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Tips for Running With Metatarsalgia

Your feet take on your entire body weight when you run. Even with perfectly healthy feet, you need to take steps to protect them so that you can prevent injury.

When you have metatarsalgia, pain in the ball of your feet, running can become challenging and much less enjoyable.

Here are our tips for running with metatarsalgia so that you can keep performing at your best and be as pain-free as possible.

What Is Metatarsalgia?

Metatarsalgia is an umbrella term used to describe pain in the ball of your foot.

Metatarsalgia isn’t a foot condition on its own, and the pain isn’t the cause of the problem. It’s a symptom of an underlying condition that causes you to experience pain in the ball of your foot.

At first, you may notice mild discomfort, which steadily turns into a burning, stabbing, or aching pain in the ball of your foot. You may also experience pain when you flex your foot, or have a numb or tingling sensation in your toes.

You may even find it difficult to put weight on your foot after running a long distance.

While metatarsalgia develops over time, the symptoms can come on suddenly, it’s often triggered by overuse.

Your foot absorbs more force when you run than during any other activity. If you’ve suddenly increased the intensity or distance of your runs, it can lead to you developing metatarsalgia.

But several different conditions can cause pain in the balls of runners’ feet. These include:

Contributing Factors

Aside from the repetitive nature of running, which puts excessive pressure on your forefoot, several contributing factors can lead to you developing metatarsalgia.

These include:

  • Tight calves
  • A hypermobile 1st ray
  • Tight Achilles tendons
  • Limited ankle flexion
  • High arches or flat feet
  • Weak or tight muscles in the foot
  • Excessive overpronation
  • Poor fitting shoes
  • Old and/or worn-out running shoes

If the symptoms of metatarsalgia feel worse when you walk, stand, or run, you may want to decrease your mileage or give your feet a break for a few days.

Set up an appointment with your doctor or podiatrist so that you can get to the root cause of what has been causing your ball-of-foot pain.

This will help to put the correct treatment plan together to get you back on your feet and back to your typical level of activity as soon as possible.

Fortunately, there are tips and tricks for running with metatarsalgia that can help you recover and prevent metatarsalgia from recurring.

Tips and Tricks for Running With Metatarsalgia

1. Spend  More Time Warming Up

Research has shown that tight calves and Achilles tendons are often associated with metatarsalgia.

Spend a few more minutes on your warm-up, as this will get a good supply of blood flow and oxygen to the muscles before you run.

It will also increase the range of motion and flexibility of the muscles, joints, and tendons.

This will help reduce the amount of strain placed on the midfoot while you run, in turn improving your running mechanics and overall performance.

You can include dynamic stretches such as opposite-toe touches, walking lunges, or jumping jacks into your warm-up.

Before launching into your run, start by jogging at a slower pace, gradually building up to your “normal” pace.

To reduce stiffness in your feet, ankles, and legs after your run, you can include the following stretches into your cool-down:

  • Low lunge stretch
  • Calf stretch
  • IT band stretch
  • Quad and hamstring stretch
  • Butterfly stretch

2. Wear the Right Shoes

Wearing the right pair of shoes when you run and while you go about your daily activities can help prevent metatarsalgia.

If you’re already experiencing metatarsalgia, the right shoes can minimize pain and discomfort.

Metatarsalgia running shoes should have a wide toe box that lets your toes splay naturally, as this will reduce the pressure placed on the forefoot.

The shoe should also provide good arch support, adequate cushioning, and excellent shock absorbency. This will help reduce the shock that reaches your muscles and joints.

3. Incorporate Cross-Training

There are many benefits of adding cross-training to your weekly routine.

Not only will you be able to keep your hard-earned fitness gains, but it allows you to continue training while you’re recovering from an injury.

Cross-training provides excellent cardiovascular workouts that build on some of the same benefits of running.

It will help strengthen muscles that you may not necessarily use while running and correct muscle imbalances, which will reduce your risk of injury.

By adding low-impact workouts to your schedule, you’ll also be giving your feet and joints plenty of time to recover and heal between your runs.

