Why You Shouldn’t Ignore Foot Pain

Athletes generally don’t hesitate to seek medical attention for acute (sudden) foot injuries. But it may be tempting to ignore pain that lingers or pain that comes and goes. This type of chronic pain often occurs with overuse.

“With overuse injuries, you can often still participate in workouts. It just hurts. We see a lot of athletes whose feet may hurt some days but not other days, or they may have daily, persistent pain. They think that they can just tough it out,” says Gregory Waryasz, MD, Mass General Brigham sports medicine specialist. “But in reality, you might be causing more damage by overloading a tendon or running on a broken bone.”

Persistent foot pain or pain accompanied by certain other symptoms should be assessed by a specialist.

“Assessment and treatment can help prevent more serious damage and improve your long-term performance,” Dr. Waryasz says.

Foot pain causes

Overuse foot pain can occur in a wide variety of sports, particularly those that involve a lot of running. The most common overuse injuries in the foot are:

• Achilles tendonitis: The Achilles tendon connects the calf muscle to the heel bone. Tendonitis is a common condition that involves irritation and inflammation of a tendon. Untreated, Achilles tendonitis can lead to a tendon tear or rupture.

• Morton’s neuroma: Also called intermetatarsal neuroma, this condition affects the ball of the foot. The nerve tissue thickens, causing pain in that specific area. It may feel like burning, tingling, or like you’re walking on a pebble.

• Plantar fasciitis: This condition happens when the plantar fascia, a band of tissue that supports the arch of your foot, becomes inflamed. Also called plantar heel, it causes heel pain and stiffness.

• Sever’s disease: This condition involves inflammation in the growth plate in the back of the heel. It is a common cause of heel pain, particularly in children who play sports or exercise regularly.

• Stress fracture: A stress fracture is a small crack in a bone. It occurs when too much repetitive pressure is put on a bone over time. Stress fractures can become full fractures if they are not allowed to heal.

• Tarsal tunnel syndrome: This condition involves the posterior tibial nerve, located on the inside of the ankle. If the nerve is compressed (squeezed), it can cause painful feelings like electrical shocks in your ankle and foot.

How do I know if my foot pain is serious?

Dr. Waryasz acknowledges that it can be difficult for athletes to tell whether they need medical attention for certain foot injuries.

“You may have just a little bit of pain early on, then it might go away after the first 24 to 48 hours. You may just feel weak, and you may think there’s nothing wrong because you don’t have pain anymore,” he says. However, overuse conditions in the foot tend to come back and get worse over time without rest or treatment.

“If you wake up and start having a fair amount of pain but you can put weight on your foot, you can rest a day or two to see if it gets better,” he says. “But if you’re really having trouble bearing weight, or you’re having certain other symptoms, you should get it evaluated.”

Dr. Waryasz emphasizes a few other red flags that warrant medical attention:

• Back pain along with foot pain

• Bump that wasn’t there before, such as in the front of the ankle

• Difficulty pushing off of your foot when walking or exercising

• Inability to perform normal movements, such as lifting your toes or lifting your foot with the same strength as before

• Pain anywhere in the foot or ankle that gets worse over time or prevents you from walking normally or exercising

• Popping sound or popping feeling with a specific motion

• Sudden foot pain without injury, especially when you can’t put weight on your foot

• Weakness when doing certain movements, such as lifting the front of the foot toward the shin

If you’re experiencing any of these symptoms, Dr. Waryasz recommends talking to your athletic trainer, physical therapist, primary care provider, or an orthopaedic urgent care center.

Early treatment for better outcomes

Some athletes hesitate to seek treatment because they don’t want to hear that they need a procedure or rest. However, Dr. Waryasz encourages overcoming this fear to maximize their future health and performance. An overuse injury can get worse over time and eventually prevent you from participating in the things you love.

“Nobody wants to sideline you from your sport. But a quick checkup on an injury can often prevent you from missing months of your sport, instead of just missing a week or two for rest,” he says.

He emphasizes that many overuse injuries can be treated with short-term, non-surgical approaches, such as:

• Activity modifications or a few weeks of rest

• Advice on how to minimize risk factors for foot and ankle pain

• Cast or boot rather than surgery

• Cross-training, such as limiting high-impact movements to a few days a week and adding effective low-impact options

• Corrections to form, such as adjustments to the way you jump or run

• Physical therapy or nutrition counseling for musculoskeletal health

• Proper footwear, such as a different shoe or a corrective insert