Foot Pain in Athletes

By Matt Paulus MS, ATC

Foot Pain in Athletes- Overview

The foot is generally a very resilient structure and is able to sustain forces up to 20 times body weight with some sport specific movements.  It can sustain over 10,000 contacts with the ground each day in active populations.  However, due to its constant role in weight bearing and movement, it is susceptible to injury.  Athletic foot injuries can be classified based on the location of pain.

Foot pain in athletics are common.

Foot Pain in Athletes Overview

Common Causes of Foot Pain for Athletes Broken Down by Location

Bottom of the Heel

  • Heel Bruise or Heel Pain

    • This seemingly minor injury caused by direct impact to the calcaneus (heel bone) can become quite persistent and debilitating.
    • After an injury to the bone or the fatty padding that covers it, protecting the injury from continued trauma is difficult because we are constantly bearing weight on our heels.
    • In summary, a silicone heel cup in the shoe for all weight bearing helps to speed recovery.  Custom orthotics can also help with a heel spur.
  • Plantar Fasciitis

    • Please watch this video from Dr. Vosseller on Plantar Fasciitis
    • Caused by inflammation or degeneration of fascia of the longitudinal arch where it attaches to the bottom of the heel.
    • Tendency is to become chronic in nature if it is not addressed initially.
    • Athletes with high arches need to stretch the fascia by pulling the toes up towards the shin.
    • Athletes with low arches need to stay in supportive footwear with arch support.  Stretching the calf can certainly help.
  • Stretching for Plantar Fasciitis

    Proper way to stretch the calf

Back of the Heel

  • Achilles Tendinosis

    • Characterized by aching pain at the back of the heel, not on the bottom, that is worst at the onset of activity and then after activity.
    • The tendon fibers begin to degenerate and lose strength in chronic cases.
    • Acute cases can be managed with a heel lift and ice, but more chronic cases need eccentric loading exercises to remodel the tendon.

Mid Foot

  • Metatarsal Stress Fracture

    • In athletic populations, this usually occurs in the fifth metatarsal bone on the outside of the foot.
    • Athletes will have centralized pain with impact activity that is not relieved with rest.
    • Treatment involves a period of immobilization and limited weight bearing and full recovery will be extensive.
  • Posterior Tibial Tendonitis

    • Pain on the instep of the foot in the arch that is increased with prolonged activity.
    • Typically occurs in patients with low arches or flat feet.
    • Can be managed with over the counter arch supports or custom orthotics.


  • Morton’s Neuroma

    • Pain in the ball of the foot and burning sensation between the 3rd and 4th toes caused by irritation of nerve between metatarsal bones.
    • Need to constantly stay in shoes and recommend a teardrop shaped metatarsal pad in placed just behind the area of pain for all footwear.


  • Bunion

    • Pain caused by degeneration of the large joint in the big toe as it bends inwards towards the second toe.
    • Can slow the rate of progression by stretching the big into extension towards the top of the foot.
    • Bunions are bony deformities in the big toe where is meets the foot

      Bunions can be a cause of pain in athletes

  • Toenail Problems

    • While they seem rather minor, Ingrown Toenails and Black Toenails (Subungual Hematoma) if left untreated can sideline runners and impact athletes.
    • Ingrown toenails can be treated by packing cotton under the nail, lifting it out of the affected area.  Black toenails can be decompressed with the use of a needle, heated paperclip, or other cauterizing device.
    • To avoid further complication these techniques are best performed by a medical professional.
  • Turf Toe  

  • Another common cause of foot pain in athletes is turf toe.  This is a sprain or strain to the first metatarsophalangeal joint or MTP joint.  It happens when the toe is forcibly bent up into hyperextension, such as when pushing off into a sprint and having the toe get stuck flat on the ground.  Sometimes surgical intervention is needed to debride or repair structures in the joint.

JOI Rehab for the Treatment of Foot Pain in Athletes

Whether you are suffering from foot issues, foot pain, or injuries resulting from any type of activity, JOI has 12 physical therapy clinics conveniently located in Jacksonville and Northeast FL who specialize in orthopedic rehab.

If you are interested in scheduling an appointment at JOI Rehab for physical therapy, call (904) 858-7045. Come see us!

  • To schedule a new patient or follow up patient appointment with your MD, please call (904)JOI-2000.
  • To schedule an appointment for physical or occupational therapy, call 904-858-7045 or call any of the 12 area JOI Rehab Centers.

JOI Fracture and Injury Care

JOI Physicians are currently offering ASAP Fracture care. Make an appointment by calling (904)JOI-2000. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care.

By: Matt Paulus MS, ATC 

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