Foot Pain

Foot Pain and Injury

Foot Pain and Injury


Yes, occasionally my feet hurt. One of the main reasons to run barefoot is because it will make your feet hurt. If running barefoot didn’t hurt, we might not realize that we need to change the way we run, so that it doesn’t hurt. Listening to foot pain (and figuring out how to run without causing foot pain) is one of the quickest ways to learn to run smoothly and naturally. Think about it, if it hurts right now to run with technique that could cause serious or chronic injuries in the future, there is a lot of incentive to correct the way we run right now.

If my feet hurt because I am running barefoot, then I am either running badly, or running too much too soon. It is rare that a barefoot runner over-trains on challenging terrain to the point of chronic injury. It is also rare that a barefoot runner will purposely smash his or her heels into hard pavement or rocks.

Teaching us to run and walk more gently is exactly why our soles are so very sensitive!

Top of Foot Pain

Top of Foot pain is the most commonly reported injury from running “barefoot” – though the feedback I get (from emails, discussion groups, and in my workshops, and presentations) indicates it is nearly exclusive to runners who use minimalist footwear (which some refer to as “barefoot” running shoes), or those who avoid challenging surfaces while trying to learn how to run barefoot (It’s the challenges that teaches us the most).

In any case 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, once when I kicked a sand hill – details below). And in most other cases, the top of foot pain comes after suffering excess calf pain. The reason for this is because tense calves put excess strain on our feet, but the calf muscles being softer tissue will complain first. It is ignoring this calf pain, or hoping it will pass as our calves get stronger, that often leads to the dreaded top of foot pain.

I’m no doctor, but I believe that, living in a shoe-addicted culture, our foot muscles, tendons, ligaments, even the bones, 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.

Though not from “pushing-off”, I have personally experienced a similar pain, following a snapping sound. I was running on the beach several years ago (barefoot – naturally), and I didn’t pick my trailing foot up high enough to clear a sand hill. When I kicked the sand hill, it torqued my foot backwards, and I heard/felt a loud snap. The interesting thing, though probably I shouldn’t recommend doing this, is that I not only finished a 5K race the following day, without any pain, by using the techniques outlined below, But I even managed to finish 2nd in my age division! (O.K. it was a relatively small event for Los Angeles, CA).

But on to the actual problem…

Ever try learning a new song while wearing earplugs?

Many folks, particularly those wearing “transition” footwear, might think that these pains are simply a result of trying “too much, too soon”. But, If we had actually been barefoot, we probably wouldn’t do too much too soon, our soles would complain, LOUDLY. And “too soon”, doesn’t necessarily mean “before we have toughened up” (to endure our off-key singing) – it really should mean, “until we have learned to sing on-key.”

When we remove rigid shoes, and especially if we replace them with minimalist footwear – which blocks some of the feedback from our soles, feedback which would encourage us to change our running technique, to a more gentle way of running (singing on-key), which would reduce stress on our feet (and the rest of our body too) – and then those minimalist shoes don’t provide the support necessary to do the “push-off” we might be used to doing in more rigid shoes – that is, we continue to run as if we had the support of rigid shoes, without the support of rigid shoes – then, we are asking for trouble!

It’s like getting used to hitting yourself in the head while wearing a helmet. Then removing the helmet and expecting that you should be able to continue hitting yourself in the head just as often and just as hard! But, it isn’t that we should be able to hit ourselves in the head repeatedly without a helmet, the idea is to have the sense to NOT hit ourselves in the head, whether we’re wearing a helmet or not. After all, a helmet isn’t protecting your neck or spine from damage caused by the impact of hitting ourselves in the head. Much like shoes, which may protect our feet from the immediate pain of bad running technique, do not protect our knees, hips, and spine from long-term damage caused by bad running technique.

Pain Avoidance

The best way to avoid this type of injury (and perhaps most running injuries) of course, is to transition to Running Barefoot, by;

  1. Removing our shoes
  2. Not replacing our shoes with lesser shoes!
  3. Taking the time to relearn HOW to run, this time, gently, as if our shoes aren’t supporting and cushioning our feet, while gradually allowing our feet to build and develop from the gentle exercise they had been denied while living inside rigid shoes.

Take the time, like a child, to feel the earth beneath your soles, to discover how it feels for your soles to interact with the earth, to play and experiment (are the two really different?) with touching the earth with your bare soles. And since you probably aren’t an infant, to understand that it can take months for your bones, tendons, ligaments, etc. to develop the strength necessary to run barefoot – and that is if you have taken the time and attention to learn how to run gently!

How Strong Do Our Feet Need to Be to Run Badly?

It will take much longer, if ever, to toughen your feet enough to run badly while barefoot. I can’t even begin to guess how long it takes to develop the strength to run badly, without injury – perhaps forever, as many folks who try (with or without footwear) seem forever plagued with pains and injuries (their solution, sadly too often, is to take pain-killing drugs, and run even more).

If we are trying to run the same way we ran with shoes (assuming we weren’t, then, running as if we were barefoot), except without the rigid shoes, then we are most likely going to, at some time, suffer from some sort of pains, as we are discussing here. And rigid shoes are going to create their own set of problems, so best to just Run Barefoot, naturally, or at least, as if we were barefoot. But, before we can run “as-if” we are barefoot, we must first, almost necessarily, be barefoot – we must remove the earplugs, so we can hear the tune, and learn to sing on key!

Starting As If Going Barefoot Is New to You – Because it Probably Is New to You

Standing, walking, and running, while barefoot, exercise and help develop muscles, tendons, ligaments, etc., on the top of the foot, but only if we run correctly – and most beginning barefoot runners do not run correctly. After years of wearing shoes, and trying to “power” themselves through each run, pushing-off has become an ingrained habit. Add to this, that we, sadly far too often, get the advice (usually from “experts” who have never run any significant distances while barefoot), that “Running Barefoot IS running up on the balls of our feet” – but Running Barefoot really is NOT running up on the balls of our feet – NOT if we want to run barefoot without injury, in the long-run (so to speak).

Building up Gradually

So, as we build up distance walking and running barefoot, the plantar (sole) muscles, grow stronger with exercise, and we often end up straining the weak upper foot muscles (until we begin to change our running technique as described below). This pain is like some sort of counterpart to Plantar Fasciitis, a similar pain in the soles and heels (common among shoe-wearers), which seems to respond well to barefoot exercise of those tissues.

Exercising While Walking or Running Barefoot

I used to recommend the Extra Exercise below, for top-of-foot pains. 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 provide 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…

In reality, our heel will still be coming off the ground before our forefoot, however, the act of TRYING to lift the forefoot with the heel, will reduce the strain on the foot. In a video, these techniques look identical – that’s why we must realize that what the observer sees another runner doing, does not tell us much about what the other runner is feeling – and how running feels, while barefoot, is one of our biggest clues as to whether we’re running in a way that increases our risk of injury, or not.

And that’s how we prevent (or at least reduce) these injuries. If you are already injured, try the following simple exercise, which I devised, and have recommended to folks who have suffered this type of injury or pain in the top of the foot, and have found this GENTLE exercise to help (I now believe these exercises is not necessary, if we follow the above advice on lifting the forefoot while running and walking).

Extra Exercise

Note, this exercise is no longer necessary, as I’ve discovered that you can get a 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. But the exercise is good if you’re already suffering top-of-foot pain caused by mistakenly tensing your calves and trying to stay up on the forefoot.

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.

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…

Posted in: Pain and Injury

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