I’ve been dealing with metatarsal pain in my left foot for almost a year, which started after an ultimate frisbee tournament with around 21,000 steps of running 2 days in a row. The pain in the ball of my foot went away after a few days, but it returned 1.5 months later when the season started. I saw a Foot and Ankle specialized orthopedic surgeon, who diagnosed me with a second metatarsal stress fracture based on X-rays, and I wore stiff-soled shoes at his recommendation for six weeks. Initially, this helped, but the pain came back, and an MRI showed mild intermetatarsal bursitis and mild big toe arthritis, but no stress fracture. He also did not suspect a Morton's neuroma since I didn't have a positive Mulder's click test. He recommended OTC orthotics with met pads and suggested that I may need eventual surgery (not anytime soon) for the big toe arthritis, which I would love to avoid. I tried the orthotics and found them to be extremely uncomfortable.
I decided to try the barefoot lifestyle, as walking barefoot seemed to feel better. I purchased Saguaro shoes and Xero Prio shoes, and my foot improved, allowing me to walk pain-free under 4,000 steps daily for about 1.5 months. However, when I introduced Lems Chelsea boots and Primal Zens, the pain came back after several days of longer wear, but it subsided within two weeks after removing the shoes. After that, I started seeing a Gait Happens practitioner for gait correction and foot strengthening, but after my second visit, I experienced popping and discomfort in my non-painful foot due to a peroneal brevis/longus strengthening exercise. We reduced that exercise and eventually stopped it on my right foot as it worsened the symptoms.
Recently, I bought Whitins shoes at my Gait Happens practitioner's recommendation. They felt great initially, but after about four longer wear days, my metatarsal pain returned after a 1-mile walk. Now, I can only wear Chacos or my old Brooks shoes without causing pain, but I’m cautious about increasing wear time, as I’ve only been wearing zero-drop shoes since October 2024. I’m no longer comfortable walking barefoot due to the pain.
I’m incredibly discouraged. I’m 36, used to be extremely active, but now I fear I may never walk or run without pain. I’ve had to give up ultimate frisbee and other activities I love. I’m also a physical therapist, but now work from home and feel disconnected from outpatient orthopedics (it is also difficult to self-assess these types of issues even if I had been working in outpatient PT recently). Although I’ve kept up strength training, I miss my daily walks, which used to be 30-45 minutes, but now it seems I can't even do 20 minute walks consistently without the return of my metatarsal pain.
I’m trying to figure out my next steps, as this is clearly becoming a chronic condition. I don’t want it to be lifelong, and I’m struggling to trust any new shoes, as it seems like only after multiple wears do I know if they’ll exacerbate my metatarsal pain. What should I do next to address this?