I am active in a couple of barefoot running forums, and I am linked in on a number of barefoot sites. I love the opportunity to share and learn from fellow barefoot folks like myself. Having an extensive background in running and training, I tend to get a lot of questions, which I also enjoy. It seems that a majority of the questions I get are about injuries. This has kind of always been the case even before I became a full-time barefooter, and I was a little surprised to see that it also translates to the barefoot community. There is however a big difference in injuries between the two worlds, barefoot and shod. That difference is that barefooters are getting injured because they are not transitioning properly, and my shod runners are dealing with injuries from poor form, improper shoes, or overuse. With that said I decided to create a section on the site that will address common injuries for all types of runners from beginners to pros, both barefoot and shod.

My first injury to address is one that a lot of barefoot runners face:

Top-of-the-Foot Pain

There seems to be a lack of talk online about why runners get this injury, and I believe that is because a shod runner will rarely have to deal with it. Barefoot running is considered a new running fad so a lot of the issues surrounding it are not yet well studied or explained.

We all know that the foot is an extremely complex mechanism that gets seriously underused while wearing conventional shoes. It is made up of a lot of muscles, connective tissues, and nerves that are constantly handicapped by the stiff and cushy soles of most shoes. When a person decides to let his feet out of those shoes he is essentially taking his foot out of a supportive structure. I won’t say “cast,” but it is close. So there has to be some adjusting done to the way you approach your feet in terms of how much they can take and how to alleviate pain issues. I have outlined a beginners’ transition period in other posts, and I recommend you read them if you are making the switch. I also recommend you go there if you are suffering from pains or injuries in your barefoot running quest. Injuries are signs of doing something wrong, and learning to correct those issues will make the switch easier.

When running in a conventional shoe, the foot comes down on the heel, which means the toe is up, and the calf muscles are lengthened. That lengthening of the calf muscle puts it in its weakest range, and other muscles will have to make up the difference. One effect of this calf lengthening is the shortening of the muscles and tendons in the top of the foot and front of the lower leg or shin. You might not notice any of this, but over time it is happening, and switching to a barefoot or minimalist shoe will reverse it. When landing on the fore- or mid-foot, the foot is pointing down as it approaches the ground. This will lengthen the foot muscles and flex the calf muscles. You have essentially changed the muscles that are being engaged at foot strike and every joint has a balancing act that it goes through to work and stabilize the joint. The difference in foot strike will make a change in the joint’s balance and start using the muscles in a different way.

The typical runner making the switch will usually complain of sore and tight calves after the initial barefoot runs. This is because the calf muscles are now being tightened and flexed. After that initial shock is gone and the calves begin to adapt, the same runners typically complain of pains in the tops of their feet. These pains are usually coming from two muscles and/or three tendons that run the length of the top of the foot, one of which actually starts along the tibia.

The two main foot extensor muscles are the Extensor Hallucis Longus muscle (EHL) and the Extensor Digitorum Longus muscle (EDL). The tendons from these muscles cross the front of the ankle, pass across the top of the foot, and attach into the big toe and lesser toes. These are the muscles that run along the top of the foot. There is also the Extensor Digitorum Brevis muscle, but it is more along the upper/outer part of the foot and not typically associated with this issue. Three tendons cover these muscles: the Extensor Digitorum Longus Tendons. These muscles and tendons all function to pull the foot upward and work with resistance from the Achilles tendon and the calf muscles (flexor muscle group) that pull the foot downward.

When these tendons are over-stressed they become inflamed and painful. Swelling may come with the inflammation but not always. Most commonly it is the extensor tendon to the big toe (EHL) that is affected. In other cases the extensor tendons to the lesser toes (EDL) are affected.

Top-of-the-foot pain is typically considered to be a form of tendonitis but can also just be a muscle strain. The most common factors that cause extensor tendonitis are excessive tightness of the calf muscles, over-exertion during exercise, and falling of the foot arch. A barefoot runner will not have to concern himself so much with the falling of arches as the forefoot strike most commonly strengthens and builds the arches. That would mean the barefoot runner would typically be dealing with calf tightness since he is now using the calf muscles more than before. So if you switch to a forefoot landing after years of heel striking, then you are suddenly activating the weak muscles opposite the strong muscles you have been using your entire life. The pain in the top of the foot is usually going to be some form of tendonitis as these tendons are not used to being pulled on and stretched. The other problem is that in switching to the fore/mid-foot strike you are also contracting the calves more than before, which will then cause stress on the opposing muscles and tendons in the top of the foot.

All of you who started out with calf pain transitioned to top-of-the-foot pain for that very reason. Your calves got extremely tight and sore. A lack of proper stretching and relaxing caused a counter balance problem, which manifested itself in the connective tissues in the top of the foot. Remember that every joint in the body is a balancing act between muscles, and the pain you feel is rarely coming from the spot you are feeling where you feel it.

With top-of-the-foot pain you should stretch the calves and arches as well as taking anti-inflammatory meds. Getting the calves to relax and loosen up should be the main focus, as this will allow the release of the muscles and tendons in the top of the foot. Icing the top of the affected foot will also help in the recovery process. As with any injury the main prescription is rest. This may be the toughest of all pills to swallow, especially for someone who has just learned the pure joy of running bare, but rest and time, stretching, and ice will heal this issue, allowing you to get back out there and do what you love.

If you have more questions check out the article on Treatment and Recovery

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151 responses »

  1. Duncan says:

    Timely and helpful posting once again! It seems the greatest risk incurred in barefoot/minimalist running involves the occasional consequence of enjoying too much of a good thing. :-) I seem to have done that and am trying to “moderate my fun” a little to allow some minor TOFP to go away. Again, thanks – great work!

    • Duncan I’m sorry to hear about the injury. It’s always tough to deal with and tougher sometimes to come back from. I hope it all goes well and I’m glad the article was of some use.

  2. Great article! This is a good explanation of a common complaint.

  3. Andy says:

    Great post on TOFP, with a diagram to boot for honing in on the problem area! I was worried I had gotten a stress fracture, where the top of my foot felt slightly bruised, but after jogging on it for a few minutes the pain would go away, only to return pretty much the day after running. I have taken almost a full week off and the pain is going away! But I was still unsure about the stress fracture vs tendonitis or the like. Reading your post has me leaning towards an irritated tendon. Any advice on how long to rest, or how long to wait once I don’t notice the irritation any longer? Thanks for the article!

    • Donald says:

      Same here Andy! My left foot is “slightly bruised”. The pain diminishes with rest, so I guess I’ll give it another day or two to go away completely. I also have felt a deep horizontal stretching mid left foot twice during my last 2 runs which eventually relax after the first 1/2 mile.

    • Scott says:

      Hey Andy…how long did it take for your injury to recover?

  4. Jason M says:

    Yea, great article. I have the same question, how long do I need to rest it? I hate not being able to run, an I know this is going to be hard.

    • Due to the many questions i have gotten on recovery times i am going to add to the article so that it covers that area. I appreciate all the great feedback that I am getting on this and see that it is much more of an issue that I originally thought.

  5. James says:

    Great post! I had the same issue with top of foot pain… it was definitely tendonitis as after a few days I could trace the pain directly along the tendon path. I could also trigger the pain by squeezing my foot from the sides. I was able to get rid of the pain quickly by icing and putting some cottonballs in between all of my toes (I saw this online somewhere) and it pretty much instantly removed the pain so I left them in for a day and no more pain. I still stayed off of it for another few days to make sure it wasn’t coming back.

  6. Jason T. says:

    Great post and great additional information in the comments, too. This is the best explanation of the pain I’m dealing with, and a good source of encouragement in terms of how to deal.

  7. Jill says:

    what about side of the foot pain? under the ankle bone and extending toward the big toe? I am afraid that I have a stress fracture. I have been wrapping it but have had the pain since July.

    • Jill I would say it’s time to have it checked out. At the very least get it x-rayed and see. You’ve had the pain more than long enough for a stress fracture to show on an x-ray. Having a pain for that long in the place you say it is is not a great thing to have. Your description also sounds slightly like the pain is in the plantar fasciitis area but I’d say have it checked either way to try and rule things out and point you in a direction for recovery.

    • adam says:

      Hey. That sounds like Plantar Faccitis. Are you heal striking?

  8. Habib Omar says:

    I have injury waling playing football back side of left leg above ancle from last two month i am suffering i am used TFT & Ultra sound,Massages and exceises i am not geting out this paing i am unable to walk properly & running and i am unable take waight on front foot of left leg any budy sugess me a good excises or medicine

  9. [...] learned about TOFP on the web, realized my overzealousness and went back to my running shoes.  While I healed, I again walked [...]

  10. John Burden says:

    It is a very awesome information. Thanks for sharing. St. Petersburg FL back pain

  11. Brad DeLong says:

    I’ve been having TOFP for over a month. The majority of the pain has subsided but there is still slight swelling and pain even when not running, although after and during a run the pain goes away. Should I have it checked out or keep working on stretching?

    • At this point I think you need to shut it down and let it actually heal. If you can use phrases like “during and after a run the pain goes away” then I typically consider that not letting the issue heal. In your case it sounds like you need to try and stay off of it for a while and let the irritation actually subside. Stretching is great but sometimes you just have to stop and let stuff sit still. You are having pains and swelling when you are not running which is a big indicator that it’s time to do some serious resting and healing; like time in a boot healing. If a couple of weeks don’t do the trick then it would be time to seek medical opinions for sure.

  12. Tim says:

    Thank you! Great post and needed as i go down the barefoot transition.

  13. Gloria says:

    Fantastic post! I am not a runner, I am however almost always barefoot :D I have a bulging muscle on the top outer side of my foot and have been searching for some answers, this is very helpful tx

  14. [...] Which leads to my next problem. My inability to fully toe off on my left foot. I have a severe pain on the top of the foot where the shoe laces tie and after looking for some answers, stumbled across this blog post by gobarefooting. [...]

  15. Theresa says:

    Pain sucks. :(

  16. Ah! Thank you SO MUCH for your post! You described the exact thing I am experiencing, including the calf soreness, which went away several months ago. The doctors did not seem to know what was going on (as they probably don’t know much about barefoot running), so I was so glad to find your post. I will let it rest and heal. I was running on it, because I noticed that once it warmed up, I could run really fast and the pain was at bay, but it would come back twice as badly once I finished my runs and sprints. Thank you again!

  17. Edwin says:

    This is just what I needed, thank you!

