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Cross Training For Runners

The 5 Most Common Causes of Top of Foot Pain When Running

14 Mins read

Are you ready to conquer the relentless nemesis known as top-of-foot pain in running? Brace yourself, my fellow runner, because we’re about to dive headfirst into the fascinating world of foot discomfort and emerge stronger than ever before.

Let’s face it: running is a thrilling adventure that can take us to unimaginable heights, but it also comes with its fair share of challenges. And when it comes to challenges, top-of-foot pain likes to sneak into the spotlight. It’s like an unexpected detour on our running journey, threatening to dampen our spirits and slow us down.

Yet, unlike its notorious companions like runners knee and plantar fasciitis, diagnosing the exact cause of this foot pain is a daunting task. It’s like searching for a needle in a haystack, with numerous conditions vying for attention and making the identification process a true puzzle.

But fret not.

In this article, I’ll navigate through the labyrinth of possible causes, shedding light on the most prevalent culprits that afflict runners far and wide. Armed with the latest research, expert insights, and a touch of metaphorical magic, we’ll unravel the complexities and equip you with the tools to prevent and overcome this persistent foot pain.

Are you ready, Let’s get going.

Anatomy 101

Get this: The human foot is made up of 26 bones, 33 joints, and over 100 muscles, ligaments, and tendons. Yes, what a remarkable piece of anatomical artwork.

When you lace up those running shoes and hit the road, each and every one of these structures springs into action, playing their unique roles in the grand symphony of movement. It’s a true feat of coordination and harmony. But here’s the kicker—when even one of these components falls short, it can wreak havoc on your entire system. Think of it as a domino effect, where a deficiency in one area can cause discomfort, pain, and even throw off your alignment elsewhere in the body.

In other words, the human body is a beautifully interconnected chain, only as strong as its weakest link. So when you feel that nagging ache, experience inflammation, tenderness, a burning sensation, or even sharp pains that come and go, it’s your body’s way of sending distress signals, urging you to pay attention and take action.

Now, here’s where things get interesting. The causes of top-of-foot pain can vary, and understanding the underlying reasons behind your discomfort is key to finding relief and getting back on track.

Without further ado, let’s shed light on these mysteries.

The 5 Most Common Causes of Top of Foot Pain When Running

Here are the main conditions that can cause pain on top of your foot while running:

  • Extensor Tendonitis
  • Metatarsal Stress Fracture
  • Bone Spur
  • Vamp Disease
  • Arthritis

Let’s briefly discuss each one of these, then share a few ways to prevent the top of the foot pain while running.

1.     Extensor Tendonitis

One of the most common causes of pain on the top of the foot is a condition known as extensor tendonitis.

We’ve got these snappy little tendons called extensor tendons that run along the tippy-top of your foot. Their job? To give our feet that extra oomph by pulling it upward and straightening those wiggly little toes. But when these tendons decide to rebel and throw a tantrum, well, that’s when extensor tendonitis comes into play.

Now, when you find yourself in the clutches of this pesky condition, you’ll feel a distinct pain on the top of your foot, right in the sweet spot between your ankle and the ball of your foot. It’s like a nagging reminder that something’s not quite right in tendon land. But that’s not all—swelling, bruising, and even a touch of redness might join the party, making your foot a sight to behold.

Let’s not forget about the symptoms. Along with the pain party, you might also notice that your foot is rocking some swelling, bruising, or even a touch of redness on the top. And that pain? It loves to cozy up in the center of your foot, making its presence known right in the middle and off to the instep, near that trusty big toe. Oh, and keep an eye out for a sneaky little bump that might pop up along the tendon. It’s like a little souvenir from your tendonitis adventures.

But what brings on this chaotic foot fiasco, you ask? Well, my friends, there are several culprits to consider. One of the main instigators is running too much too soon. Your foot might revolt if you push it beyond its limits without giving it the chance to adapt. And let’s not forget about our friends who stand for long periods of time—they’re not off the hook either. Improper shoes that are too tight or too small? Oh, they’ll definitely contribute to the foot rebellion. And don’t even get me started on running on uneven surfaces—that’s like sending an open invitation to tendonitis.

But wait, there’s more! Biomechanics deficiencies can also play a role in this topsy-turvy situation. If you have a fallen foot arch or tight calf muscles, your tendons might be feeling a little extra strain, leading to the party that is extensor tendonitis.

