Running is a popular and rewarding way to stay active and improve your health, but it’s not uncommon for runners to experience foot pain, especially if they overtrain, wear inappropriate footwear, or have biomechanical issues. Not only does this discomfort interfere with performance and enjoyment of the sport, but if left unaddressed, it can lead to more serious injuries.
As the foundation of your running, your feet endure significant stress with each step, making them susceptible to injuries. It is vital to identify and manage the root cause of your foot pain before it worsens or leads to other issues. Ahead, explore five common reasons behind foot pain while running and get some actionable expert advice on managing and preventing it.
Running-related injury rates occur in up to 79% of recreational runners and 85% of beginner runners. As many as 40% of these injuries happen in the foot.
Overtraining
Training hard and improving your speed, distance, and overall performance is key to any runner’s long-term goals. But when you push your body too hard, you can experience the effects of overtraining. It also can lead to other injuries as well including stress fractures, plantar fasciitis, and tendonitis.
"Overtraining is a byproduct of doing too much too soon, not enough rest or recovery, or even not enough variation or cross-training," says Daniel Geller, DPM, a podiatrist, foot and ankle surgeon, and chief medical officer at Kane Footwear. "In my practice, overtraining represents an overwhelming majority of the injuries I see."
Symptoms can range from mild to more intense as the body struggles to recover from intense physical activity, explains Rebecca Pudvah, PT, DPT, OCS, CSCS, a physical therapist with Athletico Physical Therapy. "Overtraining can sneak up on any athlete, and it can feel as simple as a small ache or as overbearing as constant hunger and fatigue."
How to Prevent Overtraining
Preventing overtraining is a must if you want to maintain your running routine and avoid further injuries. To address foot pain caused by overtraining, Chris Mohr, PhD, RD, an exercise physiologist, says prioritizing recovery is essential to allow your body to recover.
"Exercise itself breaks down muscle, which is normal, but it's [also] important to give your body time to recover, and that's done with sleep, hydration, and the right foods," says Mohr.
Tracking your symptoms before and after workouts can also help you identify ways your recovery might not be optimal and allow you to adjust your training accordingly. Also, rest often. Rest days should be free from planned exercise routines, although you can perform light activities like gentle yoga, walking, or recovery swims.
"An athlete beginning a training regimen should rest three to four days per week, and a more experienced athlete may be able to rest one to two days per week," says Pudvah.
Another smart approach is to use periodization, which involves alternating periods of intense training with lighter loads or recovery periods. Switching up your training allows your body to recover and adapt to training stresses.
When You Need to Take a Break From Running
Improper Footwear
Improper footwear is one of the top reasons so many runners will get injured, says Dr. Geller. “Not only will poor shoe selection or fit create blisters, chafing, and toenail issues, but it will also cause more complex injuries due to a lack of support, cushioning, and protection."
Having the right shoes can make a big difference for athletes. Runners who wear shoes without enough arch support may experience common issues such as plantar fasciitis, shin, and ankle pain due to overpronation, and even knee discomfort because of the strain on the leg, he says. Likewise, athletes with high-arch feet and shoes that lack sufficient cushioning may be at higher risk for stress fractures, metatarsalgia, and tendonitis.
"Repetitive microtrauma will catch up with the best of us if we're not careful to protect these smaller structures," says Dr. Geller.
What Is Metatarsalgia?
Metatarsalgia is pain and swelling in the ball of the foot, making walking, balancing, and exercising difficult. It may be caused by sesamoiditis, bursitis, capsulitis, tendonitis, and periostitis. Symptoms include sharp, aching, or burning pain in the ball of the foot, which may worsen during physical activity.
How to Choose the Right Footwear
Preventing foot pain from improper footwear means knowing how to sift through all the options to find a pair of running shoes that works for you. Here are some things to consider when picking out your shoes.
- Activity and surface: Pick shoes made specifically for your type of running, whether on the road, trail, or track. Each type of shoe gives the ideal support and traction for different surfaces.
- Fit and comfort: Make sure the shoes have enough room in the toe box for your toes to wiggle and fit snugly around the heel to avoid slipping. They should feel comfortable when you put them on without needing to be broken in.
- Support and cushioning: Find shoes that provide the proper support and cushioning for your feet and running style. This will help reduce the impact on your feet and legs, lessening their stress.
- Wear and tear: Regularly check your shoes for signs of wear and tear. Over time, the cushioning and support in running shoes can break down and put you at risk of injury. Dr. Pudvah suggests checking the bottoms of your shoes and ensuring the material has its original shape, form, and texture.
Research shows that the shape of your foot changes with prolonged running, so pay attention to how your feet feel and whether you need to adjust your shoes. This will help prevent foot pain and other injuries.
