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Originally Posted by Admin
Posts from people seeking help for their own foot problems are usually deleted here. See this.
I was just over at the Foot Helth Forum (where we refer people for help on teir problems) and this one caught my eye:
After excessive exercise in higher heart rate zones (lactate threshold) a rash develops under the skin and a painful burning in the toes. Have seen any number of docters physios and podiatrists. Any thoughts?
The nature of the topic makes it worthy of discussion here.
Any ideas? |
What is a rash "under the skin"??? Could this simply be the reflex cutaneous vasodilation that normally occurs with exercise in warmer temperatures??
http://jap.physiology.org/cgi/reprint/93/4/1215 How long does the "rash" last? If the "rash" ceases within 30 minutes of exercise and is non-pruritic then it is in all likelihood normal reflex cutaneous vasodilation that is seen much more prominently in fair-skinned individiuals.
Burning in the toes is not normal with exercise but first one would need to know if it is heat related (probably not) or neurological in origin (e.g. more likely and probably an interdigital neuroma or
transient plantar pressure neuropathy).
What we first need to know is what type of exercise is being performed? I see a number of patients now who are regularly using the elliptical trainer machines for exercise in gyms and describe a burning and/or tingling and/or numbing sensation plantarly on the feet. I believe this syndrome is what I call a
transient plantar pressure neuropathy from the unrelenting, high magnitudes of pressure to the metatarsal heads and the interposed interdigital nerves. I have also seen these same type of symptoms in cyclists, but not as frequently.
If the patient is on the elliptical trainer, then I have them try leaning backwards a little while on the machine so that they put more weight on their heels than their forefoot. If the patient is a cyclist, then moving their cleats posteriorly on the bike shoe sole also helps. These easy solutions work quite well for many people who complain of these types of symptoms.
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Sincerely,
Kevin
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Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
e-mail:
kevinakirby@comcast.net
Private Practice:
107 Scripps Drive, Suite 200
Sacramento, CA 95825 USA
My location
Voice: (916) 925-8111 Fax: (916) 925-8136
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Exercise induced burning toes
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