Can Running Cause Foot Pain?

The structure of the foot

The foot is a complex structure containing 33 joints, 26 bones, and more than a hundred muscles, tendons, and ligaments, that all work together. During running, there is additional downward force between a person’s foot and the ground, reaching up to twice their body weight. This might explain why foot injuries account for up to 40% of all running injuries, and the second most common place for running injuries of the lower leg.

The foot is divided into 3 sections – the forefoot (toe area), the mid foot (arch area) and the hindfoot (heel area).

[Illustration] Areas of the foot

Image adapted from: Vasiliadis et al.

Common types of Foot pain from Running

There are a variety of foot injuries that can result from running. Here, we’ve grouped the types of pain and possible injury or condition, according to where it might be felt in the 3 areas of the foot. You’ll also learn about the possible causes of these common types of foot injuries associated with running, in the section that follows, in this article.

[Illustration] Some of the common types of foot pain from running & where they may be felt

Image adapted from: Vasiliadis et al.

Hindfoot pain

The hindfoot is made up of the heel and the ankle joint. Pain in the hind foot after running, may be:

• Heel pain from stress fracture of the heel bone Achilles tendonitis, Plantar Fasciitis, or a bruised heel
• Ankle pain from Achilles tendonitis, snapped tendon, ankle sprain or strain
• Nerve pain caused by a condition known as “Joggers Foot” felt as a burning heel and arch pain

Midfoot pain:

The mid foot is between the heel and toe area where the arch of the foot is formed. The flexible and sturdy bone structure of the midfoot supports the arch of the foot. Pain in this area may be:

• Muscle strains and sprains which can cause pain, swelling or bruising in the bottom of the foot
• Stress fractures, affecting the long metatarsal bones of the midfoot may cause pain when putting weight on the foot and may be inflamed
• Sharp pain between the arch and heel of the foot, from a condition called Plantar Fasciitis
• Nerve pain on the inside arch of the foot up to the first and second toes and numbness in the sole of the foot, caused by “Joggers Foot

Forefoot pain:

The forefoot consists of the bones that form the base of the toes, also called the ball of the foot, and the toes. Pain in the ball of your foot is known as metatarsalgia. Forefoot pain may be:

• Sprains may cause pain, swelling and bruising in the ball of the foot
• Ingrown toenails may cause pain or swelling around the nail
• Stress fractures of the metatarsal bones that are situated between the toes and the arch of the foot, may be painful when pressure is applied and may also be inflamed.
• Nerve pain also known as Morton’s neuroma, felt as sharp, burning or shooting pain at the ball of the foot, near the third and fourth toes

Common causes of foot injuries from running

Some injuries can be sudden from accidental causes like twisting your ankle or losing your balance. Or they may develop over time, such as a strain from overuse.

Sudden or accidental injury:

These types of injuries are more likely to occur if you don’t warm up before exercising, overestimate your fitness and ability, use the wrong footwear or equipment, have poor technique, do too much too quickly or over-train:

• Sprains or fractures are usually caused by twisting injuries when running or jumping. It takes a lot of force to break the ankle. A sudden sharp pain in the heel may also be a sign of a heel fracture. Read more about the difference between an ankle sprain and fracture (broken bone) here.
• Ruptured Achilles tendon is a full or partial tear to the tough rubbery cord that links the calf muscle to the bone. A sudden, sharp pain at the back of the ankle or heel may be a sign of a rupture in the Achilles tendon.
• Bruised heel is caused by a bruise to the heel pad.

Running injuries caused by overuse:

Most foot injuries from running, are caused by overuse. These types of injuries are a result of overusing the foot such as marathon runners, whose feet spend long periods in a repetitive action without sufficient recovery time. Poor running technique also plays a role. Overuse injuries can affect any part of the foot, including muscle, tendons, ligaments, and bone. People who train regularly, including professional athletes with intense training schedules, are more likely to have overuse injuries.

Common overuse injuries from running, include:

• Stress fractures are common sports injuries that are small, incomplete breaks (fractures) in bones. It’s caused when the muscles and tendons can no longer absorb and cushion the bones, because of an overload of repetitive weight-bearing force, such as during running. Stress fractures can affect the bones at the ball of the foot, top of the foot and heel.
• Achilles tendon pain also known as tendinopathy, is caused by overstretching this strong tendon. Regular running can cause wear and tear to the tendon over time. 8B The back of the ankle or heel may feel mildly, but continuously painful and might be swollen. It may also feel worse in the morning.
• Plantar Fasciitis affects the thick band of tissues stretching under the foot (known as the plantar fascia). It’s a common cause of pain between the heel and foot arch. Likelihood may be affected by a runner’s foot structure, running style, how much running they do and their height. This condition can also happen if you suddenly do a lot more running, run uphill or your shoes are worn or unsupportive.
• Nerve pain can be caused by conditions such as Mortons Neuroma or Joggers foot, when a nerve might be pinched, irritated, or damaged. Morton’s neuroma can feel like burning, shooting, or stabbing pain near the toes, sometimes with tingling or numbness or feel like a pebble is stuck under your foot. Jogger’s foot may cause pain in the hind- and midfoot areas, sometimes with numbness at the ball of the foot near the big toe.

