The foot is one of the most complex structures in the human body.
It is an intricate arrangement of 33 joints, 26 bones, and over a hundred muscles, tendons, and ligaments that work together to absorb impact forces, support your weight, and propel your body forward when you walk and run. 1Manganaro, D., Dollinger, B., Nezwek, T. A., & Sadiq, N. M. (2021). Anatomy, Bony Pelvis and Lower Limb, Foot Joints. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK536941/
Damage to any of these structures can cause foot pain after running.
From seemingly minor foot problems like blisters and black toenails to more severe foot injuries in runners like plantar fasciitis and stress fractures, foot pain after running can be difficult to diagnose initially, given the number of potential causes.
Keep reading for our guide to foot pain after running, where we look at the common causes of foot pain in runners, discuss contributing factors, and most importantly, cover helpful tips and fixes for foot pain to help you get back to training pain-free.
Why Does My Foot Hurt After I Run?
Running injuries are, unfortunately, quite common.2van der Worp, M. P., ten Haaf, D. S. M., van Cingel, R., de Wijer, A., Nijhuis-van der Sanden, M. W. G., & Staal, J. B. (2015). Injuries in Runners; A Systematic Review on Risk Factors and Sex Differences. PLOS ONE, 10(2), e0114937. https://doi.org/10.1371/journal.pone.0114937
And, if you’re experiencing foot pain from running, you’re not alone. According to research evaluating the incidence of musculoskeletal injuries in runners, anywhere from 5.7% to 39.3% of runners experience foot injuries.3van Gent, R. N., Siem, D., van Middelkoop, M., van Os, A. G., Bierma-Zeinstra, S. M. A., Koes, B. W., & Taunton, J. E. (2007). Incidence and Determinants of Lower Extremity Running Injuries in Long Distance runners: A Systematic Review. British Journal of Sports Medicine, 41(8), 469–480. https://doi.org/10.1136/bjsm.2006.033548
Foot injuries are prevalent, as the feet take the brunt of the impact and are the site of initial landing and ground contact.
When you run, your feet are subjected to forces approximately 2-3 times your body weight, and research indicates runners take approximately 1,400 steps per mile at an 8-minute-per-mile pace.4Hoeger, W. W. K., Bond, L., Ransdell, L., Shimon, J. M., & Merugu, S. (2008). ONE-MILE STEP COUNT AT WALKING AND RUNNING SPEEDS. ACSM’s Health & Fitness Journal, 12(1), 14–19. https://doi.org/10.1249/01.fit.0000298459.30006.8d
Foot Pain After Running? Here Are the Possible Causes
There are several common potential causes of foot pain after running, including the following:
#1: Plantar Fasciitis
Most runners have heard of plantar fasciitis, the notoriously persistent foot injury from running that can plague a runner for weeks or months.
Plantar fasciitis causes pain along the bottom of your foot; the affected area is anywhere from the heel bone to the foot arch. Heel pain is often worse first thing in the morning and after running.
This foot injury is due to damage and inflammation to the plantar fascia, fibrous connective tissue along the sole of your foot from your calcaneus (heel) to the base of your toes.
Risk factors for plantar fasciitis include overtraining, increasing volume too quickly, obesity, and wearing unsupportive and worn-out running shoes.
#2: Tibialis Posterior Tendinopathy
Foot pain while running that you feel mostly around your instep or inner arch and heel is often due to tibialis posterior tendinopathy.
The tibialis posterior muscle plays a key role in supporting your arch and preventing your foot from rolling and collapsing inward while you run.
You may also have some pain along the inner ankle and calf and notice a flattened arch. Overpronation, excessive downhill running, worn-out shoes, and weak lower leg muscles can increase your risk of this running injury.
#3: Peroneal Tendinopathy
Foot pain after running along the outside of your foot near the ankle bone can be a sign of peroneal tendinopathy.
Not to be confused with the Achilles tendon, the peroneal tendons wrap around the lateral malleolus, and inflammation causes pain under the lateral ankle joint along the outside bottom of your foot.
The peroneal muscles run down the outside of your lower leg and work to turn your foot out while you run and walk. Excessive supination (foot rolling out) and tight calves can contribute to the development of this foot injury in runners.
#4: Extensor Tendonitis
Extensor tendinitis is one of the most common causes of foot pain after running. It is inflammation of the tendons along the tops of the feet that lift and extend toes.
