Why Do I Feel Foot Pain After Running?

Man with foot pain after running
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Are you feeling post-run pain in your arch, top of foot, toes, heel, side of foot, toenails, or maybe more than one spot? Foot pain is a common ailment among runners and also one that can be confusing because the causes and treatments for the pain can vary widely.

Some foot issues may require a doctor’s care, while others can be remedied with some rest and a change in your running shoes. For some runners, their foot issues are caused by non-running shoes (flip-flops, anyone?), so be sure you’re wearing supportive, comfortable shoes even when you’re not running.

Where Does It Hurt?

Take a closer look at the descriptions below to determine possible causes and solutions for your foot pain. Keep in mind that if you’re dealing with one of these issues and you don’t see any improvement after a week or so of self-treatment, you should make an appointment with a physical therapist or doctor for evaluation and treatment.

Location of Pain: Arch of Foot, Heel

If you’re feeling a stabbing or burning pain in your arch, especially when you first step out of bed in the morning, you may have plantar fasciitis. If you attempt to run, the pain may decrease and be more tolerable, but then comes back an hour or so after your run.

Plantar fasciitis is typically caused by tight arches, tight calf muscles, or overpronation (your feet roll in too much when you run). It’s more common among runners with flat feet.

Stretching your calf muscles can help relieve the arch tightness.

You can also try rolling a golf ball under the arch for a half-hour once a day. It may hurt the first week, but you should see some improvement by the second week. This can help reduce pain and increase blood flow to the area. If self-treatment doesn’t work, you may need custom arch support orthotics to take the pressure off the plantar fascia.

Location of Pain: Toes

Bunions are an enlargement of the big toe joint. Under too much pressure, this joint can swell, causing the bone to stick out on the side of the foot.

Surgery is the only way to get rid of a bunion completely, but you can ease the discomfort without going under the knife. First, make sure your shoes are not too small or too tight. Next, try to take pressure off the bunion. Your local drugstore probably sells bunion pads which will cover the bunion and pad the area around it to help take the pressure off the bunion itself. Finally, an arch support (available at most drugstores and running stores) may also help relieve some of the pressure. If you're still feeling pain and discomfort, schedule an appointment with a podiatrist.

If you have a hard, painful lump on your toe, you may have a corn, which is caused by constant rubbing and pressure from shoes that are too tight. They can also be a result of wearing shoes and sandals without socks, or socks that don't fit properly or have rough seams.

For many people, once you eliminate the source of friction or pressure, the corn will disappear on its own. If that doesn’t work, you can try using a corn remover. Corn removers, which are sold at most drugstores, are small, adhesive bandages with a medicated, cushioned pad that fits over the corn.

The corn remover will provide some relief from the pain and discomfort, and the medication on it will also help dissolve the corn. You can also use a pumice stone, nail file, or emery board to smooth away dead skin before applying a new patch. Talk to your doctor if it’s very painful or you notice redness or any other sign of infection.

Location of Pain: Toenails

If your toenail is painful and dark, you may be dealing with a black toenail, or a subungual hematoma. They’re usually caused by the toes rubbing up against the front of the running shoe, usually because the shoes are too small.

If you have a black toenail it's best to leave it alone, as long as the pain is manageable. The pain is usually the worst on the first day and then it gradually dissipates. The damaged part of the nail is gradually pushed off, and a new nail will replace it. Don't try to force your old nail off—it will fall off on its own once the new nail comes in.

If the toenail is extremely painful or you notice any infection or redness, consult your doctor. To prevent future black toenails, make sure that you're wearing the correct running shoe size (at least half a size bigger than your street size; you should have plenty of room in the toebox).

Location of Pain: Top of Foot

If you feel pain on the top of your foot as you’re running, you may be dealing with extensor tendonitis. You may also notice swelling on the top of your foot and see a large bump somewhere along the tendon. Some common factors that may lead to extensor tendonitis are very tight calf muscles, overtraining, and falling of your foot arch.

