Top of Foot Pain

Barefoot Terry

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Apr 3, 2010
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Ok, I've been running BF for 4 months now. Just about 50 total miles. I had to take a couple weeks off due to TOFP in my first month. Then out of the blue last week, got the TOFP again. Anyone have a suggestion to ease the pain. Last time I had to take 2 weeks off. I've got a half marathon in about 5 weeks and need to get in some more miles and time on my feet. Of course, my health comes first before a race, but I want to run this race!!! HELP!
 
Does ice help, Terry?  Ken

Does ice help, Terry? Ken Bob has a great write-up about this. I will try to find the link and post it back here.
 
This is copied from KB's

This is copied from KB's site. (I hope this helps.) He has made this addendum:
I've revised the post since it's originally posting, as I discovered the exercises aren't needed. And some people (particularly ex-marines) we're trying to overdo, the gentle lifting of small weights, by increasing the weight, or trying to pull their entire body weight across their mattress when pressing "gently" against the edge of their mattress with the top of their foot.

Anyway, we can simply do the same exercise while running, that is, lift up the fore-foot, exercising the top of the foot, which is actually better, because you get about a thousand very gentle fore-foot lifts each mile you run, and avoid the excess strain of pushing off with the trailing foot (it's really difficult to push off while lifting the fore-foot), instead of trying to do the fore-foot lifts in a separate workout.


Pain in the top of the Foot
Many of us have experienced pain on the top of the foot – sometimes following a distinct “snap” sound during push-off (or in my case, when I once kicked a sand hill).

I can’t give a specific diagnosis, but, as a general diagnostic guess, I believe that, living in a shoe-addicted culture, our foot muscles atrophy from lack of use. In any case, I do have the benefit of the experiences of many other (especially newbie) barefoot runners behind me.

exercises below, for this problem. But, more recently, have come to the conclusion that the best solution involves learning HOW to run barefoot, which, when done as described below, will p
rovide the same sort of exercise with each and every step, as well as providing a less stressful, more gentle stride. Specifically, the problem seems to occur (along with other problems) if we have a tendency to “push off” while running (and most of us do have this tendency – just look down and watch your trailing foot, just before you lift it off the ground), and especially if we add the “ball-of-foot” landing as mentioned above – so that the foot never really gets a break, or at least not a good break, as in a rest, but it is likely, eventually to get a break, or at least a severe strain, if we don’t give it a rest, by letting the pressure distribute across the entire sole, by keeping our heel down.

But It isn’t just about NOT pushing off, but also a failure to let the ankle flex as the foot is lifted, resulting in too much pressure on the balls of the foot, and strain along the length of the foot.

Instead of pushing off, begin lifting your foot BEFORE it lands. Also, do not try to get up on your toes. Instead, try to keep your heel on the ground, until the foot begins to lift. In keeping your heel down, you will be exercising the muscles and tendons on top of the feet. Basically, while the foot is in contact with the ground, try to keep your entire sole on the ground.

But, let’s go a step further, and take an ACTIVE roll in this. Let’s PULL the front of our foot up, in order to allow the heel to stay on the ground – actually, we WILL need to pull the front of the foot up, if our knees are bent enough – if we don’t NEED to PULL the front of our foot up, then we NEED to bend our knees more…

And that’s how we prevent these injuries. If you are already injured, try the following simple exercise, which I devised, and have recommend with good success, as reported by folks who have suffered this type of injury or pain in the top of the foot (but, I now believe these exercises will rarely be necessary, if we follow the above advice on running technique – which provides the same type of exercise during each run).

better version of this, with every single step you take, while walking and running, simply by lifting your WHOLE trailing foot (not just the heel) – a fore-foot lift.

Place a small weight (up to 5 pounds) on top of the toes, and resting the heel on the ground, GENTLY lift the weights a few times each day, with the front of the foot.

With a small dumbbell you can curl the toes up, to keep the dumbbell from rolling off the front of your toes, while lifting. Leave only the heel of the foot on the ground, while raising the entire fore-foot. If you try lifting the weight with only your toes, while keeping the balls of your feet on the ground, your toes probably won’t be long enough to lift the the dumbbell.

The heel can also be raised slightly, by placing it on a book or board or something, which tilts the foot forward, and keeps the weight from rolling too far back on the foot.

