Common Foot Problems of Runners

Almost every runner will eventually be sidelined by a foot problem. Anything from a simple blister to a more serious stress fracture can derail training schedules.

While running injuries typically involve the lower body — knees, ankles, hips, groin, and legs — the feet often bear the brunt more than other areas.

Read on to discover the most frequent foot complaints among runners, why they develop, how to recognize them, and ways to treat and prevent them.

Which foot problems are most common for runners?

Any seasoned runner will tell you the feet take most of the impact from repetitive pounding. Overtraining, ignoring warning pain, or skipping preventive measures can leave you with one of the following foot troubles runners commonly encounter.

Blisters

Blisters may not be severe injuries, but they are certainly uncomfortable.

“Blisters develop from excessive rubbing inside the shoe combined with moisture from sweat, which softens the skin and creates high-pressure spots vulnerable to breakdown,” explains Donna Robertson, Ped, ATC-MS, a certified pedorthist, athletic trainer, and teaching consultant for Foot Solutions.

She suggests choosing shoes that offer:

• firm heel containment
• a stable midfoot platform
• sufficient toe space for natural spreading and gripping
• a flex pattern that aligns with your metatarsal bend

Also watch for bothersome seams, stitching, or closures that can rub and irritate the skin.

Toenail trauma

Runners sometimes experience toenail trauma when toes repeatedly strike the front of a shoe because the shoe is too small or the foot slides forward — especially noticeable when descending hills.

Robertson notes this is frequent among long-distance trainees. “When the nail is repeatedly pushed into the nail bed it becomes bruised and inflamed, and often the nail may eventually fall off,” she says.

Hallux rigidus

The base of the big toe contains the metatarsophalangeal (MTP) joint, which bends with each step. According to the American Academy of Orthopaedic Surgeons (AAOS), stiffness in this joint makes running particularly painful.

This condition is known as hallux rigidus or “stiff big toe.” Arthritis of the big toe MTP joint can produce hallux rigidus, and the AAOS says it may follow an injury or repetitive overuse.

Plantar fasciitis

Plantar fasciitis is a painful condition characterized by inflammation of the plantar fascia.

Andrew Schneider, DPM, a board-certified podiatrist at Tanglewood Foot Specialists, explains that the plantar fascia attaches to the heel and runs across the sole. With every step it tugs on the heel, and repetitive stress from running can inflame it.

Schneider notes plantar fasciitis is common in runners with flat feet, though it can also affect those with high arches. “It’s an overuse problem resulting from the cumulative load a runner puts on the feet,” he says.

Stress fractures

Stress fractures arise from repeated stress without sufficient recovery time, says James Gladstone, MD, associate professor of orthopedic surgery at Mount Sinai. “If untreated, a stress fracture can progress to a full break where the bone displaces,” he warns.

Gladstone explains stress fractures commonly appear:

• at the ends of the metatarsals (the long foot bones)
• at the base of the fifth metatarsal (the small toe side)
• in bones around the ankle joint

Metatarsalgia

Robertson characterizes metatarsalgia as painful irritation of the tissues supporting any of the five long metatarsal bones that connect to the toes (phalanges).

When this occurs, the tissues over the metatarsals can become inflamed after running. Robertson says the usual culprit is repeated force against the ground during running, leading to wear or trauma of the metatarsals.

Morton’s neuroma

Morton’s neuroma is an enlargement and irritation of a nerve in the ball of the foot.

Schneider says repetitive pressure on the forefoot while running makes this common among runners. “The nerve becomes compressed between adjacent metatarsal bones and a ligament, causing it to swell and become painful,” he explains.

Morton’s neuroma tends to affect runners with high arches who land on their forefoot and those who wear overly narrow shoes. Tight footwear increases pressure on the nerve, worsening pain.

How should foot pain be diagnosed and treated?

If you have persistent foot pain, consult your primary care physician, a podiatrist, or an orthopedic foot and ankle specialist. They can identify the issue and advise on treatment.

Left unmanaged, many common foot ailments can worsen, particularly if you keep running through the pain.

Gladstone cautions that untreated injuries such as stress fractures, impingement, and tendonitis can deteriorate to the point where rest, immobilization, or physical therapy won’t suffice and surgery becomes necessary.

Recovery time varies by condition: for tendinitis it can be as short as two weeks, while stress fractures may require six weeks to three months to heal, Gladstone notes.

How can you prevent foot pain in the first place?

Whether you’re rehabilitating an injury or aiming to avoid one, taking preventative steps goes a long way toward keeping your feet healthy. Below are practical strategies to protect your feet.

Choose shoes that suit your feet

Wearing shoes that fit properly and feel comfortable is fundamental. Nelya Lobkova, DPM, advises selecting running shoes based on your running mechanics, performance level, and the terrain.

“Proper shoe fit starts with understanding your foot type — for example, flat feet often need a wider forefoot and midsole or arch support to prevent arch collapse,” she explains.

Conversely, a high-arched foot typically benefits from some heel lift and cushioning under the toes to spread pressure away from the ball of the foot.

Consider orthotic support

“Orthotics are the only devices that truly position the foot neutrally by providing appropriate heel tilt and arch support,” Lobkova says.

While over-the-counter insoles can help, many people select the wrong style. Flexible materials, for instance, may offer minimal structural support.

“Properly made custom orthotics can deliver the support needed across various activities and performance levels,” she adds.

Evaluate your running mechanics

Good running form is essential for foot health.

Gladstone points out that although some runners naturally have efficient mechanics, many must learn them. He recommends working with a running coach or a physical therapy clinic that focuses on running gait analysis.

Mind the running surface

Lacing up and heading out is easy, but too much time on hard surfaces like concrete or asphalt can stress your feet.

To reduce impact, Schneider suggests running on rubberized tracks or crushed gravel and choosing level routes when possible. Minimize frequent hill repeats or running on sloped surfaces.

Stretch before and after runs

Appropriate stretching is another key injury-prevention habit.

“Stretching wakes up muscles and tendons by increasing blood flow and elevating heart rate,” Lobkova explains. Preparing these tissues helps prevent overuse injuries such as tendonitis, sprains, and tears.

Before running, she recommends dynamic stretches since they mobilize and warm muscles in running-specific patterns. “Dynamic stretching simulates running motions, while static stretches are better used after the body is warmed,” she says. About 15 minutes of pre-run dynamic work is usually adequate.

During cool-down, spend 5 to 10 minutes on running-focused static stretches for the quads, glutes, hamstrings, calves, and hip flexors.

Don’t delay seeing a specialist

Ignoring foot pain is ill-advised. Schneider urges prompt evaluation by a specialist.

“The longer treatment is postponed, the more advanced the injury can become, increasing the likelihood you’ll need to stop running for a while,” he warns.

The good news is that physical therapy and custom orthotics are effective treatments for many common running injuries and can help prevent recurrence.

Takeaway

Foot pain, irritation, or injury is a common experience for runners. If you’re covering long distances or are new to running, pay careful attention to how your feet and toes feel during and after workouts.

Some issues, like blisters, are minor and usually require short rest and perhaps footwear changes. More serious conditions, such as stress fractures, demand weeks of recovery and specialized care.

If you notice any pain, soreness, or skin irritation, rest and consult a foot specialist if symptoms persist. For related concerns like a numb heel, seek evaluation to prevent escalation and get appropriate treatment.