My daughter is a very competitive basketball player and back in June was playing a physical game. After that game she said the top of her foot hurt. She played a few more games over the next few days but then the pain was so bad she couldn't walk on it. She had an XRAY & MRI - both came out negative. She went to a chiropractor (specializing in sports) and he said where the first & second metatrsal join that joint was not moving causing the issue. We had about 4 treatments and was a little better and thentried to play in nationals (only about 10 minutes total) but the pain really heated up again. She has gone back to the chiro for the last month and the joint is moving but the pain is still there and now is in the arch. SHe just had a bone scan - negative. She is now in physical thereapy where they believe it is the arch and am working on stretching and strengthing. We are all so fustrated as we have never heard of these types of issues. Does anyone have any idea or thoughts what it could be? Does PT sound right? She is already missing her fall sport (and her coach is very upset) and the High school BB caoch is getting nervous. We really need to get this corrected. Any ideas is greatly appreciated!

You have had an opinion from a chiropractor, a PT and negative findings from MRI and X-ray.

What do you know about her foot? Is it high arched, normal, low arched? Does she over pronate or under pronate? The shoes she is wearing are they the correct size?

The structure of her foot could that be factor?

She most be doing more than just playing 10min in nationals. How is her training? Does the pain happen during conditioning run? during drills? When she is not playing basketball what is she doing? What kind of shoes is she wearing or not? The shoes she wears day to day are they fit properly?

Arch pain can be from many different reasons. All of the the following and more: Spring ligament laxity or sprain to include other nearby ligaments, weight change (up or down), growth, Posterior tibialis insertion strain and more.

I would recommend good fitting shoes (that include size and choose for her foot and activity) appropriate arch supports that are fit well custom or other wise.

I hope this helps thanks for the question.

came out negative?WHy?A small careless will lead a damage result.

Dear DebM
How is your daughter doing now? Sometimes pain on top of the foot between the first and second metatarsals can be secondary to a sprain or strain of the Lisfranc's ligament or even a lisfranc's fracture. If xrays are taken too soon, a stress fracture to that area could easily be missed. I would recommend to have the MRI also re-read in order to re-evaluate that joint. Repeat tests will be required. Pain in the heel or arch is usually treated with physical therapy (rice/stretching/other modalities) , anti-inflammatories (if not contra-indicated), orthotics, injection therapy and a night splint. I would recommend following-up with her doctors and hopefully she'll be back to an optimal competitive level.

Good-luck and thank-you for contacting foot.com,
SBarlizo, DPM, CPed
foot.com expert

We went to an Orthopedic surgeon specializing in sports injuries and they re-reviewed all the films and agreed there was nothing there. I did question if it was possibly a Lisfranc injury and they said based on the films and feeling her foot they did not feel it was that. THey said it was first a sprain to the top part of the first (first and second Metatarsal). THey noticved how her foot had additional flexibility that it should not have after years of ankle sprains added to a lower than normal arch helped to attribute to the sprain happening (along with the huge girl hitting her while going in for a layup). Becuase the sprain was not healing from wearing sandals and not having the proper orthotic the foot continued to get strained which then caused the arch to fall.

We are no having her wear the orthotic and continue with PT. I am praying between the two this will heal her foot as this has been going on far too long.

She is now wearing her orthotics all the time correct? I am guessing the injury is to her dominant foot, correct? More than likely her right. If this is the case ( this suggestion is easy to suggest very difficult to do) then she should try to switch dominance. She should not use the injured foot as the take off foot. Try and train with the lefties and match them. If she can take a break from sports and concentrate on recovery I think that would be better.

If that is not possible. Use the pool in your training aqua aerobics, drills. Work on three point shots and free throws become the best free thrower and I lay odds they won't foul as much.

Let us know how the recovery goes.

all these months later we ended up in Boston at the head of a foot and ankle center Hospital. As luck would have it the Xray was not read correctly - there was a bone spur. He also felt she has a stress reaction. Not wanting to due surgery out of the gate, she went into a cast and boot with no pain relief. He even sent us to a sports specialist (orthopedic/Children's). IN the end (and almost a year later she is getting surgery to remove the spur). I pray this will be the end of this foot.com. To all out there - do not rely just on radiologist reports - ask for the doctor to review the film. Unfortuntely for us we showed an orthopedic surgeon the film, but we don't know how much he looked at it becuase he never mentioned it. (THis spur is as clear as day!)

Thank you for keeping us up to date I hope the surgery goes well.