  18. Alyssa says:

    Thank you so much, for this post. I walked 12 miles in my five fingers the other daY, and I was puzzled by the pain on the top of my foot. I’ve been in ‘barefooting” it for 2 years now. My question is, my pain gets worse ,whenever I wear “normal” shoes/slippers, is this normal?

    • Yes it can be worse when put in conventional shoes. The reason is typically the heel to toe differential. That drop from the heel stretches the tissues on the top of the foot which can cause it to hurt a bit. I’ve gotten to a point where I cannot wear a pair of shoes with more than a 3mm toe drop without pain issues. I also posted an article I wrote on how to recover from TOFP so if you haven’t read that yet I would recommend it :-)

  19. Chad says:

    Lovely and informative post! All the more reason not to freak out.

  20. Erik Lee Skjon says:

    I have experienced this too. I have always enjoyed going barefoot, and started barefoot running about two months ago. I was out of shape generally, so it was easy to take it slow, from one mile, then to one and a half miles, then two miles, until, after about a month, I tried three miles, and got Top-of-the-Foot Pain, on my left foot, for the first time. However, on that same run my ‘index’ toe got caught underneath my foot twice towards the end of the run, when I was tiring and not picking up my foot sufficiently. Could that have caused the pain, or do you think it’s a coincidence?

    • Erik I think it could be a bit of both. I would probably lean toward the toe getting caught as the main culprit though. Consindering you had no pain till that run where you had that happen I would say it probably came from those toe drags. The key will be to let it heal to a point of no pain and then see how your foot feels after a short run of a mile or so. The next thing I would pay attention to is the fact that you were getting to a fatigue point where you were not able to maintain your form. That is a solid sign that you were doing more than you needed to be so when you do get back at it I would say to add the mileage a little slower so you have a better adaptation phase.

  21. Erik Lee Skjon says:

    Thank you for your timely reply, and the great advice. I forgot to mention that for the last three weeks I have reduced my runs to one or two one-mile runs per day, along with about two miles walking barefoot with my daughter on my shoulders, to and from daycare. The pain had been gradually lessening, but then today it seemed greater, after three days of no walking or running barefoot. So perhaps I’ll try a full week of rest, or to the point of absolutely no pain, as you recommend. Thanks again.

  22. Frank says:

    Great article. It describes the pain I have in my left foot. I train in both lightweight neutral shoes and Vibram 5 Fingers. Three weeks ago, I did 1.5 miles of hill training in racing flats and several days later noticed discomfort in the top of my left foot. I thought it was from too tight laces and shifted more to the Vibrams. I am training for a marathon in 9 weeks and was hoping to get in an 18 mile run today but stopped at 10 as I felt that the foot pain, while not severe, was a sign to give it a rest. Do you recommend I lay off running for a while? If so, how long? Also, should I keep training in the Vibrams or do more running in neutrals? Finally, what about Advil? Thanks!

    • Taking it easy would be a good idea but you don’t have a lot of time left to get ready for your race so there is a conflict there. I would advise you to lay off the Vibrams for now and possibly for the rest of your training for this race. A less flexible shoe will help you keep those irritated muscles relaxed even while running. Yes running minimal and bare is all about working those muscles but if they get over worked then you are left sitting. I recommend icing the foot as well as massaging it to help work out the irritation. You may try taking a week off as that won’t cost you very much in terms of training and just adjust your taper period the weeks before the race. Advil is good for helping to get rid of inflammation so I do recommend it but not while running. You should avoid all pain relievers other than Tylenol 24 hours before and 6 hours after racing. Good luck

      • Frank says:

        I’m happy to say that after laying off a week I saw my doctor (former runner) who initially thought I had a stress fracture. X-Rays and lack of pain changed his mind. He recommended I layoff Vibrams and X train for another week while gradually building up mileage to former levels. I’m happy to say that, after two weeks, I’m just about back to former mileage albeit at reduced pace. I’m taking Hammer Recovery pills and skipping Advil since I no longer have swelling. I’m also much more mindful of Chi Running technique of NOT pushing against feet and toes and landing with midfoot strike. I’ve also adjusted expectations for the race and, instead, focused on how good it feels to run pain free again!

  23. Brandon says:

    I took on barefooting (slowly) a couple months ago and I started getting top of the foot pain a few weeks ago, so I stretched, relaxed, iced, and took it slow. It seemed to go away mostly after 2 weeks and I figured I was healthy enough to compete in a 4 mile race this weekend. Not even a mile into the race my TOFP came back, and it was 1000x worse. I finished the race walking because that didn’t hurt as bad. Turns out I broke a metatarsal, the one of my second toe (one next to my big toe).
    So I have a theory that perhaps some TOFP could be from small fractures from muscles and tendons not being strong enough to support body weight properly and putting too much stress on the bones.
    Since this happened to me and I thought it was just sore muscles and tendons based on everything I read online about TOFP, I would advise anyone with TOFP to be a bit more cautious, take time off, do more stretching and strength training for your lower legs, and be sure your form is correct before even taking on distances of a mile or more.
    Hope someone can learn from my mistakes!!!

  24. Chris says:

    This is such a great post! Thank you!!

    I am dealing with this issue now and am having a very hard time finding information on the web that I feel I could trust.

    Just a few questions…

    1) What are the risks of continuing running on a foot with this kind of pain? Fracture?

    2) are there any particular stretching and strengthing exercises you could recommend? I read on KenBobs site that lying on a bed on your stomach with feet hanging off mattress, flex feet and toes up, hold for 30-60 second, repeat. Thoughts??

    3) is there any good way to distinguish between muscle pain/ tendinitis and fracture??

    Again, thank you so much for this post and this site!!

    Chris (aspiring barefoot runner that can’t get past 9mi without getting hurt)

    • Hi Chris I hope things are going better for you and I will try to help as much as I can. 1) Running on a foot that is suffering from tightness or connective tissue irritation can cause stress fractures so you need to be careful. 2) I think Ken Bob’s exercise is perfectly fine but I recommend curling your toes into carpet, picking up a towel with your toes, and doing barefoot calf raises for strengthening. Between those three movements you basically hit all the muscles in your foot. For stretching you just need to flex and stretch your toes both forward and backwards as well as apart. 3) It is difficult to determine if soreness is a fracture or not. This biggest indicators are typically the sharpness and acuteness of the pain. If it’s sharp and in a specific spot then it may be a break. If it’s more dull and spread out then it might not be broken but you are at risk. I hope that helps and I would also tell you to stop trying get past nine miles. People get too caught up in trying to increase distance when what they need to be doing is building a base. Doing more 4-5 mile runs will build your strength and allow you a better opportunity to adapt which will allow you to get those longer distances in.

  25. Rachael says:

    I’d also like to ask for some information on distinguishing a stress fracture from tendonitus. I ran a tough trail marathon a little over a week ago in minimalist shoes and felt fine during the race. However, a few days afterwards I went on an easy run on some flat trails and there it was–TOFP on my right foot. It seemed to fade the next day so a few days later I tried again and it was bad enough that I had to stop and limp home. It was swollen and stiff for a few days. I’ve been crosstraining and icing and while it doesn’t really hurt anymore, it is still swollen and stiff. I tried running on a treadmill yesterday and stopped immediately because I was limping. The weird thing was that it didn’t hurt. I was limping because I didn’t have the full range of motion in my foot to push off properly. At first I feared I had a metatarsal stress fracture, but since I can’t find any particular location of sharp pain, I’m leaning more toward tendon issues… Any guidance or advice?

    • Sadly Rachael my advice is to have your foot looked at by a doctor. The swelling not going away is something I would say is a concern. If it had swollen and gone away in a day or two I might have said you had some inflammation but since it’s sticking around I fear it’s more than that. I like that you were able to go run without pain but the limping and lack of motion is a big concern. I would definitely recommend you not run on it and try to avoid doing things that will have you putting excess pressure on it until you can have it looked at.

      • Rachael says:

        I just wanted to follow up on this and thank you for your advice and great article. You were definitely right. I’m usually wary of heading to the doctor right away, especially since many are not supportive of the minimalist thing, but it turns out that this time I needed to. I was also lucky to get a great podiatrist who diagnosed me within minutes before even the x-rays confirmed it. I had a stress fracture in my third metatarsal. It’s amazing how quickly it happened. I felt like there wasn’t much warning, but now that I’ve experienced it, I think I understand the symptoms better. The sharpness of the pain and the way it throbbed even when I wasn’t moving my foot should have been a tell-tale sign. Thankfully, it healed very well and quickly, and I was given the go-ahead to start running again almost a month ago. I’m gradually increasing mileage and am still running in minimalist shoes (Merrill Barefoots). Ironically, I’ve actually been having very slight TOFP that feels markedly different than the stress fracture, more like what you describe in this article. The biggest difference? How diffuse it is and how related to movement. When I flex my toes I can feel the tightness.

        Anyway, thanks again for putting me on the right track!

  26. Erik Lee Skjon says:

    Just a follow-up to add to the info already given: I found that stretching my foot really helped with my top-of-the-foot pain in my left foot, as per gobarefooting’s advice. I now stretch both my feet before and after running as well as periodically throughout the day. I stretch them both toes up and toes down, the latter by holding the top of the foot to the inside of my thigh, sole facing me, knee pointing away at a 45-degree angle (a stretch I Iearned in karate). I’ve also become more vigilante about stretching my calves and hamstrings, but I think stretching the foot has been key to my recovery. Thanks again.

  27. Thanks to all for the information on TOFP. I have been suffering with this for over a month and all of this info makes so much sense. I will try stretching more and strengthening my lower legs. I am more of a walker and mountain biker and it is strange because when I am exercising I don’t notice the pain as much as when I am laying in bed trying to sleep or just going about my business during the day. I am a hairstylist so I am on my feet a lot of the day and I am sure it does not help that I wear flip flops much of the time. I live in the desert.

    • Yup, this sounds like my problem too. I walk about 3 miles a day, 5-6 days a week. I started wearing VFFs mid-summer-ish. The top of my right foot towards my ankle has been bothering me for at least 3 weeks. It is most bothersome during non-walking times and having the weight of winter blankets pressing down on it at night seems to aggravate it. Right now it is tender to the touch and hurts if I have my ankle at anything but a right angle.

