Toe Running Injuries

By Liz Brabston, P.T.A.

Toe Running Injuries

Do you like to run?  Have you ever had pain in your toes and not sure what is causing the pain or how to fix it so that you can keep running?  To treat the toe pain, you must know what toe injury you have.  Let’s discuss toe running injuries, what they are, what their symptoms are, and what to do to recover from these injuries and get back out on the road.

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Toe Running Injuries


What Are Toe Running Injuries?

There are many toe running injuries usually caused by poor running form, weak intrinsic muscles of the foot (these are the muscles that control your toes bending and straightening), repetitive motion such as the push-off phase of running gait, and/or increasing your mileage too quickly.  Here is a shortlist of the most common toe running injuries:

  • Blisters
  • Black toenails
  • Metatarsalgia
  • Sesamoiditis
  • Morton’s neuroma



Blisters are a common injury for runners. They are usually caused by an improper fit of running shoes or socks that create friction when running.  Blisters are easy to combat by using dry wicking socks, applying a lubricant, and wearing properly fitting shoes.


Black Toenails

Black toenails, which can also be referred to as runner’s toe, can be caused by too-small shoes or a toenail being too long. Toes that constantly rub or bump into the toe box of the shoe repetitively cause the toenail to bruise and sometimes blister. Often the toenail will fall off, causing relief in pain.  Keeping your toenails cut short and ensuring you have at least a thumbnail length of wiggle room in your toe box will keep black toenails at bay.



The bones of the foot anatomy. Metatarsalgia is pain in metatarsal bones of the foot.

The Metatarsals and other foot bony anatomy

Your metatarsals are the five long bones that come from the arch of your foot to your toes, and when running, these bones take on approx—110 tons of cumulative force per mile.  Your body weight is transferred onto the metatarsals during the push-off phase of the running gait cycle.  If you are wearing improper shoes, have weak intrinsic muscles, or tight Achilles or calf muscles, it can also cause pain in those bones.



Sesamoiditis is inflammation of the sesamoid tendons and bone, which is just below the big toe (you can also find sesamoids in other areas of the body). The sesamoid helps absorb the weight that is placed on the ball of the foot when running.  It can become inflamed with repetitive use, and the pain can be intermittent.  Sesamoiditis is treatable with rest and anti-inflammatory medicine. To reduce the risks of sesamoiditis, strengthening the intrinsic muscles is beneficial.


Morton’s Neuroma

Morton's Neuroma can cause pain between the 3rd and 4th metatarsal bones in the foot

Painful Morton’s Neuroma

Morton’s neuroma causes pain in the ball of your foot, usually between the third and fourth toe, which can often feel like a rock is in your sock or shoe.  Most people describe the pain as a burning, tingling sensation.  It happens when the bundle of nerves is inflamed.  Sometimes resting can cause it to away on its own. Sometimes placing a metatarsal pad in the sole of your shoe, a wider toe box, or avoiding shoes with a higher heel can also decrease the pain.  Other people have responded well to injection, and a lesser number of people have opted for surgery to remove the inflamed nerve and had excellent results.


How Do You Prevent Toe Running Injuries?

Most toe running injuries are related to muscle weakness, poor-fitting shoes, and overuse/repetitive movement.  To prevent these injuries from happening, ensure the running shoe you are wearing is properly fitted by seeing a fit technician at a specialty running store, take rest days, and perform strengthening exercises for the intrinsic muscles in your foot.  Below are exercises you can do with your toes at home:

  • Towel scrunches
  • Marble Pick up
  • Toe Yoga
  • Toe abduction (spreading your toes apart and holding 3-5 secs)
  • Baps Board
  • Resistance band exercises
  • Eccentric Calf Raises

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What is a Lisfranc Injury?

Preventing low ankle sprain tips and techniques

If you continue to have pain, you should make an appointment with your Primary Care Physician or Orthopeadic Doctor, who can refer you to Physical Therapy.  The Jacksonville Orthopaedic Institute has the area’s top foot and ankle specialists.  They are experts at treating patients with running injuries.  For physical therapy appointments, please call 904-858-7045.

Schedule an appointment with a JOI Foot and Ankle Specialist, call 904-JOI-2000, Schedule Online, or click the link below.

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