How To Treat Extensor Tendonitis

The most effective way to manage mild extensor tendonitis is to soothe inflammation with rest, ice, and stretching the calf muscles. You should also perform a few grip exercises to reduce stress on the tendon, along with flexing your foot up toward the shin.

What’s more?

Consider using custom orthotics if you have a high-arch foot type as well as changing your shoe lacing pattern and loosen your laces a bit (more on this later).

Consult a doctor for serious cases.

Additional resource – Common cause of lower leg pain while running

2. Metatarsal Stress Fracture

Another common cause of top of the foot pain in runners is a stress fracture.

Logging the miles too hard or too fast can take a toll on your weight-bearing bones and, over time, lead to stress fractures. Stress fractures are tiny, hairline cracks in the bone that sneak up on you over time, fueled by the repetitive shock of running a little too hard, a little too fast, and a little too often.

You see, when you’re out there pounding the pavement, pushing your weight-bearing bones to the limit, they can only take so much before they cry out for mercy. Overuse is the name of the game here. But it’s not just about logging those endless miles—it’s also about how you do it. Bad running technique can put extra stress on your bones, increasing the risk of stress fractures. And let’s not forget about the treacherous hard surfaces we often find ourselves running on. They’re like the unforgiving battlefield where our bones face relentless pounding.

But that’s not all. Improper running shoes? Oh, they can contribute to the bone-break party too. And get this—vitamin D deficiencies have also been linked to an increased risk of stress fractures.

Now, here’s where it gets interesting. Your foot is home to a grand total of 26 bones, each with its own story to tell. But when it comes to stress fractures, the spotlight falls on the metatarsal bones—five of them sitting right in the center of your foot. These metatarsals are like the unsung heroes, taking on the brunt of your running adventures. But if you push them beyond their limits, especially the second through fourth metatarsals, they may crack under pressure, quite literally.

So, how do you know if you’re dealing with a stress fracture? Well, it starts off innocently enough—a mild pain that gradually worsens over time. At first, you might only feel it when you’re out there pounding the pavement, but as the condition progresses, it becomes relentless, following you even in your restful moments, disrupting your precious sleep.

Here are the telltale signs to look out for: pain and swelling that zero in on the top of your foot, right over those delicate bones. You might even notice tenderness in the exact spot where the stress fracture is having its little party. And let’s not forget about the swelling—a not-so-subtle reminder that your foot is not happy.

How to Treat A Stress Fracture

If you suspect a stress fracture, consult a doctor immediately as it requires a more aggressive treatment plan. Plus, it can only be confirmed by getting an X-ray.

More than likely, you’ll need to wear a boot or some other form of device.

Once your fracture heals, it’s key to go back and assess your running habits to determine why you got hurt.

Or else, you may risk exacerbating your condition, like creating a full-on fracture or another stress fracture.

3. Bone Spur

A bone spur refers to a little bony growth that decides to crash the party on your otherwise normal bone, causing all sorts of trouble by rubbing against your precious tendons, ligaments, and nerves, leading to wear and tear and, of course, pain.

So, how does this bone spur come to be? Well, it’s all about the body’s valiant attempt to repair the damage caused by excessive shock or prolonged pressure on the bone. It’s like a construction crew working overtime, building extra bone in an effort to reinforce and heal the affected area. But sometimes, this repair mission goes a little haywire, and instead of creating harmony, it creates a pesky bone spur.

Now, there are a few culprits that can contribute to the formation of these unwanted bony guests. Improper shoes, for instance, can be like accomplices in this bone spur drama. When you’re not giving your feet the proper support they deserve, it’s like opening the door wide for these spurs to make themselves at home. And let’s not forget about injuries—those unexpected guests that can leave a lasting impact. Sometimes, when you’ve experienced a significant injury, the body’s response is to go into overdrive and produce those bone spurs as a part of the healing process.

Age also plays a role in this bone spur saga. As we gracefully (or not so gracefully) journey through life, our bodies go through changes. Our bones may decide to sprout these bony growths as a little reminder that time keeps marching on. It’s like Mother Nature saying, “Hey, you’ve been on this planet for a while, here’s a little souvenir.”

Additional Resource – A Tibial Posterior Tendonitis Guide in Runners

How To Treat A Bone Spur

To treat a bone spur, consider changing your running shoes and trying an orthotic to cushion the top of your foot and see if it helps relieve symptoms. As a rule, run in proper shoes—a pair that’s not too tight or too loose and that fits well with your foot type and running style.