  28. Christie says:

    Thanks for you article! I had been experiencing tight calves for a couple of weeks, but it gradually got better and was gone. I then developed TOTFP, and wasn’t sure what was going on. I am training for a half marathon in two weeks. I did the first six miles today, and my foot was hurting, so I came back and changed from my five fingers to my nike frees, and it felt much better! I was encouraged to find your article to tell me what was going on. Now I am off to ice my foot!

  29. Sara says:

    Thank you so much for this informative article! I’ve been experiencing tendonitis in my foot and ankle for way too long! Your article not only explains what’s going on, but also gives helpful suggestions on how to solve the problem! It’s hard to stay off my feet long enough for the tendons to truly heal, but I’m hoping that stretching my calves will help.
    Thanks again! :)

  30. [...] run the length of the top of the foot, one of which actually starts along the tibia.” (from http://gobarefooting.wordpress.com/2010/04/21/injury-top-of-the-foot-pain/) That sounds about right! GA_googleAddAttr("AdOpt", "1"); GA_googleAddAttr("Origin", "other"); [...]

  31. Ian Highland says:

    Thanks for the article. I’ve spent hours researching the injury online since getting the pain on Sunday night (now Tuesday). Great to know it’s not as serious as I thought. Am resting now but have a half marathon booked for Sunday night (White Night, Brighton) and really want to take part. That said it will be the furthest I’ve run in minimalist shoes (Trail Glove) even though I’ve been running in them since July. Will ice again tonight and not do any training at all until the race is upon me, my question… do you think I’ll be fit enough for it or am I kidding myself?

    • You’ve got a week or so before the race so you could be okay to run the race. The other key is how long you have been able to run in your Trail Gloves up to this point. If your long distance is near the race distance then you should probably be alright to go after resting this week. At this point I would say if your prior training is up to par and the foot feels healed and without pain on race day then go for it. If your long run isn’t 8 or more miles up to this point and/or the foot still hurts then you might need to sit it out. I wish you good luck and think you’ll probably be okay to go after resting.

      • Ian Highland says:

        Thanks gb. I’ve run 9 miles in my Merrells without any problems at all. I run 3 times a week in them two 3 milers and a 6 miler and have done for the last month, as well as running 10k trail races for the last 3 months (1 a month). Pre this injury I was feeling like I was getting to the next level with the new barefoot technique. Perhaps in the excitement I’ve been overstretching my stride and that’s led to this. Or it could be that my last run came after playing soccer for 90 minutes in the morning and it was too much. I don’t know. However I will do as you say and rest until the day of the race and see how I get on. Until then I will keep icing and taking anti-inflammatory tabs. Thanks for all the help and advice.

  32. Ian Highland says:

    Hi again, Just thought I’d let you know I completed the Half Marathon race in the end. Not fast as was difficult course half of it uphill, 1hr 52m. All went absolutely fine, no pain in my foot… apart from fatigue. Thanks again for all the advice, it really helped.

  33. Thank you for the information about barefoot running and pain. About nine months ago I began running half-time with Vibram Five Finger shoes. And in the past five months or so I’ve been running exclusively running in these “shoes,” to alleviate the knee pain I have suffered for years, knee pain that I believe was initially caused by being a heel-striker. Running with Vibram’s has allowed me to continue running by runningon the balls of my feet, taking strain off my knees. However, in the past couple days I’ve had severe pain at the pain of my big toe. So much pain that I’ve hobbled around in to work today like an old man. I wonder: Is this related to the TOF pain you describe here, in which case “RICE” is the best antidtoe. Or is it something else?

    • Sadly the answer is that it could be both. It could just be TOFP and it could be more. It could be soft tissue damage or it could be a stress fracture. In these cases I tend to take a wait and see approach. If it’s just TOFP you’ll notice it getting better each day as you rest. If it’s more than that the pain will stay at the same level as you rest and you should have it looked at.

  34. I just googled my injury because it has been 5 days since I ran last and I am freaking out. Then I find your post here that describes what happened to me perfectly from start to now. I am so impressed!!! I just started running 3 months ago barefoot on the beach down by the waters edge and I for sure don’t want to give this up! I am dissappointed about the rest part, very difficult for me. I went for a 1 mile walk on the beach today to see how it (the injury) is doing and of course I am in pain again. I usually run 5-6 miles so this is a shocker! I actually couldn’t walk at all on my right foot for 2 days when it first happened. I now can walk but still have pain. I have been icing it as well. YES, I had major tightness and pain in my calves after every run but I started spending much more time stretching afterwards and my calves felt better THEN this top of the foot pain which is way worse. So here is my question finally…..What can I do to get back to running sooner than later. I am a big eater and running is the only way I equal out. Help!

  35. again thank you for having this blog!

  36. zachary says:

    this happened to me, and then i rested and massaged my foot. but i think i might have made a bigger problem. one day i was massaging my foot with a golfball and accidentally put all of my weight on it. i heard a snap and felt a lot of similar pain. now my bone feels higher compared to my other foot. i’m referring to the bone that leads to my second largest toe. for about two months now the swelling has reduced but not gone away completely, given i still occasionally tried to run. please recommend a course of action. i’m in highschool and feel like i have a lot of potential. but my xc seasons have been riddled with injuries and now i only have senior year left.

    • The only answer I can give you is that you need to see a doctor and do not run on the foot until then. When you have things like “pops” and bones that feel out of place you have to take it seriously because it usually is. Injuries come from a lot of reasons but most of them are from improper training or care of the body. A lot of injuries also come from things like muscular imbalances that go unnoticed or untreated and they build up until the body breaks. Once you’re healthy and cleared by a doctor your best course of action is to adopt a well rounded routine that focuses on base ability, good flexibility, overall strength training, and functional stability training. All of that will help you become a better runner but more importantly keep you healthy. You also need to make sure your form isn’t an issue that’s working against you. Study running form inside and out. Look at different running types of runners as well as the history of running technique and then analyze your own form and technique. If you want to be good at a sport you have to know the mechanics of the sport and I also encrouage you to learn the history as well. To excell at something you have to know it inside and out. Go see a doctor and good luck.

      • zachary says:

        ok. Thanks. I do do a lot of cross training and balance training and all the years I’ve been injured I’ve wanted nothing more than to just be able to run so I had been looking into everything I could do. and for two years people convinced me out of running barefoot and to get a shoe with good stability. and I can’t tell you how many crazy shoes I have about 20 miles on now. Finally my brother’s friend kurt showed me how to fix my shin splints by running with the pose and evolution methods of running, and my shin never hurts when I feel like I’m doing it the right way, but my foot does. Now I have one of the most recommended wide barefoot flat shoes with a little stability for transitioning, (altra instinct) and I tried to not blow out my calves, and then my foot hurt really bad about two miles in one day out of nowhere. So I think I’m doing everything you said was the problem in the article. The only difference is the possible bone and swelling that won’t go away. So I’ll be sure to get it checked out. Thanks for the advice.

  37. Jill G says:

    Do you think that extensor tendonitis could result from a stress injury from running? i was diagnosed a couple years ago with a “stress reaction of bone” in the 4th metatarsal on my left foot. xray never showed an actual fracture, but the pain was definitely right on the metatarsal and it hurt really bad…so doc treated it as a fracture. i was put into a boot for almost eight weeks (while 7 months pregnant) and since then i’ve had on and off (mostly on) TOFP. For a long time we thought maybe the metatarsal hadn’t healed…even went into the boot for another few weeks…but as time went on, and after lots of internet browsing, i began to think that maybe i had developed tendonitis in that same area. i lost a lot of muscle, strength and flexibility in the ankle/calf from being immobilized for so long. this past summer the doc sent me to PT which confirmed some strength and flexibility problems. i’ve managed to get up to 2-3 times a week running, but no more than 3-4 miles…and never on consecutive days…without horrible pain. but anytime i push it, in terms of distance, speed or frequency, i end up on the sidelines again…and back in the pool. i’ve noticed that when i walk barefoot my foot usually feels pretty good, but as soon as i put on my running shoes i feel the pain…which leads me to believe that the angle of my foot in the shoe is stretching and irritating the tendon…before i’ve even started running. (i do try to soak my foot in warm water before runs to loosen up/warm up the tendons, but with three little ones, let’s just say that doesn’t always happen.) so anyway all of this is leading me to consider trying a minimalist shoe (not sure i’m brave enough for barefoot! especially with a cold snowy Cleveland winter approaching!) wondering what thoughts you or any of the other readers might have. i’m getting really close to asking for a cortisone shot in hopes that it will wipe out the inflammation (and associated pain) for good!

    • Yes I do think that your problems could have been caused from running but not just running itself. It was probably the shoes in combination with your mechanics on some level. It sounds like you’ve done all the right things medically which is great and I’m glad you have. At this point I would make two recommendations. 1. Strengthen your feet. Treat them the same way you would your core or your biceps and do exercises that specifically strengthen the muscles in the feet. I listed some in both articles I wrote about TOFP. 2. Change the shoes. You don’t have to go all the way to a minimal shoe. A lot of barefoot purists will tell you that you need to just run barefoot but you don’t have to go that far in order to obtain improvement. For people who want a conventional running shoe and the same cushioned feeling I highly recommend Altra footwear. For the women the shoe is called the Intuition and I just don’t think it gets any better in the world of cushioned running shoes. It has a foot shaped toe box, Zero Drop (perfectly level) sole, and they are gender specific in the design to fit a woman’s foot. If you want to go minimal Altra also has a really great minimal shoe offering as well. There is always of course our old friends the “Toe Shoes” known as the Vibram Five Fingers. I think with the right footwear and getting the foot stronger you can alleviate your pain issues and avoid the cortisone which may help but won’t be a permanent solution if the cause of the problem isn’t fixed.

  38. Kelly Badder says:

    Wow!! Great stuff here….I’m glad I found this….trying to help myself here. I had a brief consult with a podiatrist who wasn’t familiar with this type of pain. (“Only see this when someone has dropped something on their foot”). He ordered X-rays which were negative. He padded up my arch which helped and also placed a pad with a hole in it on the top of my foot and told me to make sure my laces dont hit there.I’m a nurse and on my feet all day and I’ve been limping around and my foot has been swelling at the end of the day!