To start, try substituting an easy run or rest day for a low-intensity cross-training workout like aqua jogging, Pilates, swimming, or even rowing.

4. Try Running on Softer Surfaces

Not all running surfaces are created equal, each having a different impact on your muscles and joints.

Switch from running on asphalt or concrete to running on softer surfaces like a synthetic track, trails, or on the grass of your local parks.

Running on softer surfaces will be more forgiving on your feet while reducing the overall amount of shock on your body.

But it will still provide a challenging workout for your muscles, while reducing the risk of overuse injuries.

You can also look at newer treadmills released, as most of them now come with a cushioned belt or a soft surface mode.

5. Look at Your Foot Strike

Most runners run with a heel strike and don’t have any issues.

But if you’re overstriding, this can place your foot under excessive pressure, leading to metatarsalgia.

An experienced running coach or a physical therapist would be able to visually analyze your running form.

This can provide vital insights into any dysfunction along your kinetic chain that could be aggravating or causing your foot pain.

You may have to improve your foot strike technique in some cases rather than change it.

6. Try Tape or Inserts

To provide additional support to the forefoot and surrounding soft tissue, you can try taping your foot or using orthotic devices such as insoles or metatarsal pads.

These will help raise your transverse arch, which allows your toes to splay naturally and reduces the pressure placed on the metatarsals.

This can help add an extra layer of protective cushioning, disperse your body weight more evenly, and provide effective relief from pain and discomfort.

Finding the right pair of metatarsalgia insoles for your foot shape can provide additional support for conditions that could aggravate metatarsalgia, like flat feet or high arches.

7. Check Your Running Shoes

There are a few factors to consider when replacing your shoes, such as what surface you’re running on, your running style, and your body weight.

With that being said, you should replace your shoes every 300 to 400 miles. Every mile after that will put you at risk for an injury.

Check your shoes before every run and look for signs of wear that include the following:

  • Tread on the outsole that’s wearing down
  • Shoes are wearing unevenly
  • Sides of your shoes have worn through on the upper
  • The cushioning feels flat and provides less shock absorption
  • You’re experiencing more been muscle fatigue or pain

If your running shoes show any of these signs, it’s time to replace them.

Keep track of your miles ran in your shoes by recording it either on a running app like Strava or in your running journal.

This will help you to replace your shoes before your next run or race while reducing your risk of injury, especially if they’re done with excessive mileage.

8. After a Run, Rest Your Feet

The best way to prevent metatarsal pain is to rest your feet as much as possible after a run.

You can soak your feet in cold water or apply ice to your sore foot for 10 to 20 minutes. This will help constrict the blood vessels in your foot, reducing swelling and alleviating pain.

Give each foot a nice massage for 5 to 10 minutes, paying attention to any trigger points that you find. Not only will this help to ease sore, tight muscles, but it allows you to check your feet for any potential issues.

Then put your feet up, keeping them elevated above the level of your heart for 20 to 30 minutes. This will help to relieve pain and reduce swelling.

9. Treat Acute Symptoms

It’s always best to address the symptoms when you first notice them, which can help prevent the condition from worsening.

Ice your affected foot for 10 to 20 minutes several times during the first 24 hours and rest your foot as much as possible.

Avoid any activities that make the symptoms or pain worse.

To help manage the pain and swelling, you can take over-the-counter non-steroidal anti-inflammatories as needed.

If your symptoms don’t improve within 7 to 10 days or they get worse, then you should see your doctor or a podiatrist.

They would assess your foot and rule out other possible conditions like a stress fracture. They would then recommend a treatment plan to get you back on your feet.

10. Strengthen the Plantar Sling Muscles

The plantar sling muscles descend from the leg as they run on either calf, creating a “sling” or “stirrup” under the foot.

The plantar sling muscles help control overpronation, prevent the foot from flattening, and provide the metatarsals with protection from impact.

By strengthening these muscles, you’ll reduce your risk of developing metatarsalgia and protect your foot from future injuries.

Ben Drew

Ben Drew

Ben is an avid road and trail runner, and has completed multiple marathons and ultras. A former running store owner, he now shares his knowledge and experience writing these articles.

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