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 without treatment.
    • 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.
  • To read more about Plantar Fasciitis, please read this article: Best Treatment for Plantar Fasciitis. 
  • 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.
    • Treatment 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.
    • Treatment of ingrown toenails by packing cotton under the nail and lifting it out away from the toe.  Treatment of black toenails can occur with the use of a needle, heated paperclip, or other cauterizing device.
    • To avoid further complications, medical professional should perform these procedures.
  • 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.  This occurs when the toe is forcibly bent up into hyperextension.  Like when pushing off into a sprint and the toe is stuck flat on the ground.  Sometimes surgical intervention to debride or repair structures in the joint.

JOI Rehab for the Treatment of Foot Pain in Athletes

Learn more about Plantar Fasciitis Here

Plantar Fasciitis

Related Articles:

Foot Pain in the Morning

 Home Remedies for Foot Pain.


Ligaments in the foot/

Bones in the toes/

Foot anatomy/

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By: Matt Paulus MS, ATC 

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