    I have a life dream of running a marathon and recently started running (or jogging I’m slow!) and the tops of my feet have been hurting but also my calves! I stopped and went on vacation but was walking in sandals – they are flats with a supportive bed but also did a lot of barefoot walking in the sand. Anyway, when I returned home the TOFP in my left foot is severe! This article has given me hope – every time I have started to train it seems that some pain stops me. I have to do run this next year – I just have to…..I can’t imagine running barefoot as I wasn’t doing that so it had to be the improper stretching of the calves? Thanks for the article and what type of shoe to buy. I will stretch, Motrin and ice and rest till the pain subsides and find those shoes!! I’m going to strengthen my feel too which makes complete sense. Wish me luck as I go for accomplishing a lifelong goal!

    Do you have any advice for me? I know in my head I can do this but will my body agree? I feel like I don’t care how much or what hurts – I have to do this even if I crawl past the finish line. Date of race is 10-21-2012!

    • I like your drive but don’t let it take you to a dangerous place. If your pains keep coming back then there is either something wrong in your mechanics or in your gear (shoes). For someone who has a lot of foot swelling and/or mechanics issues I’ve found that shoes can make a world of difference. I’ve recently spent a lot of time running in and working with the Altra line of footwear and I have never been more impressed with a shoe. For women the shoe is the Altra Intuition and the benefits it brings are huge. By having a level sole it offers a lot of help in overcoming heavy heel striking as well as decreasing impact forces at landing. All this is done by something very simple and that is what I like. It’s also foot shaped which gives the toes room to spread out and give you better balance through the ankles (pronation). I hope you reach your goal and keep me posted on the progress. I always love a good success story. Also if I can help in any way please let me know.

      • Kelly says:

        You’re the best!! Foot feels better with rest and stretching!! I’m going to find those shoes and start again. I have to do this….lifelong goal and dream!! I will keep you posted!

  39. Teppo says:

    I think I fell victim of the “too much too soon” syndrome. Yesterday my third actual “minimalist” outdoors run went fine aside from the to-be-expected tired-out calves, but a couple of hours afterwards my left foot started showing… well, symptoms.

    First, I felt a sort of ache, yet also a kind of numbness at the ball of the foot. Then, it seemed to move to the top of the foot. And now I can’t even really locate it anymore, though it’s definitely more to the top and also outer edge of the foot, even perhaps including near the ankle. Go figure!

    There’s no sharp pain at any given location or such, so I assume it’s not bone-related. Nerves, tendons… who knows. I’ve tried poking places, like the “knuckles” etc, but still can’t locate what is wrong exactly. Putting ice on it doesn’t seem to make a difference, except for a brief period it actually aches more all around. My feet don’t seem to like the cold much!

    I can walk with the foot ok, heck I could probably even run (which I obviously will not), but despite the lack of any sharp pain it’s not entirely comfortable to even walk. And if I’m not thinking about what I’m doing I notice I sometimes start to slightly limp to keep weight off of it.

    I suppose I’ll just keep monitoring the situation and try to figure what, if anything, I can do about it. Visiting a doctor around here is useless, they seriously know less about sports injuries and such than most non-doctors ;)

    • It sounds like you have the right plan. The most frustrating thing about TOFP is that it’s not always pressure sensitive because there are multiple layers of muscle in the foot so not all of them are reachable through the skin. You can only feel the pains during movements because of that. A great indicator is movement and whether or not you can feel the pain then.

      • Teppo says:

        Hmm, for the last couple of days I’ve thought the foot has swelled somehow, somewhere, but couldn’t pinpoint it. But it seems to be at the ball of the foot where the numbness and ache began. If I don’t put any weight on the foot and lay it on the floor, the ball is swelled enough that that the two smallest toes on the left don’t actually touch the floor all the time. This also explains why now it feels that the foot tends to land “side-heavy” towards the left, with the outer edge taking a lot of the weight. Should I just try applying ice on the ball of the foot and hope the swelling subsides? The foot does feel slightly better now, but definitely not normal yet. Anything else I should look for in the swollen area?

      • Teppo says:

        Meh, on further thought these symptoms lead be back to the “condition” that I first read about before ending up here – metatarsalgia. Darn it.

      • Teppo says:

        Or possibly even worse, Morton’s neuroma. Sigh, further investigation warranted.

      • I’m curious where you wound up? Did you ever have it diagnosed?

      • Teppo says:

        Haven’t had it diagnosed… and rest hasn’t really fixed it yet either. It’s still strange in that the symptoms seem to shift, with sometimes the ball of the feet being problematic, other times the outer edge of the foot, etc. Still no sharp pains, but not entirely comfortable to walk/stand for long periods of time even in padded shoes either.

        I did go on a short (about 2,5km) run a few weeks back with “normal” shoes and heel-striking. It didn’t make the foot any worse, but damn did it immediately kill my back once again. Other than this, haven’t done any running since the foot issues first exhibited.

    • Teppo says:

      Funny thing. I still didn’t go to the doctor, but two months ago I started running again, and the foot’s gotten a lot better. Actually, at first it got a bit worse and got some symptoms on the right foot too. But that can be blamed on having gained weight again (always happens if I can’t run, sigh), as well as my regular running shoes (can’t really do barefoot/minimalist with my current weight) being in absolutely terrible condition. So I got a new pair of shoes and started running on packed dirt instead of concrete again, and it’s been a lot better. Now I don’t normally even notice much of anything being wrong in my feet. I do have to be careful of my shins now though, in fact I now cut back a lot on running again to avoid shin splints and/or stress fractures, because of some warning signs. If only I could be without a plethora of health issues just once in my life :P

      • That does sound like a rough cycle to be caught in. In my coaching practice I have found that when people go back to shoes after running minimal or bare for a while that they get shin pains. This is typically from two causes. One is they revert to a heel strike. Second is they can’t feel the ground as well as they were used to and they put the foot down with more force. The good news is that both of those can be worked on if you pay close attention to what you are doing. I do high speed video analysis on people and see this happening all the time. I’m glad the foot is doing better and I’d bet that using shoes again has something to do with it but we should also make sure that you are working on keeping your form proper so this stuff can all go away.

      • Teppo says:

        Well, it’s hard to be 100% sure, but I think my running form is better now than prior to my minimalist shoes. For that matter, I only ran with the minimalist shoes for only about two weeks anyway before the foot issue started. But now with “normal” shoes I don’t “push off” as much as I used to and I don’t reach forward as much with each step. It certainly makes for a slightly smoother and more balanced ride. One noteworthy effect has been that my knees rarely hurt at all even after an hour of running, while they were the first thing to start hurting even when I was still a LOT lighter than I am now. Now it’s the darned shins. It’s generally the same thing as I’ve heard many have – it’s OK while running but can have slight pain before and after running.

      • I’m glad that your form has improved. That really is the most important part. You can wear any show you want but if your form isn’t right then you’re gonna find problems at some point. The shin pains could just be “getting back into it” pains. I’d say if they go away or get less painful as you go then you should be ok. If they get worse then rest and let the irritation go away. Hopefully it’s just an adjustment phase.

  40. Erik says:

    After having recovered, after a while I went on a 5.5-mile run, and got some TOFP pain again in my left foot. So I finally got the foot xrayed. Turns out I have a tiny stress fracture on the third metatarsal. But the doc said it was already healing. So I started running every other day, three miles max, and adopted a mid-foot strike instead of a forefoot strike. This helped a lot, but I did feel it a bit more in my knees. So perhaps other folks might want to try a midfoot strike while they’re working through their TOFP.. It seems to help take some of the stress off the metatarsals.

    • I like your thoughts and think you are on the right track with moving to a mid foot strike. A forefoot strike is not very natural unless you’ve been doing it your whole life. Forefoot striking is a big misconception among those just starting in minimal/barefoot running. A mid foot landing is by far the best in my opinion.

      As for working through TOFP I don’t recommend it. Rest and rest properly is my advice. Let it heal and you won’t have to “work through” it.

  41. Yvette says:

    I was so glad to find this article. I’ve been running in regular shoes, but once a week I run low mileage (5-6 miles) in Vibrams. Last week during my run,the pain started on the bottom outside of my foot; after my run, I ended up with TOTF pain. I have to start training for Boston in a couple weeks but can’t find your article addition on how long to lay off with TOTF pain. If I stretch and ice, what’s your opinion? Also is it bad to switch back and forth between regular and Vibram shoes?

    • Sorry for the long time to respond but hopefully your problems have subsided. Resting time for something like TOFP is extremely variant. It’s completely different for nearly everyone. It shouldn’t be a problem to switch between shoes if your form is good. If your form cannot hold itself across different types of shoes then it could cause problems. I personally could go run just about any distance in nearly any shoe but not everyone could do that without problems. Starting something like minimal running is not something I advise during marathon prep because it requires a lot of monitoring and sometimes rest which is not something you can do during long distance training. My advice would be to limit the VFF running to 3 miles or so; forget what you think short distance is because 5-6 miles is not short for someone new to minimal footwear; and see if that helps. I would also only do it for the one day like you said. If it’s still causing problems I would leave the VFFs alone until you are in a downtime with your running so that you can give your feet the rest they need to make that transition.

  42. samluking says:

    I have bought a pair of VFF two months ago and I absolutely love the feeling of liberation from this new way of running. Besides the odd blisters I can cope, but recently the top of my foot started aching along the smaller toes. Your article was very helpful in identifying the problem! I did go a little crazy with my new shoes and ran a LOT, and I guess the best thing to do now is rest, which I’m not going to enjoy at all! I already rested for two weeks but tonight it came back and I struggled to reach 5k, it’s not swollen or painful unless it’s in mid-stride. *sigh, I just want to run :(

    • Part of your problem could be the blisters. Blisters hurt and pain causes things like your stride to be altered to try and avoid the pain. If you’re getting blisters often then you need to look at your form or the fit of the footwear and see either of those is causing the blisters. It’s a small thing but it becomes a cumulative problem that can cause a lot of issues. Other than that it might just take you longer to recover than you would like. No one likes being limited and having to rest injuries is never fun but you have to let the body heal or you’ll just be fighting this battler forever.

  43. Jesse says:

    I’ve been wearing minimal shoes for about 1 1/2 years. I stopped having calf pain a long time ago, but I have transitioned to the top of the foot pain for about 4 months. It started when I wore out my evos and decided to try NB minumus road. The pain would come and go. So I transitioned to nike free runs. Now I have more pain. The only shoe that brings slight relief is my merrell moabs. I went to the doctor and had them x-rayed and found no breaks. He noted the bone spurs on my halux on the left and right foot, which I already knew about. Your article makes sense. I will try stretching. I will have trouble resting though. My job requires me literally to walk 50 miles weekly(meter reader). What can I do? I love minimal shoes they help my halux limitus and knee pain. Can wearing stiffer soles help my feet rest? I’m also doing a barefoot near midfoot strike when I’m walking. Should go back to long strides until my foot can recover? Any help would be majorly appreciated, thanks!