Things you can do to avoid foot pain after running

Not all sports injuries can be prevented, but we’ve listed some sensible precautions that may reduce the likelihood of injuries.

Before You Exercise

• Warm up before exercise by stretching or rolling muscles and increasing your activity levels slowly. You could start your run by doing 5 to 10 minutes of brisk walking or gentle jogging to warm up your muscles and help prevent injuries.
• Consider getting a coach who can teach you correct techniques, particularly if you’re new to running. You can get advice and training from a qualified healthcare professional or a sports coach. It’s also important to maintain your fitness to avoid injury.
• Wear the correct footwear, such as supportive running shoes People's choices and needs for running shoes vary. However, before choosing something unusual such as barefoot shoes or corrective shoes, make sure you have some advice. For example, for barefoot running you need to be taught the right technique. Break in new running shoes gradually - injuries can result from a sudden change in running shoes.

While you’re exercising

• Try not to push your body too hard and stay within your own fitness capabilities.
• Sudden injuries are accidental but are less likely to occur if you exercise in a sensible way, for example, not running in the dark on rough ground.

After exercising

• Make time in your training session to cool down afterwards, by running at an easier pace or walking for the last 5 to 10 minutes. You can also do specific cooling exercises and stretches. Cooling down helps your body recover after running.

How to manage foot pain from running

When you have foot pain during or after running, consider the following:

• Stop exercising

You should stop exercising if you feel pain, regardless of whether your injury happened suddenly, or you've had the pain for a while. Continuing to exercise while you're injured may cause further damage and make your recovery time longer.

• Get medical advice

Consider seeking medical advice if pain prevents you from resuming running or your normal day-to-day activities. It’s also advisable to see a GP if you’re not sure what's wrong, to avoid repeating the same problem the next time you exercise.

Treating sudden sports injuries at home

Minor injuries may sometimes be treated at home. Follow “PRICER” if you have just injured yourself. It stands for Protection, Rest, Ice, Compression, Elevation and Rehabilitation of the injury.

When following PRICER, consider that:

• Protection means preventing movement of, or adding padding to the injured foot, or wrapping a bandage around your ankle and foot, to support it.
• Rest the injured foot or both feet.
• Icing means putting an icepack on the injury (not directly on the skin). Although this is common advice, science has not yet proven that icepacks make a significant difference and in some cases the cold ice may delay healing. However, there is no strong reason for OR against icing.
• Compressing the injury by bandaging the foot and ankle
• Elevate the foot by raising it when you can.
• Rehabilitation is in fact active rehabilitation. If you are a keen runner, complete rest is not always realistic, particularly if you want to keep your fitness level up. Instead, you may need advice from a GP, physiotherapist, or sports injury clinic for advice on how to use exercise and movement to speed up healing whilst continuing to exercise.

Treating overuse sports injuries at home

Nerve Pain from Morton’s Neuroma

• Avoid wearing shoes that are tight around the toe area (forefoot).
• Use soft insoles or pads in your shoes. These can be purchased over-the-counter at pharmacies
• You may need to reduce your amount of running to ease the pain

Achilles pain

• Apply wrapped up ice to the area, if you can feel a lump there. Never put ice directly on your skin.
• You can also gently massage the area with your fingers.
• You can try using heel wedges in your shoes. Get advice about this from a sports or running shop.
• Rest by reducing or stopping running but restart when the pain has gone. You can put weight on the foot if it’s not too uncomfortable. Get medical advice if the pain does not go away.

Heel pain from Plantar Fasciitis

• Applying wrapped up ice to the area can help. You can do this by freezing a small bottle of water, placing it on the floor and rolling it back and forth under your foot for about 15 to 20 minutes. Never place ice directly on your skin.
• You will not be able to run with heel pain. If you treat the pain early enough, it may go away in a few weeks, after which you may be able to start running again.
• Rest the foot (by avoiding standing or walking for long periods) where possible. Wear shoes with good arch support and cushioned heels (such as laced sports shoes). Avoid walking barefoot.
• Consider purchasing insoles and heel pads to insert in your shoes.