Extensor tendonitis can also be caused by lacing your shoes too tight or wearing shoes that are too small or don’t fit properly. Check your running shoes to see if they’re creating a pressure point along the top of your foot. If you’re doing a lot of uphill running, especially on a treadmill, that could put a lot of stress on your foot extensor tendons and lead to inflammation.

For mild extensor tendonitis, your best bet is to work on stretching your calf muscle and reducing the inflammation with ice or anti-inflammatories (talk to your health care provider for advice on taking anti-inflammatories). You can also try self-massage using a massage tool such as a foam roller. You may need to take a couple of days off from running but, once the extensor tendon is no longer inflamed, you’ll be able to run relatively pain-free.

Another option: try changing your shoe lacing pattern and loosening your laces slightly. To relieve pressure on the top of your foot, try lacing your shoes across the shoe tongue in a ladder pattern, rather than in a typical criss-cross pattern. In some more extreme cases of extensor tendonitis, a podiatrist may recommend custom-made orthotics or another treatment.

Location of Pain: Front of Foot (Numbness)

Numbness or a tingling sensation (unrelated to the cold weather) in the toes or foot is a common complaint among runners. Often, the cause is wearing running shoes that are too tight or tying your shoelaces too tight.

If you think that you're wearing the correct running shoes for your foot size and gait you can also try stopping to stretch when you start feeling numb. Sometimes tight muscles lead us to run with improper form, which may put pressure on a nerve and cause numbness. So a quick stretch of any part that feels tight may help. When you stop to stretch, you can also move your foot around and massage it a little, to get the blood flowing to the numb areas.

If you’re really tight, try working some pre-run and post-run stretching and massage into your routine. Do some post-run stretches and yoga and make sure that you do some warm-up exercises before you start running so your muscles are warmed up. You may also want to try using a foam roller or other massage tool to roll areas where runners frequently get tight, such as your quads, calves, hamstrings, and IT band.

Location of Pain: Side of Foot

Pain on the side of the foot, whether on the inside or outside, is often due to tendinitis, or inflammation of a tendon. It’s usually a result of overuse, such as increasing your mileage too quickly, or improper running shoes. Side of foot pain from tendonitis comes on slowly, gradually increasing over a few weeks or months, and tends to be worse first thing in the morning and with activity, easing with rest.

Mild tendinitis is usually remedied with icing in the first 24 hours and then a few days off from running. If you’re dealing with significant pain, you may need to be put in a walking boot and take a few weeks off from running.

Another possible cause of pain on the side of your foot is a stress fracture. Side of foot pain from stress fractures usually starts off mild and gradually gets much worse. Eventually, you'll feel the pain even when you're not running. You may also notice tenderness and swelling.

If you see signs of a stress fracture and have tried self-treatment with no relief, talk to your health care provider. Early diagnosis is critical because the injury can eventually become a complete fracture of the bone.

Location of Pain: Skin on Bottom of Foot

If the skin on the bottom of your feet is hurting, you could be dealing with any number of issues, including blisters and athlete’s foot.

Blisters, or small bubbles of skin filled with clear fluid, are very common among runners. If you have a blister and it's not painful, just leave it alone, since the skin serves as protection. It will eventually break and the fluid will drain. If the blister is painful, then boil a needle for 5 to 10 minutes in water and, once cool, carefully pierce the blister. Press the fluid out and use an antiseptic cream on it. Cover the area with a product such as Band-Aid Blister Block or moleskin to protect against infection and provide cushioning.

Athlete's foot is a fungal infection that thrives in damp, sweaty places. Common symptoms of athlete's foot include itching, stinging, and burning between your toes and on your soles, extremely dry skin on the bottoms or sides of your feet, and peeling skin on your feet.

You'll need to treat athlete’s foot with an antifungal cream. Ask your health care professional or pharmacist for a recommendation of an over-the-counter or prescription cream. Apply a thin layer of the product, once or twice a day for at least two weeks, or according to package directions. Consult a doctor if it doesn't clear up after four weeks.

Sources:  

Extensor Tendonitis,” American Orthopaedic Foot & Ankle Society, https://www.aofas.org

"Peroneal Tendinosis."American Orthopaedic Foot & Ankle Society, https://www.aofas.org

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