    • I apologize for the delay in response but I have some thoughts. First I’ll ask if a midfoot strike is normal for you when walking or is it a change you made? If it’s not natural then it could be part of the problem as it’s fairly taxing to walk with a midfoot strike. Most people walk heel to toe which is perfectly ok when walking. Stride length when walking won’t make much difference as long as it’s your natural motion so I wouldn’t worry about that part much.

      A stiffer shoe when walking will definitely help the foot relax. That’s sort of the whole point with this minimal/barefoot movement. Less under the foot means the foot is allowed to move more freely which works it more. A stiff shoe will hold it still and keep it from moving as if it were in a brace. While trying to let it heal it would be good to try a stiffer shoe and see if that helps.

  44. Julie says:

    Thank you for addressing this as a barefoot runner. Websites who are against minimalist and natural running all just assume top-of-the-foot pain is a stress fracture. My routine would suggest that my injury is NOT a stress fracture, so I’m glad your article was here for me to get another opinion.

  45. jess hall says:

    great article. I have been experiencing top of the foot pain after barefoot skipping. I would be interested to hear you thoughts on whether this is a good form of cardio? I’m not a runner.

    • I’m assuming that by skipping you mean jumping rope? My answer is yes. Jumping rope is a great form of cardio because it uses a lot of muscles and really gets your heart rate going. You can vary the speeds and ways you do the exercise to keep the body guessing as well. Doing this barefoot gives you more strain and strengthens the feet a lot. It also will help you develop better balance and coordination. This has long been one of my favorite exercises that I feel really is underutilized. If you meant actual skipping, like across a field of daisies, then yes that is also a good form of exercise that will give you similar benefits to jumping rope.

  46. Ophelia says:

    I was recently introduced to barefoot running. Unfortunately for my feet & bank account, I approached this like a science experiment; I went out & bought 4 different types of minimalist shoes, from Five Finger Vibrams, Nike’s Free Run, Merrell and Newtons, and at first only my calves hurt but as I changed to different shoes every run TOFP increased. Can changing shoe type/technology actually make my injury worse, or even more horrifying , ” can wearing different minimalist shoes make my transition from heel striker to mid foot stricker longer & more painful!?!

    • Erik says:

      Orphelia, there is a lot of anecdotal evidence that it’s best to start off barefoot, for very short distances. Once you got the form down, and you no longer feel any pain, you can use minimalist shoes if that’s your preference and/or if temps and/or terrain demand it. If you’re running on dry asphalt above freezing, there’s probably no reason to wear shoes at all. You may find it’s possible to run down to 20F or so.

    • Yes it could be coming from your constant switching of shoes. When you look at all four types of shoes and how they are approaching the same goal it could be too much of a shock to your under strengthened feet. The purpose of the shoes you bought is to change the way you run and they all do it differently. Five Fingers are super thin and super flexible. Nike Free is super flexible but the same thickness as any other shoe on the market. Merrell is an in between not being as flexible as either of them but not as thin or thick as them as well. Newton is similar to most shoes except that they have more weight and materials (the lugs) under the fore foot to force a fore foot landing (my least liked shoe here). My advice would be to go with one pair for now and out of those four I’d recommend either the Free or the Merrell’s to start with. The Free is good because it’s more flexible than you are used to but offers you a similar feel to your norm. The Merrell’s are your collection’s in between shoe so you wont have the same cushion but you also wont have a thick heel to land on either so they could be a good choice. Once you settle on a pair of shoes you need to go out for very short mileage focusing on two things. 1. Take shorter and more frequent steps. Don’t shuffle but don’t worry about having a long stride. 2. Don’t worry about the landing so much. I personally think it’s more ideal to land flat footed. The fore foot can put you too far up on your toes and we already know about landing on the heel being bad so try to land more flat footed and under your center of gravity. Most of the time just trying to take shorter strides will accomplish this. Beyond all that your focus also needs to be on making sure the sore and tired muscles of your feet recover and stop hurting or you’ll be dealing with more severe issues like stress fractures. I hope this helps and please let me know how it goes.

  47. Ophelia says:

    Thank you, I appreciate the the advice, it was hard picking which one to use, since I kept getting different views on each one. I’ll try to stick with one for now and see how far I can go. & will definately watch my form… I’ll keep you posted!

  48. Kristi says:

    I starting using the merrell pace barefoot shoes because they were recommended to me after issues with my knee and I haven’t had a single other problem with my knee since. For the last couple of days though I have been feeling pain just below my ankle bones, on either side of my Achilles tendon. I’m wondering if it’s because I have done a lot of running in these shoes lately, or if it might be a serious problem. Thank you!

    • My initial thought is that it’s transition pains. You said ankle bones in the plural sense so I’m assuming you mean you’re feeling it on both legs. If that’s the case then the odds are this is a transition issue and you should probably back off a bit and let them heal up. If after a few days rest the pain is still there then you may have a greater issue. The problem then is figuring out what the issue is. It could range anywhere from having too much mobility in your ankles and needing strengthening exercises to landing too hard and the impact forces causing the pains.

      I would also try and look at your form. Landing too hard on the heels in a thinner shoe can cause ankle issues because the ankles are taking a lot of impact force in that scenario. If that’s what you’re doing then I’d recommend you take some rest, bring your distances way down, and focus on training yourself to land more flat footed. For some people that’s as simple as shortening the stride and for others it’s a lot more work but it can be done and you should benefit from it if it’s what you need.

  49. Lauren says:

    I started wearing the Merrell minimalist shoe about 2 months ago. I transitioned to a forefront technique from a heel striker and was running mostly in snowy trails and other than tight calves (which I tried to be good about rolling out and stretching)I had no problems and I was up to probably running between 6-8km (still slower than before my transition). About 2 weeks ago I went for a run on paved pathways and at the start of my run I felt pain on the top of my left foot (where the big bump is on the top of your foot). At first I just thought my shoe was too tight. I kept running and after about 15 minutes it was so bad I couldn’t run and could hardly walk because flexing my foot hurt. I should also point out that at the start of this run I rolled my left ankle out on uneven ground but it didn’t seem to cause any pain in my left ankle.

    I haven’t ran since and I iced it a little bit but I do a lot of walking. The pain has subsided so that I’m not limping anymore but I still notice if I try to jump or do calf raises – at the point where you’re just about on the ball of your foot and have to push to jump up. Do you think this fits the bill for TOFP or might it be something more serious?

    • I don’t think this is a case of TOFP. I’d say it is more related to the rolling of your ankle that happened. Rolling the ankle can do damage to the foot just as easy as it can the ankle. You could do everything from strain to sprain to break the foot by rolling the ankle. At this point it sounds like it’s getting better but I wouldn’t do anything to push or test it until the pain is completely gone. I wouldn’t recommend running until there is no more pain when you do anything. If the pain lasts longer than a month without going away I would recommend you see a doctor to have it fully evaluated but if the pain is gone in that time you should be fine to start back slowly.

  50. Sydney says:

    Great explanation and perfectly describes my symptoms! I’ve been icing the top of my foot but hadn’t thought to stretch my calves–makes total sense given the pain is usually worse when i first wake up in the morning. I kept thinking “shouldn’t it feel better after resting all night?”. Tight muscles is a very logical explanation!

  51. Doug says:

    This has been extremely informative. I too have recently switched to a more minimalist shoe (Inov8 f-lite 230’s) and being the bright guy that I am, I went out and ran a fast for me 4 miles the first day in them (I run about 15 miles week). My calves were sore for a week. I have since slowly increased my mileage in them, and my calves are now pain free, but I now have TOFP, but only on my right foot. Today, I placed a single pro-kinetics shoe insert into only my right shoe, and just walking around it feels great. Is that arch support helping? Is this crazy? Should I put the insert in both shoes? By doing so, am I making the shoes less minimalistic and thus affecting my conversion to a mid foot strike? I have a ten mile race tomorrow that I will run pretty slow, as I am pacing a friend and then a half marathon in two weeks that I’d like to run fast. Do you see any issues with that? And finally, I have noticed that the wear marks on these shoes are a little on the lateral heel and the medial midfoot, am I still a long way from a proper foot strike? Thanks for your help!

    • Doug that was a lot of questions :-) I’ll do my best to address them. I will start by saying that the 230’s aren’t what would be considered a minimal shoe. They are probably a lot lighter and more flexible than what you are used to but they still have a fair amount of cushion to them and really they are more like a fairly typical racing flat in comparison to an every day cushioned trainer. I would say it’s the extra flexibility that you are not used to that caused the problem. With any transition to a lighter and more flexible shoe there will be some growing pains. You didn’t say how long the TOFP has been there so I’m not sure how to address it other than to give some ideas.

      The insoles help because they are basically bracing your foot and not allowing it to flex and contract as much as they do without them in the shoe so no it’s not crazy. If you’re going to have one in then I would recommend using both or you’ll cause compensation issues, especially while running. I also would not consider leaving them in permanently as they should be treated like a typical brace. Use them until the irritated musculature in your foot relaxes and then focus on strengthening your feet some more. I would also recommend you stretch the feet, toes, and calves really well to try and get some of the tension to go away. The insoles are adding some thickness to the shoe and making it less minimal but it’s not going to hinder your ability to change your foot strike patterns. I do want to caution that something like that takes a lot of time and doesn’t come easy. It is something you’re going to have to make a constant and consistent effort on for a while. It will become natural for you but first you have to move away from what has been natural up until now.

      Based on the wear marks you are describing it sounds like you’re shifting between the mid foot and the heel with your landing and that’s to be expected while you try and change how you run. Don’t beat yourself up about the little stuff and remember that this is a long haul process and it doesn’t happen over night.

  52. Doug says:

    Thanks for the reply. I ran the ten miler in my Nike Lunarlon’s (I think that’s the name?) with no issues. However, post run, I still have the slightest right foot TOFP as I push off while walking / running. Again, it is slight pain, so I am assuming my body is just adjusting as I move from those clucky heeled shoes to a flat. Now regrding the Inov8 shoes, you stated, “really they are more like a fairly typical racing flat in comparison to an every day cushioned trainer.” Does that mean I should only be racing in these and use the cushioned trainer on an average everyday training run? Also, you asked how long I’ve had this slight TOFP, it has only been a week or two, but it has come right after switching to the Inov8 and after the calf pain. Again, it feels minor and more like adjustment pains, obviously I don’t want it to grow into more. Now you might be asking why switch if the clunky Nike’s have presented no issues? Well, it is because I would like to run for a long time and I feel that my best chance at that is to try to get away from the heel strike, and one other reason…I feel like a bleeping Clydesdale in those clucky things! I will keep you posted.