Pain caused by stress fractures

• Reduce the weight placed on the injured foot by using a supportive shoe or boot or crutches for at least 6 to 12 weeks. Fitness can be maintained by doing non-weight–bearing exercises such as swimming.

Exercises to relieve symptoms of Plantar Fasciitis and Achilles tendinopathy:

• Achilles tendon and plantar fascia stretch.
  • Keep a long towel beside your bed.
  • Before getting out of bed, loop the towel around your foot, and pull it towards your body, keeping the knees straight, causing your toes and forefoot to bend toward you, hold this position for 30 seconds.
  • Repeat three times for each foot.
• Wall push-up or stretches for the Achilles tendon.
  • Place both hands (at shoulder height) on a wall, with one foot in front of the other.
  • The front foot should be approximately 30 cm (12 inches) from the wall. With the front knee bent and the back knee straight, lean towards the wall, until you feel a tightening in the calf of the back leg, and then ease off.
  • Repeat ten times.
  • Repeat the whole exercise again, but with the back foot brought forward a little so that your back knee is slightly bent. Repeat ten times. Repeat both sets of stretches twice a day.
• Stair stretches for the Achilles tendon and plantar fascia.
  • Stand facing upstairs using the stair-rail for support. Your feet should be positioned so that both heels are off the end of the step, with your legs slightly apart. Lower your heels, keeping the knees straight, until you feel a tightening in your calf.
  • Hold this position for 20–60 seconds, and then raise your heels back to level.
  • Repeat the exercise six times, at least twice a day.
• Dynamic stretches for the plantar fascia.
  • While seated, roll the arch of your foot over a rolling pin, a drinks can, or a tennis ball, allowing your foot and ankle to move in all directions as it rolls over the object.
  • Continue the exercise for a few minutes, stopping if it gets too uncomfortable. Repeat the exercise at least twice a day.

When to get medical advice for overuse injuries:

An overuse injury may mean that you have been unconsciously overstraining or overusing a joint, or tendon, or group of muscles for a long time. Correcting this so that you can continue to exercise needs careful assessment and advice to help prevent the injury from returning or becoming worse. Advice from a sports physician or a physiotherapist with an interest in sports medicine can help you to recover and help prevent the same injury from returning. Here’s when to get medical advice or see a GP for foot pain from running:

• Stop running and get medical advice straight away if your heel or the area under your foot, is very swollen, or if the pain does not go away.
• See a GP or a physiotherapist if you have Achilles (ankle or heel) pain that does not disappear after 2 to 3 weeks, or if you have a sudden, sharp pain. This could be a sign that your Achilles tendon may have torn.
• If pain occurs when you put weight on one or both feet and worsens gradually, it’s a good idea to see your GP as this may be a sign of a stress fracture. You may require x-rays or a bone scan.

Pain relief for Foot Pain

You can treat most minor running injuries yourself by resting your feet and using over-the-counter painkillers for pain relief.

You can use pain relievers such as paracetamol or ibuprofen to relieve most types of mild to moderate foot pain. Ibuprofen gel can be applied to foot injuries or ibuprofen tablets can be used if necessary. Nurofen contains ibuprofen, which has anti-inflammatory properties. Nurofen Joint & Back Pain Relief Max Strength 10% Gel containing ibuprofen provides soothing relief where it is applied and penetrates the skin rapidly to help relieve inflammation in tissue and joints such as the ankle or in the foot.

This medicine may not be right for you. Read the label before purchase. Follow the directions for use. Incorrect use could be harmful. If symptoms persist, talk to your healthcare professional.

FAQs

Can I still run with foot pain?

It’s advisable to stop exercising if you feel pain, regardless of whether your injury happened suddenly, or you've had the pain for a while. Continuing to exercise while you're injured may cause further damage and make your recovery time even longer.

How do I stop my feet from hurting when I run?

Not all sports injuries can be prevented, but we’ve listed some sensible precautions that may reduce the likelihood of injuries, in this article under the heading “Things you can do to avoid foot pain after running.“

What is “joggers’ foot”?

Joggers foot is a type of nerve pain where a nerve might be pinched, irritated, or damaged. Joggers foot may cause pain in the hind- and midfoot areas, sometimes with numbness at the ball of the foot near the big toe.

What does it mean when your foot hurts when you run?

There are a variety of foot injuries that can result from running. Some injuries can be sudden from accidental causes like twisting your ankle or losing your balance. Or they may develop over time, such as a strain from overuse. Most foot injuries from running, are caused by overuse.

This article is for general information only and not intended as a substitute for medical advice. All information presented on these web pages is not meant to diagnose or prescribe. In all health-related matters, always consult your healthcare professional.

RKT-M-05836