By Marnie Kunz, CPT

If you’re experiencing running foot pain, it can throw a wrench in your training. Whether you suspect you have an injury or you have mild foot discomfort, paying attention to foot pain is essential. This guide will go over the common causes of running foot pain and what to do about it. Also, remember to seek medical care if you have persistent pain, suspect you have an injury, or have pain that does not go away with rest.

Running’s Impact on Your Feet

Running puts a lot of pressure on your feet, as your feet absorb the most impact from striking the ground. And since your feet hit the ground more frequently and with greater force when running than walking, running can lead to more foot injuries than low-impact activities like walking.

According to researchers, about a quarter of running injuries affect the foot and ankle. With the right precautions, however, you can take steps to minimize your risk of running foot injuries and heal from any foot pain you’re suffering from.

Defining Running Foot Pain

The first step to determine the cause of your running foot pain is to examine your symptoms. Take note of these details:

Is your foot pain sharp or dull?
When does your pain begin, and how long does it last?
Where is your pain exactly?
Do you have foot pain while you’re running, after running, or when you’re resting?
Does anything help the pain go away? If so, what?

A clear picture of your foot pain will help you figure out when to go to the doctor and rest or take self-care measures. If you have pain that worsens with time or does not go away with rest, it’s time to see a doctor. Take notes of your symptoms so when you go to the doctor or physical therapist, they can more accurately diagnose and treat you.

If you suspect you have an injury, see your doctor or a physical therapist for a diagnosis and treatment plan. Taking some self-care measures like resting, changing old or poorly fitting running shoes, and placing ice or heat on the inflamed areas of your foot can also help.

Common Causes of Foot Pain When Running

Now, we’ll examine the most common causes of running foot pain. These are some of the most prevalent causes of foot pain among runners:

Plantar Fasciitis

According to researchers, plantar fasciitis is one of the most common causes of running foot pain. Johns Hopkins Medicine defines plantar fasciitis as the inflammation of the plantar fascia, tissue in the foot used during walking and running.

Symptoms: Heel pain that increases over time. The pain is often worse after rest periods, such as when you begin walking or running. As the injury progresses, you may experience more pain with prolonged and intense activity.

Common Causes: Quickly ramp up your running by adding a lot of distance or intensity to your program, prolonged standing on hard surfaces, tight calf muscles, excess weight, and having flat feet or high arches.

Treatment: Physical therapy, foot stretches, icing soles of feet, rest, decreasing training intensity and mileage, modifying workouts by running on more cushioned surfaces (such as a track or treadmill).

Stress Fractures

Stress fractures are bone injuries that include a small crack in the bone or severe bruising within the bone. Runners can get stress fractures in different areas, including in the feet. Stress fractures in the foot often occur in the metatarsal bones, the calcaneus (heel), sesamoids (two small bones associated with the tendons of the big toe), and the navicular (a bone on the top of the midfoot).

Symptoms: Pain that gradually increases with time, especially during activity. Often, runners start to feel the pain while running, but it may go away with rest. As they continue training, however, pain increases and can also happen when resting. Another sign is tenderness and swelling on the top of the foot or where the fracture occurred. Usually, putting weight on the foot increases the pain.

Common Causes: Overtraining (adding too much mileage or intensity to your training too quickly), poorly fitting shoes, running on uneven or hard surfaces, or suddenly changing running surfaces. Low vitamin D levels and osteoporosis can make runners more likely to get stress fractures.

Treatment: Ice, compression, rest, and elevating the foot. See a doctor if you suspect you have a stress fracture, as the injury will get worse and can lead to a broken bone without treatment and immobilizing the foot.

Morton’s Neuroma

Pain in the ball of your foot is a common sign of Morton’s neuroma. This condition includes thickening of the tissue in your foot surrounding the nerve that leads to your toes. Morton’s neuroma is sometimes called interdigital neuroma, Morton metatarsalgia, interdigital neuritis, or plantar neuroma.

Symptoms: Burning or pain in the ball of your foot that can radiate into your toes. The pain is often worse when you put pressure on your foot by running or walking. Tight or narrow shoes and high heels can worsen the pain. You may also have numbness or tingling in your toes.

Common Causes: Morton’s neuroma is caused by entrapment of the digital plantar nerves, according to research. The cause of the entrapped nerves is not always known. Doctors may perform imaging tests to check for joint inflammation, arthritis, or stress fractures that may be causing the pain.