    Doug

    • I would say that based on what you’ve told me that the TOFP is just a side effect of the transition and I do like the fact that it is getting better. You can by all accounts run your training miles in the Inov-8’s you have. Just be aware that there will be a transition period and with that there will be some growing pains. I don’t expect much more for you in the way of pains or troubles but you never know. I like the idea that you want to run more efficiently and say it’s great that you are working your form. I know what it’s like to hate the big heavy heeled shoes so if your legs will handle it then you should be able to stick with the Inov-8’s without any trouble. I have a pair of 195’s and 155’s from them and I’ve logged long training miles in both. Good luck

  53. Ian says:

    Dear BF..What a great article, I have just read through the whole thread top to bottom after spending the last 3 nights researching the web about my TOTF pain.
    Firstly I should say I’m relatively new to running (18 mths) and am definitely not a natural, I actually have had numerous physio sessions which included me becoming more of a forefoot runner albiet in structured shoes (Asics Kanayo) with my miles increasing & lack of hip pain, I stopped the physio and had a new confidence in my technique.. I did some research and purchased some Newtons (structured) and took it slowly increasing miles.. I did however get the calf pain for a couple of weeks which soon disappeared and have been running between the 2 sets of shoes 5 X a week upto 15 miles without issue…
    So here’s my problem, I’m now in full training for the London Marathon which includes a 20 miler (Ashby) this coming Sunday.
    Last Thursday night doing hill work, I felt a pain in my right foot – like the shoe laces were too tight but carried on for maybe 8 miles (in the Asics), I followed this up with 5 miles on the Friday (Newtons) then now thinking stupidly did 15 miles (the longest distance yet) in the Newtons.. and I’ve been struggling ever since..
    I saw a podiatrist yesterday who really couldn’t help since the pain wasn’t specific and there is no inflammation, so have been to see a very helpful sports massage therapist today who has really hurt me massaging around the the aplicable tendon, when she was getting deep into the Tendon the pain was really sharp in a specific spot on the inner side of the right foot although the left foot had a similar pain in the same spot but just not as prominent.
    Do you have any advice on what I do next, I’m planning on resting until Sundays race and praying the pain starts disappearing tomorrow. Maybe there is some exercises I can do? – the sports massager suggested a tennis ball massaging under my foot?? I’m half considering buying some new structured asics (I’m thinking the Kanayo are upto around 400 miles) I presume you advise a more structured shoe in the short term?
    Any thoughts would be greatly received…

    Best regards
    Ian

    • Ian I read your comment three times to try and work out what I thought was the problem. The biggest issue here is that you are still a relative new comer to running so getting into these long distances can cause some problems. My advice is always to back off or stop when something hurts. Aches and pains happen but pushing through them for too long can only cause injuries. With that said I think your problem might be the shoes you’re wearing. The Asics you’re wearing are motion control/stability shoes and they have a multi part sole. When the softer (white) foam starts to break down the stiffer (gray) foam does not and that really can mess things up under your foot so you may need to start there. My other concern is the Newtons. I like what Newton wants runners to do in terms of running with a more natural form but I’ve never quite endorsed the way they do it as it can become forced and unnatural. That may not be the issue though as it could be the switching from the two very different shoes. When you’re going to be switching between shoes you usually want them to be a similar build, shape, and type of shoe so you don’t throw things off in your stride patterns.

      If you’re going to be looking into new shoes and want something with cushion I recommend the Altra Instinct or the new Provision. They are basically built around the same “natural running” premise that the Newtons are but they take a very natural approach to it. The shoe is foot shaped and flat so it’s a very stable ride but also comfortable. I don’t usually like cushioned shoes but I love the Altra’s and wear them all the time. If Altra isn’t what you’re interested in then I suggest trying to get more natural in your shoes by finding something with a lower heel so the calf and Achilles can function more naturally. I also would suggest staying away from stability shoes because of the way they break down and wear out.

  54. Ian says:

    Dear BF..
    Thank you very much for the prompt email and advice, I really appreciate your comments. The pain seems to bea little better today after the massage yesterday so fingers crossed it continues to ease before Sunday.
    Sorry, my earlier note wasn’t particularly clear… The pain seems to be on the top of my foot when wearing trainers, (maybe the Tibialis Anterior) and I feel particular discomfort in my toes when either pushing off or walking down stairs. The sports therapist yesterday caused me the real pain when massaging deep underneath the arch in my foot, which she explained could be plantar fasciitis – This was a real sharp pain at a certain point, which I have been feeling again today when self massaging with a tennis ball.
    Your comments make absolute sense and the break up of the Asics hopefully is the cuprit.. I really hope so!! I’m going to scrap the newtons in the short term – well until after the Marathon.!!
    Thanks again and fingers crossed…

  55. Daniel Bustamante says:

    Great article, but it started with a really tight caff and the next day i had severe pain on top if my foot, and then it became a bruised on top, the bottom of my foot and top of my ankle. I have put ice every and ive been resting for a week now and the pain is still severe. I went to the doctor to get it x-ray and nothing was wrong. Any help please? What could this be?

    • Daniel the bruising means you need to see an orthopedic doctor. TOFP is not a major injury. It’s just soreness and inflammation and those things do not bruise. Breaks and tears bruise so the bruising means your injury is well out of the scope of my diagnostic abilities. A basic x-ray will not show tissue injuries like tears and sometimes they won’t show stress fractures either because the fracture is too thin to show up. I’m a little bothered that your doctor did not mention this and recommend more testing to take a look into it. Did he put you in a boot or anything like that to stabilize the foot while it heals? I would say you need to pursue further examination and definitely try and stay off the foot till the pain and bruising are gone.

  56. Linnea says:

    Good article. I sure hope this is my problem, since I am having excruciating top of foot pain after a 5K race this morning. I don’t run a huge amount, doing Crossfit, but I do run in Vibrams. I hope it goes away soon. I can’t put any weight on my foot at all.

  57. I feel like I found home. I started running in 2008. I am now a young 62 1/2 marathon runner. Lately when I start my morning run I am LIMPING. I limp for .25 miles then I loosen up and BOOM I am running my usual 7:30 – 8:30 pace and LOVING it. This stiff thing is new for me and I hate it. I wonder if this is the beginning of something bad. I don’t really do much stretching to be honest. HELP!

    • Welcome Charles and that is awesome you picked up running! I would say anything that stops hurting after it warms up is a soft tissue problem. It sounds like you strained something in your foot and it probably just needs some rest and stretching. If you can get yourself to do that then you shouldn’t find yourself in a position where it becomes something worse but if you keep pushing it then you could wind up there. I would also recommend you start stretching more. Get those calves loosened up and do the foot strengthening exercises I recommend and you should see things go back to being pain free. Good luck and let me know how it goes.

      • Erik says:

        I’ve found stretching very beneficial, both generally and with the foot and calf. I was wondering what you’re reaction is to the ‘stretching is for bozos’ slogan of Dr. Gangemi (the Soci Doc).

      • Oh the Sock Doc. Stretching has been a very controversial topic in the fitness world for a long time. Great cases have been made for both sides of the argument over the years. Some people are going to be able to never stretch and feel great and others will feel terrible so it leads me to believe that stretching is a fairly individual practice. I personally like stretching and feel that it helps keep my muscles in balance. I do not try to become contortionist flexible but have what I call functional flexibility. By that I mean I want to have enough stretch in my muscles to allow them to perform a required task without pulling or tearing. I only stretch after I’ve been fully warmed up or after I’ve worked out. Those are the only times I feel you really get any true benefit from the practice.

  58. Erik says:

    Thanks, that’s pretty much my view too, although I do a quick stretch for a few secs before running and weights too. Seems like most BFRers have been won over to the absolutist ‘just say no to stretching’ position though. Kind of like the Paleo Diet, functional fitness, and sit-stand desk–they bought the package deal.

  59. TDS says:

    thanks for this article.i recently hurt my foot practicing parkour and i was wondering why, i did the same basic stuff i do every day but 1 simple thing.i didn’t wear a shoe this time. i didnt know my leg was so properly trained. (and you arent kidding about that rest thing, hah)

  60. Nancy Yuknot says:

    Could the top of my foot pain be caused from walking too much in flip flops? It’s only on one foot (right foot). It doesn’t burn, but I get a pain on the top of my foot every now and then. The top of my foot is swollen and aches. Thank you.

    • Yes flip flops can cause and aggravate top of the foot pain. However in your case I am concerned about the swelling. It’s not common in TOFP to have swelling. It’s not unheard of but those are usually pretty bad cases. I would actually be more on the thought that the swelling is causing the pain more than being a reaction to the problem. It’s definitely something I would caution you to be careful with.

  61. Jason says:

    Thanks for this well written explanation.

  62. Lacey says:

    I recently started playing sand volleyball this summer. A few weeks ago during a game, I felt a pop in my left foot, on the outside/top. It has been hurting ever since, especially when I try to massage it. Any idea what is going on? Is this a serious injury or just something that will pass on its own?

    • Popping sounds are never good. Sometimes you’ll get away with it being a dislocation that goes right back into place and sometimes you just over extend a joint and it pops. Both of those issues tend to go away in a short amount of time and the pain gets better with each day.

      In your case I have concerns and think you should have it looked at. The fact that it is pressure sensitive (hurts when you touch it) is something that is usually a bad sign. That is a symptom that is typically equated with breaks, tears, strains, and pulls. The problem is strains and pulls don’t usually make that popping sound which only leaves the bad stuff. Most injuries to the foot will heal on their own but not having it looked at and treated properly could leave you in bad shape. Go see the doc.

  63. [...] calves can lead to pain in areas like the top of your foot (more reading on that can be found here).  Properly stretching your muscles will prevent them from pulling on each other and reduce the [...]

  64. Morgan says:

    Thanks for this! I was beginning to think i had a stress fracture or something…but this is exactly what happened to me. I have been hiking and walking in barefoot shoes for over a year, but just took up running. I suppose too much too soon. I was worried i was going to have to transition back to traditional shoes, but i am going to try to rest and ice and get back out on the trail! Thanks again!

