over the big toe - ick!). Anyone else faced this issue? Anyone have a good sport podiatrist rec in the DC/MoCo area? You know the drill - a diagnosis of "stop running" is not an option. Thanks! Joyce

drjohn's ravatar drjohn    JOINED: 6/1/11    POSTS: 7
RE: Capsulitis - Sports Podiatrist Recommendation?
POSTED: 10/12/11 11:47 AM

Hey there,

I'm Dr. John and am a chiropractor specializing in feet and extremities ( for more info).

There are a few suspects that it could be, more likely a case of tendinitis (aka tendonitis), possibly a morton's neuroma, and just a few other possibilities.

The real question, however, is why are you getting it? My GUESS is (and it is just a guess) that you also have something called functional hallux limitus that is preventing your big toe from bending properly as you pronate and "toe off" during your gait. As a result of the big toe not dorsiflexing properly while weighted (that is during your foot strike) you are either "toeing off" at the base of that second toe and/or "overpronating" that foot and toeing off at the side of your big toe. Look for a nice fat callous at the side of that big toe (hallux). Tough skin (that you wouldn't normally call a callous) is probably also at the base of that second toe, which would indicate you are toeing off incorrectly, thus subjecting that area to more stress and strain than it is made for, and as a result you've got a case of tendinitis.

Obviously all this is an educated guess, but one thing is for certain, your gait is not right. Almost guaranteed.

Another cause of this condition can be that one or more of the 26 bones that make up your foot and ankle are out of position. As a result your biomechanics are off and other joints are being taxed improperly. The result is what you've got going on right now.

I would have to take a look at your gait, your ankle, your foot, and finally that toe to make a definitive diagnosis. If you'd like to do so, visit my Website for my contact info.

In the meantime I would treat it as tendinitis for the next day or two and ice it several times a day for 10 minutes. The best way to do this is submerse those toes in an ice bath. This can be unbelievably painful, however, so crushed ice, in a baggie, directly on the point of pain (and surround the joint ideally) is second best. Also, give it a 2-day rest.

Good news is I see things like this all the time and it can be treated. I hate to tell an athlete they can't run or workout, but with overuse injuries that is sometimes the case. Can't say for certain what to do though unless I see it. There are a dozen other things that it could be and a dozen other treatments that could/should be done.

If you have any questions, feel free to contact me offline!

Good luck and hope this helped.

Dr. John

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