There are few things more frustrating to runners than injuries. Just when everything seems to be clicking with your training and you’re crushing your workouts, a niggle crops up, threatening to sideline you.
From knee pain to shin splints, there are numerous common running injuries, and studies show that up to 79.3% of runners deal with lower extremity musculoskeletal injuries.
Unfortunately, pain on the top of your foot from running is also common. Moreover, unlike certain injuries that have tell-tale signs, there are several potential causes for pain on the top of your foot when running, which can make diagnosing and treating the issue more challenging.
With that said, we have compiled a guide to help you suss out the potential causes and treatment options if you are experiencing pain on the top of your foot from running. In addition, we’ll provide you with tips for preventing and correcting foot pain from running and guidance for when you should seek medical care.
Pain on the top of your foot while running can quickly escalate to lingering pain and a more serious running injury, so before you lace up and hit the road, track, or treadmill for a few more miles, check out our guide to possible causes for pain on the top of your foot.
In this guide, we’re going to look at:
- How Common Is Pain On the Top of Your Foot While Running?
- 5 Common Causes of Pain On the Top of Your Foot From Running
- 6 Ways to Treat Pain On the Top Of Your Foot From Running
- When to Seek Medical Care
Let’s dive in!
How Common Is Pain On the Top of Your Foot While Running?
If you’re experiencing pain on the top of your foot while running, you’re not alone. According to research evaluating the incidence of musculoskeletal injuries in runners, foot injuries, including pain on the top of the foot, affect from 5.7% to 39.3% of runners.
Moreover, unlike other common running injuries like shin splints and iliotibial band syndrome, which often plague beginner runners, studies show that injuries to the foot are actually more common in experienced runners.
5 Common Causes for Pain On the Top of Your Foot From Running
There are several common potential causes for pain along the top of the foot in runners, including the following:
#1: Extensor Tendonitis
Extensor tendinitis is one of the most common potential causes of pain on the top of the foot in runners. Like other forms of tendinitis, extensor tendonitis evolves inflammation of tendons, which, in this case, are the tendons that run along the top of the foot.
The extensor tendons allow you to lift your foot upwards and straighten your toes. To understand the function of the extensor tendons, take off your sock and shoe.
First, curl your toes as if trying to grab a marble, then extend them up and open as far as you can. You should see the extensor tendons on the top of your foot pop up and feel them engage to extend your toes.
The primary symptom of extensor tendonitis in runners is pain along the top of your foot, especially between the region between the front of your ankle and the ball of your 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 may be localized more along the instep towards the big toe.
Additionally, if you’ve been have 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, and potentially even a palpable or visible bump or nodule along one or more of the extensor tendons.
There are several risk factors for developing extensor tendonitis including:
- increasing your mileage too aggressively or quickly
- wearing running shoes that are too tight
- running on uneven surfaces or cambered roads
- tight calves
- improper arch support for flat feet
#2: Metatarsal Stress Fracture
A more serious, but also unfortunately common, potential cause of pain on the top of the foot while running is a metatarsal stress fracture.
A metatarsal stress fracture 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.
The hallmark sign of a metatarsal stress fracture is pain along the top of the foot while running that progresses from mild, nagging pain only 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.
As the injury progresses, the pain on the top of your foot will reappear earlier on in your run and will linger for increasingly longer periods of time once you’re done.
Pain tends to be more localized than with extensor tendonitis, and you may even have point tenderness. 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.
Some runners with metatarsal stress fractures also have visible swelling, and potentially even bruising or discoloration, in the region of the injury.
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, various factors can contribute to developing this running injury, including:
- 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
- inadequate caloric intake
#3: Vamp Disease
Although certainly not a household name in terms of running injuries, vamp disease is a relatively common cause of pain on the top of your foot when running.
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 on the top of your foot, and can cause pain along the top of your foot when you run.
If you stop tying your running shoes so tightly and your foot pain does not resolve in a week or two, you are probably dealing with something other than vamp disease.
#4: Bone Spurs
Pain on the top of the foot while running can also be due to a bone spur, or osteophyte. A bone spur is essentially a growth of bony tissue along a normal bone in response to chronic stress or pressure on that bone.
Bone spurs can cause pain on the top of the foot if they have formed in areas where they rub against other bones, ligaments, tendons, or nerves in this region.
Runners can develop bone spurs in the feet from chronically wearing poorly fitting shoes, which can put localized pressure or friction on a certain area of bone.
Bone spurs can also result in the healing process of other foot injuries or may develop over time with age in response to accumulated wear and tear.
#5: Midfoot Arthritis
It’s also possible that pain on the top of your foot while running is merely a sign of arthritis. Arthritis involves the degeneration of the cartilage in the joints between bones.
Cartilage cushions bones and smooths the articulation of two bones that meet in a joint, such that they can move relative to one another with minimal friction.
For this reason, when you have arthritis, in addition to feeling 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 the midfoot, particularly along the heads and bases of the metatarsals. As arthritis is a result of degeneration from accumulated wear and tear, older runners are more prone to arthritis.
Arthritis can often be distinguished from other potential causes of pain on the top of your foot while running based on the injury history. Arthritis in the foot is a chronic condition that usually 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.
6 Ways to Treat Pain On the Top Of Your Foot From Running
Once you’ve identified the most likely cause of pain on the top of your foot when running, you can start addressing the problem. Here are possible treatments for these various causes of foot pain:
#1: Try Orthotics
If you have arthritis or believe that flat feet or a high arch may be contributing to extensor tendonitis, consider seeing a podiatrist or foot specialist for custom orthotics. You can also try over-the-counter insoles for runners.
#2: Rely On RICE
The classic treatment for musculoskeletal injuries is RICE, which stands for Rest, Ice, Compression, and Elevation. Any of the aforementioned potential causes of pain on the top of your foot while running can respond to RICE, at least to some degree.
#3: Loosen Your Laces
Treating vamp disease is as simple as loosening your laces or using a different lacing pattern on your running shoes. You can also ice and elevate your foot to minimize swelling.
#4: Get New Running Shoes
Visit your local running shoe store to get properly fitted for new running shoes to prevent stresses that can cause bone spurs, extensor tendonitis, and bone injuries.
#5: Examine Your Training
Reduce your mileage by either resting or trying low-impact cross-training until your foot pain resolves. More importantly, review your recent training to look for jumps in mileage or intensity.
#6: Stretch Your Calves
If you believe you have extensor tendonitis, stress your calves or use a foam roller.
Related Article: Bob And Brad 721 Foot Massager Review
When to Seek Medical Care
If you suspect a metatarsal stress fracture, you should stop running immediately. You should see your healthcare provider 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.
You may need to ice and elevate the foot to reduce swelling, and your doctor may suggest pain medication or anti-inflammatories.
Metatarsal stress fractures may take 6-8 weeks or so to heal. Stress reactions, which are less severe, usually heal slightly faster.
It’s also advisable to see your doctor if the pain on the top of your foot has not improved significantly or resolved after several weeks despite taking measures to treat it, or if you have underlying medical issues.
For more information on how to take care of our most precious assets, our feet, here are 5 Preventative Foot Care Tips For Distance Runners.