The primary symptom of this common foot injury in runners is pain along the top of the foot, especially in the region between the front of the ankle and the ball of the foot.
Pain is exacerbated when you lift the foot and may be centralized in the middle of the top of your foot when you run or localized more along the instep towards the big toe.
In some cases, if you’ve been running with extensor tendonitis for a couple of weeks and the condition has progressed, there may also be swelling or redness on the top of your foot. A palpable or visible bump or nodule along one or more extensor tendons is also possible.
There are several risk factors for developing extensor tendonitis, including increasing your mileage too quickly, wearing running shoes that are too tight, running on uneven surfaces or cambered roads, tight caves, and improper arch support for flat feet.
#5: Metatarsal Stress Fracture
One of the more severe causes of top of the foot pain from running is a metatarsal stress fracture, which is a small crack in one of the bones that run along the middle of your foot to the ball of your foot where the metatarsals articulate with the toes.
Although runners can develop a metatarsal stress fracture in any of the five metatarsal bones, it’s most common to develop an issue in the second, third, or fourth metatarsal.
The hallmark sign of a metatarsal stress fracture is pain along the top of the foot that progresses from mild, nagging pain that is only present while running to pain along the top of the foot that lingers at rest.
Eventually, the pain may even persist at night when you’re trying to sleep.
The pain reappears earlier in your run as this foot injury progresses and will linger for more extended periods when your workout is over.
Some runners with metatarsal stress fractures also have visible swelling and potentially even bruising or discoloration in the region of the injury. Pain tends to be more localized than with extensor tendonitis, and you may even have point tenderness.
Metatarsal stress fractures are considered overuse injuries, as they result when repetitive stress accumulates in the bone and exceeds the capacity of the bone to absorb the shock and loads imposed by running.
Although the primary cause of a metatarsal stress fracture is overuse, several factors can contribute to developing this running injury.
These include increasing your training volume too quickly, doing too much speed work, wearing worn-out or unsupportive running shoes, running on hard surfaces like asphalt and concrete, low bone density, and inadequate caloric intake.
#6: Tibialis Anterior Tendinopathy
Sometimes confused with shin splints, Inflammation in the tendon that runs right down the front of the shin and ankle to the top of the foot is called tibialis anterior tendinopathy.
You might feel foot pain after running right at the top of your foot where your foot meets your ankle. It is often caused by tying your shoes too tightly, running downhill, or wearing heavy running shoes.
#7: Metatarsalgia
Foot pain after running that is centralized under the ball of your foot and feels somewhat like a burning pain or as if you are stepping on a pebble might be metatarsalgia.
This foot injury in runners isn’t always due to running itself. Wearing excessively tight shoes, whether running shoes or otherwise, can compress the ball of your foot and cause pressure and inflammation between the joints.
#8: Morton’s Neuroma
If your foot pain after running is located in the ball of your foot near the base of the toes and is accompanied by some burning, numbness, shooting pains, and tingling, you might have Morton’s neuroma.
Like metatarsalgia, Morton’s neuroma can develop from wearing shoes that are too tight because they compress the nerves that run between the bones in your forefoot. This can lead to irritation, inflammation, and scar tissue formation.
Feet that are very flexible or flat, and/or wearing unsupportive shoes can also contribute to the development of this foot injury in runners.
#9: Sinus Tarsi Syndrome
Pain located on the outside of your foot, usually just in front of the lateral malleolus (the large bulging ankle bone), can indicate sinus tarsi syndrome, an inflammation of a channel under which several ligaments run from your foot to your ankle.
This condition can develop after a bad ankle sprain or if you overpronate when you run, which causes your ankles to roll in, putting excessive pressure on this channel.
#10: Vamp Disease
Foot pain along the top of your feet while running can be due to vamp disease. Vamp disease is so named because it involves pain and swelling along the top of the foot, which corresponds to the region of the shoe called the vamp.
Vamp disease is typically caused by lacing your running shoes too tightly. This puts excessive pressure on the tendons, muscles, and tissue of your foot and can cause pain along the top of your foot when you run.
The condition should resolve in a week or two after loosening your laces.
#11: Arthritis
Runners also complain of foot pain after running when they have arthritis in one or both feet. Arthritis involves the degeneration of the cartilage in the joints between bones.
Cartilage cushions bones and smooths the ends of two bones joined at a joint and enables the articulating bones to move relative to one another with minimal friction.
