Podiatry Management (October, 2010) has just published an article I’ve written titled  Overuse Injuries: All The Small Things . You are just another click away from the PDF version. This is a challenging article. It introduces mechanotransduction, a theory of cellular and tissue function, which is little known in the sports medicine community. The article touches lightly on this topic and then reviews the latest literature and theory on overuse injuries to bone and tendon.

The Needle - Kenneth Snelson

The cellular level is where things start and where we will find many answers. I expect to add more details on the web site on mechanotransduction and mechanobiology for those with hardcore, deep science interest. The article is limited in size, but was longer than many published in PM Magazine. But, I didn’t even touch on the theory canalicular flow and osteocyte induction or mechanotransduction and control of stem cell development by matrix stiffness. Research in the field of mechanobiology is growing daily and the outlook is great that it will be fruitful.

Drifting around the web, I came across a description of pain in a runner’s foot which, summarized, was essentially:

“I began having tenderness in my foot, on the top outside at the row of bones and tendons that connect with the baby toe (at about the middle of my foot).  I was also sore all the way up my shin on the outer side of the same leg… so this made me think it was a tendon or muscle issue..(praying its not a stress fracture)”

The answer to this problem follows:

The part of your foot that is indicated as hurt, on the outer part of the foot, includes the 5th metatarsal bone and the peroneus brevis tendon. Right in the middle is certainly the fifth metatarsal bone.

These parts are usually hurt when you invert or turn in your foot. This can happen when you “twist” your ankle in and sometimes ends up as an ankle sprain.

The muscle that the tendon starts at begins up in your leg on the outer side, that’s why it hurts up there. When the ankle turns in, the peroneus longus and brevis tendons are placed under stress and can become injured. The base and sometimes the shaft of the 5th metatarsal bone can become fractured because of the tendon pull. So, this problem could be either an injury to the tendon – (tendonitis, partial tear) and/or an injury to the 5th metatarsal bone – all the way up to a fracture of the 5th metatarsal bone, along with the tendonitis.

Ice, rest, an ankle brace, and possibly a visit to a local sports podiatrist, along with an xray would be a good idea.

Note: Occasionally the cuboid bone is also injured from forces created by the peroneus longus tendon. Additional information on related injuries to the peroneal tendons and to the bottom of the foot are in an article on the “zone of confusion of the midfoot“.

Best of luck with a speedy recovery!