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climb_eng
Aug 21, 2007, 10:04 PM
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I haven't posted this, mostly because I thought it would go away... so it's a long story now, a story of my toe.
It all started on the first weekend of May. I had been climbing solidly for the past month, and had been sending harder routes then ever before.. both sport and trad.
Then, one weekend (a weekend where I didn't go climbing at all, but did go hiking) my toe started to hurt when I put pressure on it. I ignored it for a few weeks and continued climbing, but it got worse and worse, to the point where I could barely walk. I swore off climbing at that point.
I got a little bit better after 4 weeks off it (though it still hurt a little bit) and tried climbing, but it hurt all over again, and badly!
I went to a podiatrist to have a look at it, but the guy seemed only interested in selling my $500.00 insoles, rather than helping me with my problem. He did however notice stress on the joint that was giving me trouble. He suggested I tape it when I climb.
I tryed this and it seemed to work for a while. Then in an unrealted incident I tweaked my toe while kayaking. This brought it back down to the barley-walk level I was at in late may (and it was now late July).
Here I am today, off climbing, toe still hurting and not getting any better. Does anyone know what the problem is and why it isn't going away!?! I've gone to a doctor about it, but the best advice I got was 'stay off it'.
I need to get this toe healed, it totally ruined my climbing season... I was planning a big climbing road trip in January, and now I'm worried that it might not happen. Help me please!
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majid_sabet
Aug 21, 2007, 10:21 PM
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sorry to hear this but human body is not a diesel engine. you need to give it some time to heel itself or else you will be dismissed from climbing for life and I know you do not want that.
Give it some chance and let it rest.
Good luck.
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boku
Aug 21, 2007, 11:53 PM
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I'm not a doctor, nor do I play one on TV. But that sounds like gout to me. My father has it. Not pleasant.
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rocknice2
Aug 22, 2007, 12:02 AM
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I was about to pass this buy as an unfortunate American without insurance seeking medical advice from the internet but your from the land of universal healthcare. Get another opinion and another until you find a Dr. who can give you a diagnosis. You may not like it but you'll know what is causing it.
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mitchgripgrabber
Aug 22, 2007, 12:36 AM
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Gout don't laugh. I might have it myself. Look it up on the Wikipedia. get off the the meat and cheese and beer shit the bed
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sinrtb
Aug 22, 2007, 12:47 AM
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Acording to Wiki cheese helps.
In reply to: To lower uric acid: * cherries were reported to reduce uric acid in a small study.[20][21] * celery extracts (celery or celery seed either in capsule form or as a tea) is believed by many to reduce uric acid levels (although these are also diuretics).[citation needed] Celery extracts have been reported to act synergistically with anti-inflammatory drugs.[22] * any kinds of cheese[citation needed]. Cheese has been recommended as a low-purine food,[23] and dairy products have been found to reduce the risk of gout. |
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EPiCJAMES
Aug 22, 2007, 12:48 AM
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i had this same problem when i rode BMX years ago. as soon as it felt okay, it got messed up again. you definitely have to give it more time. ice, then heat. always apply both. if you're going to climb, take an advil, or some other anti-inflamitory about 24 hours before the climb. it will be in your entire system, and at it's best. also, try another pair of climbing shoes. maybe some lace ups will help you relieve pressure where you need to. lastly, no more hiking, or kayaking, just climbing. hahah, just messin. hope your recovery goes well and speedy. good luck.
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HarklessDO
Aug 22, 2007, 12:56 AM
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I am a doctor but I do not play one on TV. Reading your description I can think of a few things. Gout is obviously a top choice. The other options due to the fact that this started with hiking. You could have knocked a little osteophyte, ie arthritis loose when hiking causing inflamation and further pain. The other options include a tendonitis in the joint.
I am assuming with going to the podiatrist you have gotten a x-ray to rule out fracture and you do not have an ingrown toenail. One final option all though it does not sound like this is that the toe is slightly dislocated a quick tug will fix this.
With all this said the biggest problem most likely that you have is a problem with inflamation. The easiest cure for all the above is a good 10 day course at max doseage of your favorite NSAID. Ibuprofen (Advil) or naproxen (Alleve). If not taken for multiple days and consistently you really do not get the blood levels up enough to get down inflammation instead you are just treating the pain.
For Advil it is 800 every 8 hours and for alleve 500 mg every 12 hours.
Good luck
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climb_eng
Aug 22, 2007, 1:03 AM
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Doctor rules out gout. The x-ray showed a bit of stress on the joint (in the podiatrists words) but no fracture. Not an ingrown toe nail either.
IT was almost better when I chose to climb on it last (3 weeks ago). That tweeked it a bit, but the kayaking sent me over the top.
Anti inflamitory? Would that make it heal faster or just stop hurting?
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EPiCJAMES
Aug 22, 2007, 2:02 AM
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climb_eng wrote: Doctor rules out gout. The x-ray showed a bit of stress on the joint (in the podiatrists words) but no fracture. Not an ingrown toe nail either. IT was almost better when I chose to climb on it last (3 weeks ago). That tweeked it a bit, but the kayaking sent me over the top. Anti inflamitory? Would that make it heal faster or just stop hurting?
it will help with the pain, but mostly the swelling. even if you don't see any swelling, it's probably there.
another option, go to a chiropractor. maybe it's something with the alignment with your legs.
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zealotnoob
Aug 22, 2007, 2:20 AM
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EPiCJAMES wrote: another option, go to a chiropractor. maybe it's something with the alignment with your legs.
Yes! Or a reflexologist. You may be lacking the healing power of magic crystals.
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reno
Aug 22, 2007, 3:33 AM
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climb_eng wrote: Doctor rules out gout. The x-ray showed a bit of stress on the joint (in the podiatrists words) but no fracture. Not an ingrown toe nail either.
Top of toe, bottom of toe, or all of the above?
In reply to: Anti inflamitory? Would that make it heal faster or just stop hurting?
Both, unless you use the NSAIDs for a long period of time, in which case the medication can delay healing.
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climb_eng
Aug 22, 2007, 3:46 AM
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First joint on the big toe.
Only when bending, twisting or applying pressure. Doesn't hurt in normal walking, running or most other activities. Basically, anything where my toe bends or twists while pressure is being put on (IE climbing).
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EPiCJAMES
Aug 22, 2007, 5:12 AM
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zealotnoob wrote: EPiCJAMES wrote: another option, go to a chiropractor. maybe it's something with the alignment with your legs. Yes! Or a reflexologist. You may be lacking the healing power of magic crystals.
i don't think the magic crystals will help, but good alignment might. think of a pendulum, one ball out of place, everything gets fucked up.
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dynoho
Aug 22, 2007, 5:39 AM
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climb_eng wrote: Doctor rules out gout. The x-ray showed a bit of stress on the joint (in the podiatrists words) but no fracture.
Just curious, how did they rule this out? The only certain way to diagnose gout is to have a joint fluid aspiration (arthrocentesis) test to see whether uric acid crystals are present. They may also test uric acid levels in the blood or urine, but these are not definitive and results vary with the timing of the tests.
It sounds a lot like gout, IMO. I'm not a doctor, and I've never been on TV, but I've had several gout attacks. PM and I can provide more information.
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climb_eng
Aug 22, 2007, 5:50 AM
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rocknice2 wrote: I was about to pass this buy as an unfortunate American without insurance seeking medical advice from the internet but your from the land of universal healthcare. Get another opinion and another until you find a Dr. who can give you a diagnosis. You may not like it but you'll know what is causing it.
Unfortunatly, the land of universal heath care is also the land of extreme doctor shortages. I can't get a familly doctor in this city, and I don't have time to wait 4 hours at a walk in clinic just to be told to stay off it (with no x-rays or any other sort of attention).
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elwood54
Aug 22, 2007, 7:41 AM
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I've been out of climbing for two weeks now with pain in my big toe. I hadn't really considered gout...just think I strained it climbing on those tiny jibs in the gym and didn't rest after my initial injury. After continuing to climb for a month or so, I finally had to bite the bullet and take some time off. I am heading to podiatrist next week though...but seriously? Gout???
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climb_eng
Aug 22, 2007, 2:27 PM
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Sounds like the same problem I had. My doctor was pretty sure it wasn't gout. The symptoms of gout are very accute... extreme swelling and pain that come and go. This is a constant pain when pressure is applied to the toe and theres no swelling. Plus it's the wrong joint (for me). Gout generally occured on the second joint of the big toe (behind the ball of the foot) rather than on the first joint (just south of the toe-nail).
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reg
Aug 22, 2007, 3:07 PM
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see "rocknice2" - 2nd, 3rd, whatever opinion(s)
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reno
Aug 22, 2007, 5:46 PM
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climb_eng wrote: First joint on the big toe. Only when bending, twisting or applying pressure. Doesn't hurt in normal walking, running or most other activities. Basically, anything where my toe bends or twists while pressure is being put on (IE climbing).
Any chance you've injured it recently, specifically forecful downward flexion (pointing your toes, only WAAAAY too far?)
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the_climber
Aug 22, 2007, 7:53 PM
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climb_eng wrote: rocknice2 wrote: I was about to pass this buy as an unfortunate American without insurance seeking medical advice from the internet but your from the land of universal healthcare. Get another opinion and another until you find a Dr. who can give you a diagnosis. You may not like it but you'll know what is causing it. Unfortunatly, the land of universal heath care is also the land of extreme doctor shortages. I can't get a familly doctor in this city, and I don't have time to wait 4 hours at a walk in clinic just to be told to stay off it (with no x-rays or any other sort of attention).
There is a quick fix to the waiting then no x-ray problem, but it involves a sledge hammer and a trip to the emerg. It might hurt a lot, and you might still have to wait a while, but you'll be guarantied to get an x-ray and likely surgery to fix the problem too.
 Someone had to give the smart ass responce
Seriously though I hope you get this sorted out. I had something similar a while back, but not as long lasting... it turned out to basically be an over use type thing and was basically a combination of spraining/jamming my big toe and some stress fracture(think shin splints) type thing. It royally sucked, but did get better after a couple months.
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reno
Aug 22, 2007, 8:51 PM
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climb_eng wrote: Unfortunatly, the land of universal heath care is also the land of extreme doctor shortages.
For posterity.
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climb_eng
Aug 22, 2007, 9:01 PM
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reno wrote: climb_eng wrote: Unfortunatly, the land of universal heath care is also the land of extreme doctor shortages. For posterity.
Touche! But in defence of our system. It Canada itself it's generally much better. In the particular city i'm in (Calgary, AB). Theres been so much growth in recent years that the number of doctors in town just hasn't caught up. Back in my home town (Victoria, BC) seeing a doctor was never a problem.
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midwestpaul
Aug 22, 2007, 9:58 PM
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I had similar symptoms. Then I figured out it was happening when climbing steep stuff in mountain boots and sport climbing shoes that were like chinese foot bindings. I have since limited use of these two torture devices and the problem is gone.
I'm not a doctor. But I stayed in a Holiday Inn Express last month.
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onceahardman
Aug 29, 2007, 9:23 PM
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ok, climb eng, i'll take a crack at it. i am a PT.
first, for your info and accuracy when describing this:
FIRST joint, south of toenail = 1st IP (interphalangeal joint, the other toes have DIPs and PIPs , distal interphalangeals and proximal interphalangeals.)
2nd joint is MTP. (metatarsophalangeal)
1st IP doesn't rule out gout, but reduces suspicion a lot. so does lack of swelling and redness.
What I Would Do If I Were You: i'd look for a PT who is familiar with Brian Mulligan's system of joint mobilization with movement. this sounds to me like a joint TRACKING problem. subtle subluxation or muscle imbalance leading to the joint tracking poorly, and causing pain with increased load. a good mulligan PT could at least let you know in 2 sessions if he or she could help. the treatment is really simple, but extremely effective when indicated. i am located in buffalo NY, and i know a few PTs here and there who do this stuff. you might research "brian mulligan PT new zealand NAGS SNAGS MWMS" or some such combination, and find someone close to home who could help. if you ever get to toronto i'm about 2 hours away, plus the wait at the bridge! i'd tell you how to do the treatment in this format, but it would take a long time to explain even the simplest concepts.
good luck!
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