It happens to so many runners: You came home from busting out your morning miles and something in your heel, on your foot, or your arch starts to hurt. The competitor in you tells you to ignore it and keep going. But for a long running career (and really, you know you want to be that 80-year-old zipping down the block) you should stop and assess what’s going on, says Michael Conlon, physical therapist, running coach and owner of Finish Line Physical Therapy in New York City. With his help, we’ve ID’d five causes of runner foot pain — and what you can do to get back on the road.
5 Most Common Foot Injuries for Runners
What it is: The repetitive stress of pounding the pavement can irritate the ligament that runs along the arch of your foot (the plantar fascia) and cause inflammation that you feel as heel pain.
Why it happens: Ill-fitting or unsupportive shoes, an intense training schedule (running too much or too much too soon), or not varying up the surfaces you run on (like roads, trails, etc.), Conlon explains.
The fix: “Switching things up puts less stress on tissues,” says Conlon. For example, if you run a counterclockwise loop around a park every time, you’re putting different biomechanical loads on your right and left foot. Same thing applies if you only run on roads. So switch directions and switch surfaces (grass, running paths, pedestrian roads). Also, make room for lower impact workouts, such as spinning, lifting, or ElliptiGO-ing (Meb Keflezighi’s favorite). Besides, you’ll beat boredom that way.
What it is: An acute injury. Meaning: You know exactly when this happens — it doesn’t just sneak up on you like an overuse injury. For example, you fall or stumble and end up stretching — or worse, tearing — the supportive ligaments in your ankle. In more serious injuries, you may also have a small fracture in your fibula (the outside bone in your lower leg) or metatarsal bones (the long bones in your feet that connect to each toe).
Why it happens: Conlon sees sprains most often with trail running (you step on a rock or in a hole and go down). But even he has sprained his ankle road running. “You may be running at night and don’t clearly see where you’re going, so you step in a divot and roll your ankle,” he explains.
The fix: First, it’s important to determine if it’s a break or a sprain. With a break you can’t move your ankle and can’t bear weight on it, says Conlon. Breaks should be seen by your doctor. For strains, Conlon recommends applying short bouts of ice for a minute or two, as well as continuing to move the joint. This creates contrast between cold and heat that may be more effective than using traditional RICE (rest, ice, compression, elevation) therapy, he says.
Metatarsal Stress Fracture
What it is: An overuse injury to the metatarsal bones.
Why it happens: You’ll likely encounter this one if you’re running excessively (think 50 miles a week without a proper build up) and/or if there’s a biomechanical problem with your foot strike, like your foot overpronates (rolls in).
The fix: If it’s a biomechanical issue, a sports doctor or physical therapist is your best bet to pinpoint and address the issue. Slowly ramping up mileage is key, as is a proper warm-up. Conlon recommends devoting 10 minutes to rolling out your calves and quads to get blood flow going (check out his foam rolling tips here). Then move on to a slow jog, finishing up with mobility drills (high knees, butt kicks, strides).
What it is: If you feel pain along the back of your lower leg near the heel — especially if it gets worse as you run — you may be suffering from Achilles tendonitis.
Why it happens: Overworking the tendon begins to break it down. That can happen in two scenarios. “Maybe you went out and ran 20 miles,” says Conlon. “Or, there may be something off with your running mechanics, which causes inflammation in your Achilles,” he says.
The fix: Like the other injuries mentioned here, it’s important to increase weekly mileage slowly (many coaches recommend 10 percent per week; though that may be different for every runner). If you’re suffering from pain and can’t pinpoint the cause (like that Saturday long run), get evaluated by a PT or MD to pinpoint the underlying problem.
What it is: There are two little bones underneath your metatarsal joint (you’ll notice them if you flex your big toe upward). Runners can fracture or irritate this joint.
Why it happens: While Conlon sees the other injuries on this list far more often, an injury to your sesamoid bones is another possible foot pain culprit. It may be related to a mobility, strength or stability problem within your ankle, calf, or hip, says Conlon.
The fix: A PT might suggest wearing an insert in your shoe for cushioning and support, he says. “Then, you’ll want to participate in activities that limit stress in the area, like swimming or cycling for a few days,” he says.
Note: The information presented above should be treated as a general guideline; it is not meant to replace professional medical advice.