Unless they’re causing serious pain, usually bone spurs don’t call for aggressive treatment.

Measures that can help manage bone spurts include weight loss to reduce some of the pressures on the joints. This is especially the case if plantar fasciitis or osteoarthritis is the cause. Stretching the affected limb can also help with pain relief and healing.

For starters, try alternating between cold and heat therapy to ease the pain associated with a bone spur. Ice works very well for soothing swelling and inflammation, while the heat can improve pain and stiffness.

In some cases, you might need cortisone injected administered by your doctor, which helps limit inflammation.

Additional Resource – Here’s how to use KT Tape for runners knee.

4. Vamp Disease

Vamp Disease is a condition that sneaks up on your unsuspecting feet when you tighten those running shoe laces a tad too snugly. It’s like a secret uprising, an inflammatory rebellion that targets the top of your foot, precisely where the vamp of the shoe rests. No wonder they named it Vamp Disease—it’s like a vampiric affliction for your poor feet!

Picture this: You’re all excited to hit the pavement, ready to conquer those miles. You lace up your running shoes, pulling the laces tight, wanting that perfect fit. Little do you know, the Vamp Disease lurks, waiting for the opportunity to strike. As you head out on your run, you may start feeling that irritation, that pesky swelling on the top of your foot.

But why does this happen? Well, studies and research papers suggest that when you tighten those laces excessively, it creates undue pressure and friction on the delicate tissues of your foot’s vamp. It’s like squeezing your foot into a tight corset—it may look appealing, but it’s certainly not comfortable. And your foot rebels with inflammation, causing that telltale swelling and discomfort.

How to Treat Vamp Disease

Easy. Choose well-fitting running shoes and replace them as they wear out. You should also try out different lacing techniques and see which one works the best for you.

As a rule, loosen up your laces or switch to sneakers that fit better so you don’t have to cinch up so tightly.

You should have enough to be able to put your finger under the top laces—or else, you might be lacing your shoes too tightly.

If your symptoms don’t fade away after changing up your shoes, your pain could be caused by something else.

Expect the pain to fade within two to three weeks as the inflammation subsides.

5. Arthritis

Imagine your foot as a bustling cityscape with 30 joints serving as the busy intersections. Each joint has its own role to play in maintaining smooth movement and absorbing impact. But alas, arthritis doesn’t discriminate. It can strike any of these joints, leading to that dreaded top-of-foot pain.

One particular area that arthritis loves to target is the metatarsophalangeal joints—those junctions nestled at the base of each toe. It’s like a prime real estate for arthritis, causing tenderness, pain, and a loss of flexibility in the affected foot. Imagine those joints crying out in protest as the arthritic forces take hold.

Now, let’s talk about midfoot arthritis—the mischief-maker that wreaks havoc in the middle of your foot. This troublemaker is notorious for causing pain and swelling in the midfoot region, making it even more excruciating when you engage in high-impact exercises like running. It’s like a double-edged sword—your passion for running clashes with the relentless onslaught of arthritis.

Studies and research papers have shown that midfoot arthritis often develops gradually over time, like a slow-burning fire that intensifies as the cartilage deteriorates. However, it can also be the aftermath of a significant midfoot injury, such as the dreaded Lisfranc injury. Talk about a one-two punch!

Here’s the full guide to arch support for running

How to Treat Arthritis

Book a doctor visit if you’re coming down with any of the above symptoms that refuse to fade away with rest and ice. A physician can help you determine the right treatment plan that will work best for you.

Don’t try to heal arthritis on your own—you might end up making things worse, and you don’t want that.

Depending on the the type and severity of your arthritis, your doctor may recommend any of these treatment options:

  • Steroid medications injected into your joints
  • Anti-inflammatory drugs to soothe swelling
  • Pain relievers
  • Pads or arch supports in your running shoes
  • Canes or braces for added support
  • Physical therapy
  • Custom-fitted shoes

How To Prevent Top of The Foot Pain When Running

Here are five measures that should work the best for keeping your top-of-the-foot pain at bay while running.

Proper Running Shoes

I hate to sound like a broken record, but wearing improper running shoes can cause all sorts of pains—foot pain is not an exception.

Let’s do a quick shoe inspection, shall we? Take a moment to peek down at your feet and assess the current state of your running shoes. Are they a size too small, squeezing your poor feet into a suffocating prison? Or perhaps they’re laced up so tightly that they resemble a medieval torture device. If any of these shoe sins apply, it’s time for a change.

