Random Mid-foot pain
I recently saw a 16 year old boy who has been having random midfoot pain coupled with swelling which occurred for 3-4 days at a time and prevented him from being able to walk. He states this has happened 6-7 times in the last 3 years and was eased with massage, being kept warm and rest.
On examination it appears to be at the base of his 2nd and 3rd metarsals but has not occurred for 6 months. He has a slightly increased STJ and MTJ range of motion, but his RCSP is neutral and he has an effective windlass mechanism on weight bearing. Of note, he has extremely tight calf muscles for which I have given gastroc and soleus stretching. He has had recent growth spurts in the last 3 years and is quite big for his age now, even though he has lost weight in the last year. He also states he did used to wear narrow fitting shoes.
I felt that he did not require orthotics as his footwear was appropriate and supportive. My question is was his pain which appears to have settled, due to growth spurts, excess body weight, and tight calf muscles coupled with increased motion in the Midtarsal joint which likely caused pain at the met/cuneiform joint. I haven’t been able to find anything about this on the internet.
I would appreciate any opinions.