Treatment: It’s essential to seek medical treatment for Morton’s neuroma. Treatment plans may include changing shoes, getting custom orthotics, and steroid injections. A doctor will also evaluate possible causes of your condition to help address the problem.

Tendonitis

Foot tendonitis can affect different areas of the foot and includes irritation and inflammation of a tendon in your foot. Tendons connect your foot muscles to bones and can get inflamed and painful from overuse.

Tendonitis can occur in different parts of the feet, with the most common areas being:

Achilles tendonitis causes pain along the back of your ankle. Your Achilles connects your calf muscle and heel bone.
Extensor tendonitis can cause pain along the top of your foot.
Peroneal tendonitis affects the tendons along your outer ankle.
Posterior tibial tendonitis causes pain on the inner side of your foot and ankle.

Symptoms: Foot tendonitis often causes swelling, redness, and pain along the inflamed tendon. Usually, the pain gets worse with running and other activities. The tendon may also get stiff after periods of rest.

Common Causes: As with many other causes of running foot pain, overuse, and overtraining can cause tendonitis. Foot tendonitis often gets gradually worse over time. It can also strike suddenly from overstretching, rolling your ankle, or having poor running form.

Related Post: 10 Running Form Tips from a Run Coach

Treatment: Treatment for foot tendonitis usually includes resting (taking a break from running), doing physical therapy, icing the affected area, elevating your foot, and compressing the area to reduce swelling.

Arthritis

Foot arthritis causes swelling, pain, and stiffness in the joints of your feet. There are many types of arthritis, the most common being osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.

Symptoms: Joint pain that often comes on gradually but can also be sudden in some cases. Running and intense workouts can cause more pain. You may have swelling, warmth, and redness around the joints. After resting, you may have increased stiffness and swelling in your joints.

Common Causes: The cause of your arthritis depends on what type you have. Osteoarthritis usually occurs in older adults and occurs gradually as the joints wear out over time. Rheumatoid arthritis is an autoimmune disease that can be triggered by an infection or environmental trigger. Post-traumatic arthritis can strike after an injury, like a fracture or dislocation.

Treatment: Arthritis treatment usually includes modifying lifestyle habits, such as doing more low-impact activities and less high-impact exercises (such as walking instead of running). Physical therapy and orthotics are also commonly prescribed.

Muscle Soreness

Foot pain and soreness may not be linked to a particular injury. Sometimes, running foot pain can be a sign of overtraining or muscle soreness from overexertion or poorly fitted running shoes.

If you are experiencing soreness but have no injuries, take some rest days. Also, change your running shoes if they are worn or do not fit well. Running on softer, flat surfaces such as treadmills or tracks instead of concrete and hard or uneven surfaces can also help. Reduce your running mileage until your foot soreness goes away.

Risk Factors for Running Foot Pain

You can take measures to prevent and reduce running foot pain. Here are some tips to modify your training schedule and habits to improve your foot health:

Avoid overtraining. Build your running distance and intensity gradually using the principle of Progressive Overload. This means you should only increase your running intensity or duration by no more than 10 percent from week to week.
Change your running shoes regularly. Most running shoes last 300 to 500 miles, including walking and workout miles (if you do more than run in your shoes). When your feet start to feel flat while you’re running or you get more aches and pains than usual, it is time to change your shoes.
Get fitted for running shoes. Having running shoes that fit your feet and running habits is essential. Go to your local running store to get fitted for shoes that work well for you. Try on shoes, do a treadmill test, and make sure the shoes feel comfortable when you run in them.
Take more rest time. If you’re experiencing foot pain or soreness, it’s a sign you need to reduce your running mileage and rest. Frequently, rest is the best way to prevent and reduce pain and running injuries. If you still experience pain after taking rest days, see your doctor to get checked for injuries.
Follow a running plan. A professionally designed running plan will help minimize your risk of injuries and build your fitness level gradually. Many runners who train on their own end up overtraining - increasing their mileage and intensity too quickly, which can cause running foot pain and injuries. A well-planned running program will build in rest and recovery days and easy runs to give your body the time it needs to recover from more intense workouts.

Need a running plan designed by a professional trainer and running coach? Head to our Runstreet Training Center for the best options to suit your training goals and fitness level.

If you take rest days, change your shoes, and try these tips to avoid overtraining and still have foot pain, see your doctor for treatment.

Happy running to you, and take care!

Marnie Kunz is a NASM-certified trainer and USATF- and RRCA-certified running coach, dog lover, Akita mom, and writer based in Brooklyn, NY.

Running Foot Pain: Common Causes and What To Do