  65. I noticed pain in my tibialis anterior tendon every time I ran more than 6 miles in my new minimal shoes. I was running an out and back, and had to over-correct with a bit of a heel strike to make it back to my car without pain.

  66. James Dunmore says:

    Thank you for this – you’ve put my mind at ease…. About 6 months ago, I fractured a metatarsal on my left foot – I let it heal then managed to get the dreaded plantar fasciitis in my right foot (but not through, but possibly aggravated by barefoot running, it was actually done when I slipped in the mud).

    I’ve been easing myself back into running, and now developed a tingling/dull pain on the top of my left foot. I’ve panicked and instantly thought its a metatarsal again, but the pain is very different from last time (for a start, it doesn’t hurt when I weight bare or particularly more when I run or walk) – in fact, the pain/tingle is worse when I’m sitting still. I have had very tight calves from running recently, and this seems to be bang on what it is.

    Obviously stopped running for a few days, there is no swelling (like there was with the MT last time) and no obvious pain when running my thumb along the joints/tendons.

    I think it is related to the tight calves. Here’s hoping anyway!

    Thanks.

  67. Scott says:

    I am an avid runner who gradually shifted to forefoot running 5 years ago….and recently shifted to minimal shoes in April after using Newtons for a number of months.

    My top of foot pain came after what I thought was a reasonable increase in mileage, but my longest run in my NB Minimus shoes…14 miles (I had done 10 a couple times and had been running them on my 4 times a weeek runs of 5-7 miles regularly). I ran on it the rest of the week, then ran another 14 mile run (ok…not smart but you know the type) and had pain…top of foot it seemed. I took a week off and the pain is less. I do not think it ever swelled up…and if I press the bones now I cannot find a spot where it hurts. It also is hard to pinpoint excactly the location of the pain …which seems strange to me. I feel the pain but cannot tell excactly where it is…although in general it is above my middle toe. Oh…I also have been rolling this ankle a bit before this injury, a recurring issue

    A familar story…I freaked out after reading all of the articles on stres fractures and visioned boots, casts, or surgery (yes…the internet and paranoia can be a terrible thing).

    Seem like Top of Foot injury based on my description? I recenlty started biking and did swimming last week…first time in my life I am actually ‘taking a break’ from running.

    • It does sound a lot like TOFP and that you really should benefit from some rest. The hard part about transition period is that there really isn’t anything that one can say is reasonable. It’s so individual that it just can’t be defined. We can make recommendations but everyone will adapt differently. I’ve coached people who never had a transition period and I’ve coached others who took years to fully adapt to the change in footwear and form. The move from conventional to minimal is tricky. It sounds like you’ve been careful but also tested your boundaries which is fine as long as you pay attention to the warning signs. Hopefully the rest will do you some good.

  68. Sophie says:

    Hello, reading your article, I wonder if you can help? I think I may have done the reverse of the above. Having previously always worn quite bulky Asics but always run on my forefoot (my heel rarely met the ground), I had and have very tight calves and hamstrings. I’ve switched to Nike Free Runs and am now for some reason landing heel first and for the first time experiencing pain across the top of my forefoot and toes. I have high arches and am used to support there but now have none. Is this a tight calf issue? I love my lighter shoes and dont wish to return to the bulky asics. Any advice much appreciated! Thanks.

    • There are a few issues here and I’ll try and address them all. First the Nike Free run has lots of a arch support in it. It’s got a pretty high build up in the arch to the point where I can’t even wear them. It may be less than the Asics you switched from but don’t let the flexible sole make you think you don’t have the same support. Second the Free Run has a typical 2 to 1 drop ratio which I’m guessing your Asics had as well. Basically the heel is around twice the thickness of the forefoot. Given that they have a similar drop profile the Free Run should not have changed your form to heel striking. It could be that you have heel striking tendencies and the Free Run is allowing you to feel it more than the Asics did. Getting rid of the heel striking can be as easy as shortening your stride so I’d recommend you start there. I don’t think the tight calves are your problem although I’d recommend you really start working on that as it will most likely lead to Plantar Fasciitis and similar problems now that you’re using a more flexible shoe. I think your pain issues are coming from the flexibility of the shoe and your foot muscles not being able to handle the new workload. You should probably give them a little rest and then back off the miles until you’re properly adjusted. I don’t know if the Free still comes with a recommended transition, the older models did, but if it does then you need to follow it. If it doesn’t then I’d recommend cutting way back on your miles and intensity to see if that makes them pain go away. If it does then you need to adjust your training so that you build back up gradually.

  69. Rocco says:

    Wow, this was interesting. I am by no means a runner. From a runners stand point I’d be a fat ass. (haha) Anyways I started a new job 4 months back. I am a Driver’s license examiner. I sit in the passenger seat. Anyways I developed some mild pain on the top of my feet (only when I was working) It would subside on my days off however now it is borderline excruciating while working and moderate any other time. Here is where the similarities lie. While always being the driver I had my left foot on the dead pedal and my right foot on the gas pedal. Both are in the upright position. Now as a passenger all day my feet are in the extended position… you mentioned the counter balance manifesting in the connective tissues on top of the foot. Anyhow, rest isn’t an option so going to try some over the counter anti-inflammatories and I guess see my GP to make sure.

    Thanks for the article.

    • I’m curious how this has gone for you. At first thought I would say the new stretch of being flat is causing your problems but four months is typically enough to time to adapt to a non-moving situation like yours. It could also be the level of arch build up in your shoes. If the feet are laid flat in a seated position then they are either sitting neutral or potentially stretched over the top if the toes are pointed (depends on the height of the seat). If the shoes have a lot of arch build up (most people would probably say arch support) then they are pushing up on the bottoms of your feet which would cause extra or excessive stretching of the tops of your feet. This could cause the pains you’ve described. Outside of that I’m a little lost on what it might be given that this is a static issue and not a dynamic one.

  70. tipaklong says:

    I recently have this type of pain on my right foot. I didn’t have such a problem after running my first 21k, nor during the training leading to it, but after taking a break from running for about 3 weeks due to stormy weather, I ran a short 7k trying to beat my previous 5k PR. During the run at about 3k I started feeling the pain and ignored it. It didn’t get much worse, but after the run and lifted my toes I really felt it. I use a vibram kso when I run and have been running minimalist for about 1.5 years. The calf pains have almost disappeared, but the top of foot pain has now surfaced. Thank you for this article because it has answered my problem. I will take your advice and ice and elevate my foot after every run. I’m slowly building back the milage and fitness I lost due to the hiatus :)

  71. laura says:

    Thank you so much for your article. helped big time!

  72. Wallerbear says:

    I’m trying to change my sedentary lifestyle and have recently started running barefoot on my treadmill. I have been following a C25K program, though I have deviated a couple of times by increasing what was on the schedule (I felt like I could do more and have had no problems from that). I do find that my calves get extremely tight and I have to walk and stretch quite a bit after a run, but that is really no bother and I expect that it will diminish as I continue training. However, I have also recently noticed that the just to the outside front of my lower leg (extensor digitorum longus?) becomes sore (or tight?) while running. It’s not unbearable but I don’t want to injure myself as I’m hoping to run a 5K with my youngest daughter on October 27. It is only affecting my right leg.

    A bit of history: I tried running about 4 years ago. I was in pretty good shape at the time (was doing regular weight and cardio training in the gym 5 days a week) but still had a hard time with running. I never hit a “groove” and felt like I was struggling with my pace (and gasping for air) through the entire run. Long story short, I faced some other issues (full-blown panic attacks which led to depression and other anxiety issues) that I allowed to keep me from my healthy lifestyle…four years later I am 30 pounds heavier and starting over. After raves from friends who run barefoot, I decided to give it a try. I’m amazed at how much easier it is for me…I don’t feel like I’m gasping for breath anymore. I’m still trying to find my “groove” but it feels much more natural than my previous experience with running. Other than the tightness in my calves, this lower leg discomfort is the only negative I’ve had.

    • I would say you already answered your questions and diagnosed your problems but don’t realize it. The bumping of the schedule and subsequent tightness of the calves could easily be causing the pains in your foot. It’s call connected in one way or another and a lot of times the top of foot pain is coming from the calves. This is very true for people transitioning to barefoot running. In other instances it can just be the muscles of the foot not being strong enough to handle the mileage you’re asking them to and they get irritated. I would say to back off the running a bit and stretch your calves a lot. Like three times a day for at least a minute each time to try and get the pressure of the feet. Overly tight muscles are just waiting to cause an injury so you really want to make sure you don’t let tightness get out of control.

      • Wallerbear says:

        Thanks so much for your reply! I will make a conscious effort to do some calf stretches throughout the day and adhere to the schedule by taking a day off in between each run. Hopefully that will alleviate the problem!

  73. ninarose85 says:

    I have come across this article before when dealing with some top of foot pain, but it was in a different spot (more in the middle of the foot – closer to the midfoot). To make a long story short, I was dealing with ITBS in my left knee for awhile – about five months, though I was able to continue running with the help of an IT band strap while I worked on fixing form/strength issues. Started working with a Pose Coach who helped me fix a lot of form issues that I didn’t realize I had (I always ran more forefoot, but I was still reaching pretty far). Within a couple of weeks my knee pain was mostly gone, BUT, after a 10-miler with a 10k tempo in the middle a few days ago, I noticed some top of foot pain near my toes, or rather, more tightness. I did a short (2.5 mile run) in my Vibrams the next day, and the pain mostly disappeared as I ran and warmed up. Afterward the feeling was about the same as before the run. I can jump up and down as long as I keep my foot mostly flat, and I can press down all over the top of my foot with no pain. The problem comes in when I do anything on my toes… like, when walking/running and my toes bend. I think that means I’m doing something wrong in my form, but I’m not sure. Anyways, any ideas? I JUST loosened all of my laces closer to the toes (I had done it previously in the middle of the foot area when I had pain and it seemed to help), but I don’t wanna try them out just yet. Today is my second off day, and I feel as if I could easily run, but I don’t want to mess myself up, as I am training to do the Philly Marathon in November, and my training was interrupted before my last marathon thanks to ITBS, so my time wasn’t particularly great (it was my third time attempting a marathon, and I insisted on running it despite my ITBS), and I’d like to get a decent time with this one.