As far as body position, I’ve done this exercise lying on my back, with my knees up, sitting on my butt, with my knees up, sitting on a chair with my knees bent, or even standing, with my knees straight (but not locked), and lying on my stomach (see below).

Also, since this isn’t a case of injured tissues, or overuse, but more a case of tissue not getting enough exercise, in my experience, the pain does not go away UNTIL I do the exercises! (or change the way I run – see above)

Just be certain to pay close attention to how it feels WHILE exercising. Be sure to exercise both feet, even if the other foot doesn’t hurt… YET…, and respond appropriately. If any of these exercises exacerbate the pain, then STOP! If the exercises cause sharp pains, there may be some tissue damage to address with your health-care provider.

In my case, the feet seem, immediately, quite happy to be exercising (and running correctly) – though in all fairness, it took me a few weeks to figure out this exercise, so some healing had already occurred (but the pain persisted, until I started the exercises).

Do NOT be afraid to try variations of this, and other exercises! Remember, it is lack of variation or balance that likely contributed to the problem in the first place.

Barefoot Larry recommends stretching these tendons.

Another variation can be done while in bed, laying on the stomach, and hanging the feet over the edge of the bed. GENTLY push the top fore-foot against the side of the mattress. Remember, GENTLY. This is not a contest to see how far you can drag your body toward the edge of the bed, this is about gentle balance. If you build these top muscles too much, you will be out of balance, once again, with the muscles and tendons in the soles, then your feet might start curling into a ball. Besides, you might never be able to fit your bulging muscular feet inside shoes again – hmm… maybe that’s not such a horrible side-effect, after all…
 
Thanks, TJ.  I saw this on

Thanks, TJ. I saw this on his site last night. Been trying to do the exercises. I THINK it is feeling a little better. I'll probably be stubborn and try a short run :) After reading his site, I also thought about focusing on a more mid-foot strike rather than a fore-foot strike. The pain seems to radiate from the 4th and 5th metatarsals (likely from fore-foot striking). I'm just praying it's not a stress fracture. I think the TOFP came from me over-correcting my form from a run that caused my first blisters. If it's not one thing, it's another. I just can't seem to win. :) I'll get there eventually.
 
There's a tendon that runs

There's a tendon that runs along the outside of the 5th metatarsal that can produce pain that mimics a stress fracture. Still, it's not something you want to mess with.

I actually don't buy the fore-foot strike argument. I think landing and pushing off from the fore-foot is a dangerous way to run and can cause stress fractures of the metatarsals. I think we should land and lift from a mid-foot plant. This area of the foot can better take the pressure and weight as it is distributed somewhat equally between the front and heel.

I know exactly what you mean by overcompensating or favoring one pain and creating another in the process. I have Morton's Neuroma, so when I am having horrible pain on my runs, I will tend to land on the outer part of my feet to avoid feeling even more pain in the neuromas. By the end of some of my runs, I can feel a sharp pain there, but it's good the next day...so far so good anyway.
 
I got my first TOFP at about

I got my first TOFP at about mile 48 because the person I was walking with decided it was time to run and I didn't want to be left alone in the dark :-( I had also kicked a tree root badly a few hours before that, which I'm sure didn't help. Anyway, my foot is still pretty puffy so I think I may have messed it up, we will see how the next couple of days goes. I hope I didn't break anything, but last weekend was my major A race for spring so if I have to take a month off, no biggie. Always wondered about that TOFP though.

I should add, my husband, who had not seen my feet for 7 months was astounded at how they have changed. My arches are way higher.
 
Aw, that is so sweet, Wendy. 

Aw, that is so sweet, Wendy. I'm glad he's home safe. God bless you all, and thank him for serving our country!

I too no longer have flat feet. Did you happen to take photos of your arches as they were changing. I took a couple of afters, but I did not realize that my feet would change so drastically as they have, I didn't think to take a picture of them before.
 
I know the feeling. 

I know the feeling. Sometimes I will catch myself as I walk across the floor and actually miss my arch touching the ground.
 
 I've had a few twinges of

I've had a few twinges of TOFP here and there but nothing really terrible worth complaining about, untiiilllllll I went camping this weekend.