For this reason, when you have arthritis and feel pain, you may also experience crepitus, which refers to a grating sound or sensation from the friction of bones rubbing together. There can also be a loss of flexibility in a joint.
Runners can develop arthritis in any joints of the foot, but it is particularly common along the heads and bases of the metatarsals. As arthritis results from degeneration from accumulated wear and tear, older runners are more prone to arthritis.
Arthritis can often be distinguished from other potential causes of foot pain after running based on the injury history.
Arthritis in the foot is a chronic condition that develops slowly over time. It rarely develops suddenly unless a traumatic injury (such as a Lisfranc fracture) has occurred.
In other words, if the pain on the top of your foot has developed suddenly, it’s not likely to be arthritis.
#12: Hallux Rigidus
Arthritis, specifically in the big toe, is termed hallux rigidus. Also referred to as “stiff toe,” runners with this foot injury may feel pain and stiffness in the big toe while running, with particular difficulty pushing off without pain.
Risk Factors for Foot Pain In Runners
Risk Factors:
There are several training errors and risk factors for foot injuries in runners, including the following:
- Sudden increases in volume or intensity
- Overtraining or insufficient rest and recovery
- Heel striking
- Overstriding
- Overpronation or supination
- Not warming up prior to a workout
- Tight calves
- Wearing tight shoes
- Lacing your shoes too tightly
- Wearing worn-out or unsupportive running shoes
- Osteoporosis and/or inadequate caloric and nutrient intake
- Excessive downhill running
- Weak hips and glutes
- Obesity
Preventing and Treating Foot Pain From Running
Once you’ve identified the most likely cause of your foot pain after running, you can start addressing the problem. Here are possible treatments for these various causes of foot pain in runners:
#1: Replace Your Running Shoes
Worn-out running shoes lack the support your foot needs to hold its form and absorb and transfer forces from impact to push off while running.
Visit your local running shoe store to get properly fitted for new running shoes.
#2: Consider Orthotics
Flat feet can lead to tibialis posterior tendinopathy and plantar fasciitis, while a high arch can contribute to extensor tendonitis and peroneal issues.
Consider seeing a podiatrist or foot specialist for custom orthotics inserts. You can also try over-the-counter insoles for runners.
#3: Strengthen Your Feet
Strengthen the muscles in your foot by spending more time barefoot and performing foot exercises like picking up marbles with your feet, grabbing and squeezing a towel between your toes, and flexing and extending your toes.
Physical activity that strengthens the muscles around the foot has been a staple injury prevention technique in sports medicine for a long time.
#4: Ditch Tight Shoes
Tight running shoes, as well as tight day shoes, can compress the balls of your feet and lead to metatarsalgia or Morton’s neuroma.
Ensure your feet have ample width in the toe box and are comfortable to wear.5Nigg, B., Baltich, J., Hoerzer, S., & Enders, H. (2015). Running shoes and running injuries: mythbusting and a proposal for two new paradigms: “preferred movement path” and “comfort filter.” British Journal of Sports Medicine, 49(20), 1290–1294. https://doi.org/10.1136/bjsports-2015-095054
#5: Use RICE to Heal
The classic treatment for musculoskeletal injuries is RICE, which stands for Rest, Ice, Compression, and Elevation.
Any of the aforementioned potential causes of foot pain after running can respond to RICE, at least to some degree with possible anti-inflammatory benefits.
#6: Stretch Your Calves
Tight calves can contribute to numerous foot injuries in runners, so ensure you spend time stretching your calves or using a foam roller every day.
#7: Loosen Your Laces
Fixing vamp disease or tibialis anterior tendinopathy can be as simple as loosening your laces or using a different lacing pattern on your running shoes to help with blood flow.
You can ice and elevate your foot to minimize swelling.
#8: Ease Up On Your Training
Reduce your mileage by either taking time off or doing low-impact cross-training until your foot pain resolves. More importantly, review your recent training to look for jumps in mileage or intensity.
#9: Seek Medical Care
If you suspect a metatarsal stress fracture, you should stop running immediately.
You should see your healthcare provider, orthopedic practitoner or physical therapist for an X-ray, MRI, bone scan, or other diagnostic imaging. Your doctor may give you a walking boot and potentially even crutches to offload the bone while it heals.
Our feet are our most precious asset as runners, so taking extra special care of them is crucial to being a healthy, happy runner.
Try out 10 Foot Strengthening Exercises to help prevent these potential foot issues:
