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Four Reasons the Top Of Your Foot Hurts

Brandt R Gibson, DPM
Podiatrist, Neuropathy Doctor, Father of 11 and Founder of Mountain West Foot & Ankle Institute
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Runners are not the only athletes who experience foot pain, but, because your feet take such a beating during a run, it’s not an Sometimes it can be hard to figure out why the top of your foot hurtsuncommon problem. While all parts of the foot are fair game when it comes to feeling the pain, one common sore spot for runners is the top of their feet.

Unlike other parts of the foot, like your heels, it can be hard to figure out why the top of your foot is in agony. But, ruling out a full-fledged fracture, a trained podiatrist can usually figure out the cause of the problem.

If the pain shows up every time you take another stride, and if it took a while to show up but has gradually started to build, there are four likely conditions that may be responsible for your problem.

The bad news? Any one of these conditions will require a trip to the podiatrist. The good news? Once you’re there, your symptoms are treatable and, with proper care, you’ll be back to your training in no time.

Why Does the Top of Your Foot Hurt?

Suspect #1: Tendonitis.

Tendonitis is a painful condition in which your tendons becomes inflamed. While this problem often causes knee pain, it can also make the top of your feet hurt, depending on the location of the inflammation. If, for example, the tendons that run from the center of your leg to the center of your foot become inflamed, the pain is likely to show up in the top center section of your foot. You may also experience pain along your instep and near your big toe if this kind of inflammation is your problem.

Treatments: When your tendons becomes inflamed, we usually start with minimally invasive treatments including Rest, Ice, Compression, and Elevation (RICE). We’ll also take a look at your running shoes to make sure they offer adequate support, and we may suggest ankle supports, orthotics, medications or other interventions. The important thing to remember is that this type of injury is usually related to overuse, so it’s crucial to see your doctor before returning to your old training habits.
 

Suspect #2: Stress Fracture of the Metatarsal Bones.

In the center of your foot, there are small bones known as your metatarsals. Running too hard or too quickly can take a toll on these bones and, over time, lead to a stress fracture of the metatarsals (a stress fracture is a small break in your bone that’s caused by repetitive impacts rather than an acute injury.) Stress fractures present differently than other breaks—symptoms include swelling and localized pain rather than bruising. The pain is also less of a throbbing hurt and more of a dull ache.)  

Treatments: Even though stress fractures present differently than acute breaks, they require immobilization in order to heal—in other words, expect to be wearing a boot or some other form of restraint. Once the fracture is healed, it’s important to go back and look at your running habits in order to figure out why you got hurt. A gait analysis, switch in foot wear or custom orthotics may all be useful in preventing a repeat injury in this instance.

An comprehensive foot exam can help determine why the top of your foot hurtsSuspect #3: You’re Lacing the Wrong Way

Playfully known as “vamp disease,” this runner’s term just refers to an irritation on the top of your foot. Most often, this kind of irritation is caused by tying up your sneakers too tightly. If the pain is showing up in the same spot as the tongue of your shoe, this is likely the cause of your foot pain.

Treatment: This one is easy (and obvious.) Just loosen up on your laces or switch to a shoe that fits better so you don’t have to cinch up so tightly. Of course, if you have a hard time finding sneakers that fit well, you may want to explore custom inserts with your podiatrist. These can ensure a proper fit for your feet, every time you lace up and with every pair of shoes that you own.

Suspect #4: Neuromas

A neuroma is a fancy way of saying you have an inflamed or swollen nerve While we most often see Morton’s neuromas in our Utah podiatry practice, this kind of injury can occur anywhere you have nerves. If your top-of-the-foot pain can’t be explained by any of our other three main suspects, the problem may be an inflammation in the nerves that travel near your metatarsal bones. If this is your problem, the pain will feel sharp and shooting, and may seem to run into your toes.

Treatment: Much of the time, this kind of nerve inflammation can be made worse with pressure, so it’s important to look for a running shoe with plenty of room for your toes to wiggle. Once you’ve eliminated aggravating factors, ice the problem area and take anti-inflammatory medication (as instructed by your doctor) in order to calm and reduce the swelling. Of course, we can’t see nerves on our own, so you will likely need an MRI to diagnose this condition. If the pain doesn’t resolve with conservative treatments, surgery may ultimately be necessary to treat a neuroma.

Sometimes, figuring out why your foot hurts can feel like detective work—but here’s the good news! Like Sherlock Holmes and Watson, you and your podiatrist can work together to determine the root of (and resolve) your pain! By keeping track of your symptoms and coming in to the office at the first sign of a problem, treating foot pain becomes less of a mystery and more of the science we know it to be!

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