Learn the best ways to deal with pain on the top of the foot associated with or caused by running.

Although not the most common of running injuries, runners do sometimes experience “top of the foot” pain and injuries. Because runners put so much pressure on their feet (experts say we pound the ground with up to 3 times our weight with each step when we run), it is no wonder. The types of pain that are typically experience in the top of the foot tend to be sharp, but usually not overwhelming unless they become severe. There are, basically, two types of top of foot pain – metatarsal stress fractures, and everything else. If you are having other types of foot pain you can use these links for injuries and pain related to toes and toenails, heel and arch pain, or general injuries like blisters and corns.

 Metatarsal stress fracture

When I was running in high school, I developed a stress fracture in the 2nd metatarsal of my left foot. It came on during a run one Sunday, the day after the league meet during my senior year. The pain caught me by surprise. I’d never had any problems with my feet that I could remember. The pain was on the top of my foot, near the front, but not in the toes. I went to practice the next day and didn’t say anything to my coach. I had run two bad races at the league meet, and I was hoping to make up for it with some good workouts leading up to the district championships, where I was expecting to qualify for state. I found that the injury was sharp, but that after a couple miles of warming up the pain subsided. Particularly, by the 2nd or 3rd interval of a workout of quarters, the pain seemed to disappear, and didn’t return until after the workout was over.

 I continued to train like this throughout the week. During the day and into the warm up the foot would hurt, but after a couple miles things improved and the pain mostly dissipated. On race day at the district championships, I planned to follow that same pattern. The foot hurt all the way through the warm up, and through the first lap of the race (this was the 3200m, so 8 laps). I thought the pain would ease up after a bit, and sure enough, after the first lap that’s just what happened. I raced confidently through the next two and a half laps, optimistic that I would be able to place and qualify for state. Then, with about ½ a lap before the end of the first mile of the race, the pain came back, and this time with a vengeance. It was much worse than what I had experience all week. I held my pace the rest of that lap, and was on personal record time, but the pain became too great. Four laps later I finished the race limping, in last place.

 On the way home on the team bus my foot swelled up to golf ball size. I took my shoe off for the trip home, and couldn’t get it back on to drive home. Next day I went in for x-rays and the doctor found that I had a stress fracture that had broken all the way through. I spent the next three weeks in a cast, and the next several weeks after that struggling to get back to running.

 The main cause of metatarsal stress fractures is simply a lot of running. It could be an increase of distance, or intensity or both. As you increase your training, the feet need to have time to develop the necessary strength to handle it, so if you increase too quickly you could be headed for this type of injury.

 Stress fractures should not be handled by you. Yes, rest, ice, compression and elevation can help, but if you think you have this injury you need to see a doctor; or, better yet, a podiatrist right away. With their care you may be able to recover and return to normal running in a few weeks. It is pretty rare for things to get as bad as mine did, and a cast is not likely necessary, provided you go see the doctor right away.

 Other types of top of the foot pain

The bad part of top of the foot pain is that, like the metatarsal stress fracture, it can be a sharp and severe pain. The good news, however, is that the cause and remedy is usually trivial. A runner friend of mine had been experiencing this problem for a number of months. He had tried a variety of remedies, and had even visited the doctor for it, but nothing helped. Then another runner friend of his suggested that he was tying his shoes too tightly. So, my friend tried loosening his laces a bit on all of his shoes. To his amazement, the foot pain went away almost immediately, and never came back!

 It may sound too simple to be true, but general pain on the top of the foot is usually not an injury, but is simply pain caused by too tightly tied (try saying that five times fast!) shoes! A less common, but still easy to try, remedy is to wear larger shoes.

 If the above two remedies don’t work, you may have a bone spur on the top of your foot. A bone spur is simply an enlarged bone. If you have one, you should be able to see it as a bump on the top of the foot. If you do, indeed, have a bone spur on the top of the foot, you may still be just fine with looser shoes. However, you can also try using a doughnut-shaped pad made from foam rubber. You can put it on your foot, or glue it to the inside of the tongue of your shoe.


There are two basic types of injuries runners may experience on the tops of their feet – Metatarsal stress fractures, and everything else. In the case of metatarsal stress fractures, you need to see a doctor as soon as you can. A good podiatrist should be able to help you back to health in a few weeks. In the case of other types of foot pain, try loosening the shoe laces. That is usually all that is needed to solve this annoying problem! If you are having other types of foot pain you can use these links for injuries and pain related to toes and toenails, heel and arch pain, or general injuries like blisters and corns.