Picture this: You walk into a specialized running store, where the scent of new shoes and the promise of pain-free runs linger in the air. Seek out the wise sages known as the store staff, who possess the knowledge to match you with the perfect pair of running shoes. They’re like shoe whisperers, analyzing your foot size, shape, and any special needs you may have. Have funky arches or a history of foot pain? Fear not, for they are equipped with the wisdom to guide you towards the shoes that will cradle your feet with care.

Now, let’s talk support. Just like a reliable friend who always has your back, the right running shoes provide the support your feet crave. They offer cushioning and stability, absorbing the impact of each stride and minimizing the strain on your delicate foot structures.

It’s like walking on clouds, or better yet, running on clouds. So bid farewell to ill-fitting shoes and embrace the joy of running in footwear that truly understands and supports your feet.

Additional guide – How to prevent Foot pain while running

Replace Your Shoes

Just like the passing of seasons or the fading of a glorious sunset, running shoes too have their time in the spotlight. But beware, my running comrades, for running in shoes past their prime is a treacherous path paved with discomfort and misery. So let’s dive into the world of shoe replacement, lacing techniques, and the wonders of orthotics to keep that pesky top-of-the-foot pain at bay.

Running shoes are akin to faithful companions on your running journey. They carry you through countless miles, absorbing shock and supporting your every step. But alas, even the mightiest of shoes have their limits.

Studies have shown that running shoes start losing their magic touch after approximately 400 to 500 miles.. So, heed this advice: listen to your shoes’ whispers of wear and tear, and replace them accordingly.

If you’re a 30-miles-a-week runner, that means bidding farewell to your worn-out kicks every four to five months.

Lace Properly

Did you know that the way you tie your shoes can make a world of difference in preventing top-of-the-foot pain? It’s like a secret code of foot comfort waiting to be unraveled. Experiment with different lacing methods, like tying your laces at the side or skipping the eyeholes over the sensitive area.

But wait, there’s a champion among the lacing techniques—a technique hailed as the savior of foot pressure. Enter the realm of the two-laced technique, where the art of tying knots can alleviate the pain on top of your foot.

Don’t worry, there’s no need to decipher cryptic instructions here. I’ve found a gem of a YouTube tutorial that will guide you through the process step by step. Watch and conquer the art of pain-free lacing.

Consider Orthotics

Now, let’s not forget about our trusty allies—orthotics. If you find yourself overpronating or have a history of lower leg injuries, these supportive inserts or custom-made orthotics can be a game-changer.

Think of them as the superheroes of foot support, swooping in to save the day. Consult with a physical therapist or a podiatrist, the wise masters of foot wizardry, who can guide you towards the right orthotic options. They’ll analyze your unique needs and create a personalized plan to ensure your feet are well-cushioned and properly aligned.

Additional Resource – Here’s your guide to calf pain while running

When to See A Doctor For Runners Foot Pain

Persistent pain is often a sign that you need to wave the white flag and seek professional help. Don’t worry, it’s not a defeat—it’s a wise move towards pain-free training.

You see, even seemingly harmless foot pain can be quite the troublemaker. It can nip at your heels, slow you down, and make each step feel like a battle. When those home remedies and self-care measures just don’t seem to cut it, it’s time to bring in the cavalry—aka, medical professionals.

This is especially the case if:

  • Your pain has overstayed its welcome for more than a week,
  • Stubborn numbness has settled into your foot,
  • Signs of infection like warmth, redness, and tenderness have made an unwelcome appearance, or worse yet,
  • Your foot refuses to bear any weight or allows you to walk, it’s high time to seek medical treatment.

These are the warning signs that your foot pain has taken a serious turn and needs the expert attention it deserves.

A visit to the doctor will help you uncover the root cause of your pain, unravel the mysteries hidden within, and assess the seriousness of your condition. Whether it’s additional tests, specialized treatments, or preventive measures, they’ll be your guiding light on this healing journey..

Additional Resource -Your guide to jaw pain while running

Top of Foot Pain When Running – The Conclusion

There you have it. If you’re experiencing top of foot pain while running, then today’s post most likely has the solution to what’s ailing you.

If not, then you should consult a doctor as soon as possible to rule out any other conditions that might be the culprit behind your pain. The rest is just details.

Please feel free to leave your comments and questions in the section below.

In the meantime, thank you for dropping by.

Keep training strong.


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