Are you experiencing top of foot pain after running? Depending on the severity of the pain, it could be a stress fracture, tendonitis or bone spurs. Bone spurs can sometimes form on the foot which can cause pain as they irritate the nerves. Arthritis can cause bone spurs to develop. Tendonitis is inflammation of the tendons. Pain can be felt near the toes and extend to the mid-foot. Tendonitis can be caused by tight calves, tying shoes too tightly or overuse.
Tendonitis is less severe than a stress fracture, but it can lead to a stress fracture if the issue is not resolved. Overuse of the foot tendons cause them to become inflamed or deteriorated and they can no longer absorb the shock of running. Stress is placed directly on the bones which can cause cracks in the metatarsals.
There are five metatarsals in the foot, but it is unlikely that a fracture will occur in the largest one that leads to the big toe. A break in any of these bones will result in pain on the top of foot. Symptoms include gradual pain on top of foot that increases during running. The pain often diminishes during rest. A more advanced break will continuously cause foot pain in all activities such as standing, walking and even while resting.
Swelling may be visible on top of the foot and on the outside of the ankle. Bruising may also be present and there may be tenderness in the area. If there is a fracture, tapping on the bone will cause pain which doesn't happen if the problem is in the muscles or tendons.
The following video clearly demonstrates the symptoms of metatarsal stress fractures in the foot:
A stress fracture is usually caused by overuse, but what situations create overuse? A sudden increase or change in your level of activity, a change in terrain, improper foot strike, and poor running posture are some of the possible causes that can create top of foot pain. Loss of bone density due to arthritis can also cause stress fractures. Overstriding can cause top of foot pain. It is essential that your foot land directly underneath you to prevent this injury, especially if you run in minimalist shoes.
Pain on top of foot is a common injury for new barefoot runners. As runners try to transition to running in minimalist shoes, they need to be careful not to put too much stress on their feet as they are building strength in muscles that were previously not utilized.
Their feet are being exposed to stress that otherwise would be cushioned in traditional running shoes. Therefore, they need to really focus on their posture and foot strike, ensuring that they are not overstriding and that their heels make contact with the ground to absorb some of the impact. Landing only on your forefoot without heel contact while transitioning to running in minimalist shoes can cause foot pain and if not corrected, a fracture.
I developed top of foot pain while I was transitioning to Vibram FiveFingers. I didn't get an x-ray, but I believe that it was a stress fracture as it was so painful and took a long time to heal. I had to stop running for more than two months and just standing was painful. When I started back running, I had to really focus on my posture to ensure I was not over-striding. A slight lean forward from the ankles usually corrects this.
A few months later the pain began to come back although it was much less severe. I realized that I was landing on my forefoot only and it was taking all the impact. I tried bringing my heel down so that I was landing with a mid-foot strike. Changing my foot strike has really made a difference as I don't feel foot pain when I use my whole foot.
If the pain doesn't go away after three weeks, you must seek medical assistance. To aid healing you can use a cold pack to reduce swelling and apply heat only when there is no swelling present. Don't wear shoes with heels or stiff soles. Anti-inflammatory drugs can help reduce the swelling and pain. It is important to rest your foot.
I made the mistake of taking long walks when I couldn't run as it seemed to ease the pain. However, I was just doing more damage as my doctor explained when I finally went to see him. Walking gets the blood flowing and reduces the swelling, which of course reduces the pain. However, walking with a stress fracture can only cause more damage and will extend the healing time as I learned the hard way. My doctor suggested acupuncture as a treatment and it really helped. After a few weeks of treatments, my pain was gone and I could begin to ease back into running.
If the pain in your foot is causing you to limp, you may want to consider getting crutches or using a walker boot. You don't want to develop a permanent limp. Again, rest is essential.
You may also want to try taping your foot with KT Tape as shown in this video:
You may also be interested in these articles:
Return to top of Top of Foot Pain