How to treat top of foot pain in runners?

Running isn't necessarily a pain free exercise and up to 75% of athletes might get an overuse injury each year. More frequently that not this exercise related injury is not sufficient to stop them running and they generally just need to back away a little and make use of some modest treatments to let it get better. Once in a while the injury is significant enough that this forces the athlete to discontinue on the running. There are lots of injuries that can happen to athletes, impacting numerous areas of the lower limb. One of the more prevalent injuries is what has become known non-technically as “top of foot pain” or ToFP. Technically this is called dorsal interosseous compression syndrome. This is an exercise related injury which causes pain on top of the foot, typically around the highest area of the arch of the foot. This generally happens in barefoot runners and also runners who have a tendency to forefoot strike rather than rearfoot strike initially when they are running. Running this way has a tendency to try and force the ball of the foot upwards on the rearfoot producing the jamming of the bones of the dorsum of the foot, causing the pain in that location.

At first, top of foot pain is treated with ice to deal with the swelling and maybe anti-inflammatory medications to settle it down. Most runners will need to scale back on their weekly distances run to also help settle it down. The easiest method to treat this is to work with more of a heel strike when running and use foot orthotics to help keep the rearfoot up so the jamming in the midfoot doesn't occur. Even though the change in running form may well be a good way to help this, it's not easy to perform, and it is frequently avoided to begin with to try and address the problem without doing that. If the other methods do not work, then a change in the running technique is almost certainly recommended. If you think you have this problem and self care is not helping, then consider seeing a podiatrist.


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