Plantar Fasciitis
Plantar fasciitis is a common cause of foot pain. It is characterized by inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of your foot. The most telling symptom is a sharp pain in the bottom of your foot, especially with the first few steps in the morning.
“Hard running surfaces, poor shoe selection, lack of arch support, overtraining, and runners who need improvement with their form are all reasons this injury rears itself," says Dr. Geller. "Tight calf muscles and weak foot muscles are also to blame."
How to Manage Plantar Fasciitis
Mohr says regularly stretching your Achilles tendon and plantar fascia is key to preventing plantar fasciitis. If you already feel the effects, start with stretching and strengthening exercises to treat and prevent reoccurrence.
Dr. Pudvah adds that you can also try a combination of stretching and rolling techniques to alleviate pain and promote healing. "Try stretching or rolling three times per day, holding each for approximately 30 seconds."
It’s also important to identify and address the root cause, which could be a change in routine, improper footwear, or weight gain. If necessary, consider revamping your shoes.
“Consider an orthotic and get help if your form requires some tweaking to ensure proper landing and propulsion,” says Dr. Geller. There are also specific shoes that may benefit those with plantar fasciitis.
You can also try using night splints and orthotic inserts to help maintain proper foot alignment. However, it’s best to talk with a healthcare practitioner to determine what might be best for you.
Tendonitis
Extensor tendonitis and Achilles tendonitis are two common types of tendonitis that runners experience. Extensor tendonitis is an inflammation of the tendons that extend your fingers or toes. It can result from repetitive motions, including running, and is often characterized by pain on the top of your foot. Dr. Geller says weak flexor tendons can create an over-pull of the extensors, leading to this painful condition.
Achilles tendonitis is when the Achilles tendon becomes inflamed. It often happens when you increase your running distance, pace, or terrain too quickly. Symptoms include pain and stiffness along the Achilles tendon, especially in the morning or after activity.
Managing and Preventing Tendonitis
Poor posture and core strength are common contributors to extensor tendonitis, says Dr. Geller. "Stretching and strengthening is the name of the game when it comes to the lower extremities, especially the feet and ankles."
Stretching your calves to prevent pulling will also reduce your risk of pain. Also, make sure your shoes aren't tied too tight. Too tight shoe laces can injure the extensor tendons and superficial nerves, which, says Dr. Geller, causes neuritis (nerve inflammation) in the top of the foot and ankle.
In the case of Achilles tendonitis, he says stretching and strengthening the lower body is crucial to prevent further damage to the tendon. Warm up well before exercise and cool down to prevent issues.
Shoes that absorb shock well and provide an easy heel-to-toe transfer also help dissipate forces that traumatize the achilles, he says. "Over-pronation may cause the Achilles to stress in a direction that can cause injury, so runners may consider an orthotic or motion-control shoe to control this pattern."
Foot Extensor Tendonitis Causes and Treatment
Stress Fractures
Runners have a high risk of bone stress injuries, with up to 21% experiencing them in a year. Stress fractures are small cracks in the bone that cause pain in one area that gets worse when active and gets better when resting. They are often a result of overtraining and under-fueling, says Dr. Pudvah.
How to Prevent and Manage Stress Fractures
If you listen to your body and have regular check-ins with your physical therapist, nutritionist, or even primary care provider, you can avoid this nagging injury, says Dr. Pudvah. "Maintaining a well-balanced diet and exercise routine to support your training will rarely result in bone injury, but a tip of the hat either way and you can fall into this trap."
Various factors contribute to the risk of stress fractures, including low levels of vitamin D. Research has found that athletes with lower vitamin D levels are more likely to suffer from this condition. In a study of patients with MRI findings of bone marrow edema in the foot and ankle, 84% had low vitamin D levels, 61% were deficient, and 23% were insufficient.
According to Mohr, rest is the most important thing for healing stress fractures. "Avoid putting weight on the affected foot, using crutches or a protective boot as needed, and slowly reintroducing activities under the guidance of a doctor to prevent re-injury."
He also suggests considering supplements like calcium and vitamin D to improve bone strength and investing in new, more supportive running shoes.
Bottom Line
Foot pain is common among runners, but it doesn't have to sideline you. By identifying the root causes of your discomfort—overtraining, improper footwear, incorrect running form, or a specific injury—you can take proactive steps to address and prevent it.
Listen to your body, keep good form, wear the right shoes, follow a balanced training plan, and get help from a professional like a physical therapist, podiatrist, or running coach if you have ongoing foot pain. They can give you personalized advice and offer treatment plans. Remember, running should be enjoyable and rewarding, so be proactive when you have pain so you can keep running happily and healthily.