I did a 3.5 mile completely barefoot run last week and that set off a little pain so I gave myself some rest. On my camping trip this weekend I took a little 2.5 Mile run/jog with a bit of walk around the lake. Short, easy, soft grass, no biggy right? Holy Mother of Pearl is my right foot killing me right now. I'm limping everywhere and it actually hurts to the touch.

I know TOFP is common for us newbies but daaaaammnnn, this smarts! I obviously won't be going back out again until the pain is gone, but is this normal?

I have no insurance and as such must self-diagnose, treat, and medicate, ( I'm really good with deep cuts, puncture wounds, and sub-dermal cysts) :) so I'll be taking Barefoot Ken Bobs advice from the posts before to heart. Are there anything other personal experiences people have to add? Level of pain perhaps? On a scale of 1 to 10 I'm at a 7 right now.



Ty
 
TOFP huts like a beeatch! 

TOFP huts like a beeatch! Worse part is, unless you use crutches, there isn't much you can do to really stay off of it. When I had TOFP, the rest of me hurt pretty bad to so I wasn't moving much for a couple of days anyway. Ice, maybe wrap it, maybe a TED hose type compression sock. Play with it and see what makes it feel better. Mine lasted about a week, and hasn't bothered me since. I think I had a twinge during yesterday's race, but I checked my form an started picking up my feet more and it went away.
 
Last year I had something

Last year I had something similar to this. I had chronically achy toes in my right foot. It didn't seem to want to go away. Eventually I found a quick fix. I quickened my cadence. As soon as I got close to 180 steps per minute, my foot problems went away. I don't know if this would help with TOFP, but it might be worth experimenting with.
 
I didn't really have TOFP

I didn't really have TOFP when I was transitioning, to the extent I hear others complaining about. I remember having a little ache for a couple of days on the top of one of my feet, but it didn't amount to anything. I think it has mostly to do with the structure of the foot not being supported the way it's used to. Not only are the muscles atrophied, but so are the connective tissues and joints. All of these parts must learn to work together in harmony once again. I wonder, though, why some people experience it worse than others. I'm not comparing someone who has gone nearly barefoot their whole lives to someone who has kept their feet in shoes then makes a change to ditch the shoes, live barefoot and/or run barefoot...I mean the answer there is a given. What I mean is comparing two people who basically have the same experience with shoes then suffer from TOFP, one's being worse than the other's.

Is it possible that you stepped seriously wrong at one point during your camping trail run/hike? Twisted something, damaged something? Let's hope this is normal "growing pains" and not something else. Lots of icing and elevation should help in the meantime...and anti-inflammatories if you have nothing against them.
 
Two weeks of rest on my

Two weeks of rest on my TOFP. Mostly better now. I can run up to 2 miles, but with minor twinges. Kudzu, when I've had it bad I'd say 6 to 8 on a 10 scale. Now I'm around a 2. I have a half marathon coming in just under 2 weeks. Haven't signed up 'cuz I'm not sure if the foot will get better with some training.

The first time I had TOFP I rested 2 weeks, trained through the last twinges and it went away. I'm hoping the same will happen this week. I want to hit 10 miles this weekend to prove if my foot can handle the half. If not, I may settle for the 5K race instead. Either way it will be my first BF race. I just haven't really done any 5k races and would prefer to do the half.

Patience is that GIANT PILL that I hate to swallow. But I will if I have to.
 
 Thanks for all the

Thanks for all the advice!

@ TJ - I was running around a lake, So I think that the incline of the shore and other varying terrain may have been too much for my feet which are only used to straight, predictable surface runs. I don't think I twisted anything, my ankle hurt for the rest of the night and into the next day, but that pain went away fairly quickly.

@ Terry - Yes patience is a terribly large pill indeed! I want to go out and run through it till it goes away but, that would be stupid. I'm working on trying to get to a 10k race. I don't want to break any speed records or anything. I've just never done one, and would like to complete it.

On a funny note, after working in the garden today, my foot had not been bothering me for most of the day and I had a build up dirt of in the soles of my work boots. I decided to clean them off the way I always do, by slamming my foot on the concrete as hard as I possibly can. I was quickly reminded that I was not yet healed. That hurt like somone struck the top of my foot with a hammer! I'm going to take a week or two off......
 
I'm sorry about that Kudzu! 

I'm sorry about that Kudzu! That bites.
 

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