Question
QUESTION: First - THANK You for posting your other answers, and taking the time to
consider my condition.  I will try to detail my problem.

vitals: 30 year old male; athletic; 2 marathons and avid road cyclist; active at
gym on weights for past 15 years

My tale:
In the beginning of the year while training for a marathon I was completing
my final long run (18 miles) and noticed my foot was going numb, then it felt
like it was cramping.  To the point where I walked home 4 miles - which is
indicative of the discomfort.

My condition:
My left foot - mainly the top portion (if I had to isolate the sensation) tingles
without activity (sitting).  When I attempt to run I can go for about 2-5
minutes (9.5-11 minute mile pace) before the cramping returns.  The tingling
is not continuous and does vary in presence and severity during the day.  I do
not feel it in the mornings right after getting out of bed, but any activity
makes it (the tingling sensation) return.

Treatments:
I have had an MRI of my lower spin and scans of my left leg with no problems
noted.  I have gone through 4 months of physical therapy; I have gone
through the pressure point therapy; vitamin regiments; severe stretching of
hamstrings and such exercises.  My current physical therapist has noted that
my left leg seems out of adjustment from my right (laying down my ankle
bones are not symmetric w/o treatment) and the rotation of my hip joints
seem tight and lose inconsistently.

Currently:
I am being advised to focus on building my "rear-end" muscles, by practicing
different exercises.  This treatment has reduced my condition (at worst my
whole leg was numb), but has returned me to a state of being unable to run.  

Please, any guidance, exercises, treatments to seek, etc... would be
appreciated.  I have become trapped and feel nearly depressed by this
condition that seems impervious to treatment.

ANSWER: James,

Hang in there!  THere's likely a solution.   I have questions, though.  Why is everyone looking at you spine and leg when it is your foot that has symptoms?   If you don't have sciatica, and you don't have a calf "compartment syndrome," then why isn't anyone looking at your foot.   Do you have tarsal tunnel syndrome??   If you have not yet seen a podiatrist, I'd suggest that you make that your priority.   FOUR MONTHS of PT??  Uuuuuuuuh...it's not working, dude.  As your PT how many people have unequal leg lengths.  How about if if it's almost everyone...   If you have a true difference in bone length, that's a different story.  Regardless, you must see the DPM first.   If you do not have a nerve entrapment in your foot, and if you do not have "chronic exertional compartment syndrome (CEPS)", then your next logical choice is a sports chiropractor.  Go to www.acbsp.com and see if you can find a DACBSP - at best - or someone with a lot of experience treating extremities.   If you email me off list I can help you with that.   Stop stretching.  You're likely either wasting your time or making things worse.   So long as you don't have a boney encroachment on the nerves in your foot, there's a chance that you can get some relief with joint manipulation and targeted soft tissue work (vis. graston technique).  See what the DPM has to say, first.   

Stay in touch!

Dr. G   [email protected]   www.drgillman.com



---------- FOLLOW-UP ----------

QUESTION: Thank you for the follow-up!  Let me see if I can give greater detail:

Attention was paid to the pelvis and spine were done due to a belief that I
had a piriformis type affect.  Is it typical for a whole leg to be feeling numb /
tingling sensations due to a foot injury that you are considering?  I have seen
a podiatrist and he did some evaluations but came away with nothing.  I also
have weakened muscles on the left side vs. the right side.  I also have minor
muscle reflex decreased sensations.

Not sure what Tarsal Tunnel syndrome is... will google and ask a doctor on
Thursday.  The leg lengths they are stating is muscle flexibility and tightness
and not a bone length..

I shall explore the CEPS and then the chiro next.  Can you give me your
thoughts with the above details?

Answer
James,

You didn't tell me that your whole leg was going numb.  You just said your foot.  This is one of the problems with internet-based question/answer exchanges.   You really need a live, one:one consult and physical examination with a sports chiropractor.  Go to www.acbsp.com and see if you can find a DACBSP in your region.  See if you can cross a sports chiro with someone on this list: www.grastontechnique.com.   If nobody has performed skilled, high-velocity manipulation to your ankle and foot, then you are missing out on a large chunk of therapy.   I'd prefer you email me off list on this.  Have you had an EMG?  

Dr. G.