    Here’s a little more info: I’ve been running minimal for about two years. I bought the Five Fingers, but didn’t have the patience to start from scratch, so I only did a few runs in them, bought the Kinvaras, which were the first close to minimal shoes I ran in (got some posterior tibial tendinitis from doing too much in those), and later started running in New Balance Minimus, and then added in some more Vibram runs (though still not my sole form of running shoes). I also have the NB 0 drop road shoes, and accidentally ended up doing 8.5 miles in those (previously worked up to six), but it was a little far and I developed the same tendinitis in my right foot. I’ve also done some straight up barefoot running, and mostly walk around barefoot or in flip flops as much as possible. I’ve never had a stress fracture (well, I had one once when I was about 13, but I had also twisted my ankle pretty bad when it happened), though I’ve struggled with lots of other injuries, which is part of why I switched over to minimal shoes. If I had the patience, I would love to switch to completely barefoot, or at least zero drop shoes (it gets quite cold where I am and negative temps are the norm here). I guess I’m nervous it’s a stress fracture, though your article seems to have me thinking otherwise. Maybe some tendinitis? I seem to have lots of issues with that…

    • the easy answer is to say it’s probably a bit of tendonitis and it might be. i kinda don’t think it’s even that bad and more likely just an over use irritation. i can’t say for sure obviously but i don’t think it’s a stress fracture. you’d have a lot more pain and almost certainly have pressure sensitivity. some rest should probably do the trick and back off the tempo some when you start back. easing into it a bit should allow the irritated tissue a chance to readapt. also make sure you’re really stretching the calves and feet out.

      • ninarose85 says:

        Thanks for the response – that was kind of the answer I was hoping to hear. I’ve had so many chronic injuries I’m afraid to bring on another one and tend to get extremely paranoid every time I feel a new issue coming on. I’ve been stretching/rolling my calves out all day – it does seem to help when I do. Also like someone above mentioned, putting cotton between my toes also helps (stretching the area out?) I’ll be sure to keep my pace in check I suppose. I guess I got too excited with my increased fitness/better knee :)

      • ninarose85 says:

        I discovered more today… I didn’t have much pain this morning so I went out for a run, and the pain came and went, but it was the absolute WORST when I stepped on a large rock. I noticed it only hurt when I landed a certain way on my forefoot. I came back, actually LOOKED at the bottom of my foot, and discovered a bruise on the bottom of my foot near my forefoot (RIGHT below the pain on the top of my foot). It only hurts when I put a certain type of pressure on it while walking/running (can still press on it all day without pain). Could I just have stepped on something on one of my runs and it’s JUST a bruise, or would it be something worse? This does seem like something a barefoot runner would encounter (though I don’t run completely barefoot). Interested to see if you or others have had this particular type of pain from bruising….

      • I have definitely bruised the bottoms of my feet and it is very painful. Your description does sound like that may be the case but I can’t rule out anything worse. Not being a doctor and not seeing it in person makes it kind of tough to give you anything concrete. I think if this is a new pain it’s perfectly ok to give it some time and see how it responds. Bruises will get better relatively quick and breaks wont.

  74. Mark says:

    Fantastic article, hit the nail on the head for me, thank you very much!

  75. [...] urge to run around barefoot after months of virtually non-existent running workouts (check out this wonderful post by “go barefooting” on the subject for an explanation of what causes that), I would [...]

  76. LovetoDance says:

    Your informative article was just was I needed to read to answer the questions I had about the mysterious top-of-the-foot pain I was feeling after my Scottish Country Dance class. The strike is on the ball of the foot and now I know the why behind what I am feeling on the top of my foot.
    Do you have any suggestions for ball of the foot dancing on a gym floor, as in footwear, exercises? I’d appreciate any ideas. Thanks again for the very helpful, detailed article.

    • I can’t say I know what type of shoe is best for Scottish Country dancing so I’ll just go with the best advice I can think of. First find a shoe that lets the dance happen the way it is meant to happen. If that’s sliding then find a shoe that has a sole to do that. If it’s grip then find a shoe that sticks etc. If those shoes don’t solve your problem or you’re already wearing a shoe that does what you need then you might try adding cushion to the ball of the foot. They are plenty of options on the market for forefoot pads and socks that have lots of cushioning and that would be where I would start in your situation. If what you first have or get doesn’t quite do the job then go to the next step.

  77. [...] my foot pain… gobarefooting.com seemed to have one of the most in-depth discussions of top-of-the-foot pain.  The treatment & outcome seemed much less proactive for that injury, however. 3) I made an [...]

  78. NYC-MusicGirl84 says:

    I couldn’t help but respond, especially to help everyone who reads this to stay positive, no matter what temporary injury they may have. I used to be a runner, about 5 marathons a year. I loved running more than anything. Complete joy, out on the open road, with nothing but myself and nature. I ran a solid 40 miles a week. But in 2010, I had a horseback riding accident, a fall…and then emergency back surgery after I was found about 8 hour later. I remember being on the horse and then waking up from surgery…nothing else in between. I had to have a double discectomy (lumbar/sacral – L4 through S1). I can never, ever run again. Walking is limited but doable…but never uphill. It took 5 months of 5-day a week physical therapy to be able to walk normally again, because my spine had been so compressed for a solid 10 hours or so. But, I’m lucky….and GRATEFUL to even be able to walk now. I can do the elliptical for an hour and walk all over NYC all day long. And I really do love coming here and many other places online to read about what my fellow runners are going through, good and bad. I took running for granted. Really. I wish I hadn’t. On those morning I thought, “I’m too tired” or “I’m too sore.” The morning of my accident I cut an 8-mile run to 5 miles. Now, I would give almost anything for the mental stress relief of being able to run one mile. I’m having top of foot pain right now, but I think it’s from well-worn walking shoes that need to be replaced. I WISH it was from running. Just wanted to share. Enjoy every second that you’re able to run and please take care and enjoy your barefoot running! But, most of all…be grateful. It can change in an instant.

  79. Red Mustang Runner says:

    Thanks for this helpful article. I’ve been running for more than 3 years and already conquered a Marathon. I never had an injury. I ventured to Barefoot Running 2 months ago. Gradually increasing my distance from 2k to 15k. Unfortunately, I got Tendonosis 4 weeks ago. I was trying Forerunning then, a big mistake! Despite the discomfort, I did slow runs and walk until a friend-runner Orhopoedic Surgeon Doctor advised me to abstain from running. I’m better now but I decided to extend my rest for another week. Barefoot Running is indeed not as easy as it looks.

  80. Edith says:

    I’m experiencing exactly what you talked about in this article, and I know you said it is necessary to rest it in order for it to get better, but how long exactly?
    Also, I’m really trying to work up to a good run time before I go to college and I want to have enough time to do so. So another question is, does the injury get worse if you keep running on it and turn into a stress fracture? Because if it doesn’t turn into a serious injury, and it’s just a matter of pain, I almost feel like I should keep running on it and tough through the pain, and wait for a better time later in the year to let it heal.

    • It is not something that can normally be run through. It’s basically a form of tendonosis which is inflammation. You can’t get rid of inflammation while still applying the pressure or activity to the area. It can get worse and lead to greater injuries. The time frame for healing is different based on each individual so that’s not info I can give out. If trying to run through it is something you feel you must do then I recommend you speak to a podiatrist who can maybe help you manage the issue while doing so. I’ve been in your shoes and the best advice I can give is to rest now so you can train later. If you see a doc, rest, and get the issue gone now you’ll be able to get your training in and head into college. If you try to run through it and drag it out you might not be running when school starts.

      • Edith says:

        Thanks for the advice; I’ll rest a week more and see if I can get a good podiatrist.

  81. Whitney Ebert says:

    Hello,
    Top of foot pain has been bothering me for about a month now. In the beginning it bought it might be my new shoes, because It started hurting a couple days after, but I got new shoes with I believe more support.
    The pain on the top of my foot is kinda on and off and it it more towards the inside of the top of my fot, it will feel good one day and worse the next. I have took about one week of no running off and it seemed to feel better, but after I started running again i seemed to start feeling it again.

    Recently, meaning yesterday, it only was my right foot bothering me, but now I’m starting to feel it in my left.

    I use an ultrasound machine- which has the electromagnetic waves that go into the tissue and help with healing and it seems to help, making it feel better after. I also try to ice at least once a day.

    Few questions I have:
    Do you think it would be a good idea to do a contrast bath for it? Like 5 minutes cold then 5 min warm
    Do you know any good stretches I could do for it besides stretching my calf?
    Any shoe tips? Like any god shoe brands with a lot of support on the top of my foot that won’t wear off it will offeralot of comfort always?
    Would orthotics be a good idea?

    • That is a lot to consider. My experience has shown that if you take time off and it gets better and then it comes back when you start running it was definitely something you’re either wearing or doing. Not knowing how long you’ve been running before the month that it started I’ll assume you had a decent history of running without this issue. If you recently started running as a whole and this developed then I’d say you probably just ran too many miles too soon. Now back to the assumption that this is an issue that started after a decent time of running, I would say that it sounds like the new shoes might be an issue based on what you said. More support in a shoe won’t necessarily do anything for top of foot pain in terms of helping it. It can make it worse if the shoe is pressing into the bottom of the foot too much. That upward pressure from the sole of the shoe pushes the plantar tissues up and into the bones of the feet. This all puts an unusual pressure on the muscles at the top of the foot and causes strain.

      I don’t think that doing a hot and cold swap in treatment will do much. I think your feet need to be rolled out, massaged, and stretched every day until the pains alleviate. Then you need to either try new shoes or your current ones and see what happens. If you try the current shoes and it comes right back then you know it’s the shoes. If you try new shoes you won’t have as certain an answer if the pain comes back so it’s a bit more risk there. I recommend wearing toe separators off on and on through the day to stretch and relax the feet. I use very comfortable ones from Correct Toes but the simple pedicure ones will work as well. As for shoes I am a huge fan of Altra footwear for people with foot pain issues. Altra shoes have a foot shaped toe box that allows the foot to function naturally while also giving you some cushioning. All of that combined with their zero drop sole and in my mind you have a great combination of minimal/barefoot ideals in a standard cushion shoe. I don’t think in this case orthotics will help because they are very firm under the arch which could keep the upward pressure on the foot and not allow the feet to relax. You want your feet to start relaxing so they’ll stop hurting.

  82. Lili says:

    the top part if my foot has been hurting for over a month! I’ve tried everything ! Putting icy hot and I’ve stopped running but it still hurts !

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