Central Foot Pain: Running Injuries and Recovery Tips

Pain in the center of the dorsum of the foot?

Dear Dr.
Yin Hsin-Pei,
I have recently started morning jogging (every other day, 4 km each time, only on the track).
About four days in, I began to experience pain in the central part of my foot.
Pressing on the central area of my foot or pointing my toes towards myself causes pain, and this occurs in both feet.
[For reference, the location of the foot pain is indicated in the image: http://www.ezcommerce.com.tw/oo/myshop/ezcare/upload/picture/footpain/1.jpg, approximately at the point marked "3" in the image.]
I would like to ask you:
1.
Is it advisable to continue morning jogging under these circumstances? (My current weight is 82 kg) Or should I switch to brisk walking instead?
2.
Would applying ice therapy help alleviate the pain?
Thank you for taking the time to respond.
Best regards,
Nex

Nex, 10~19 year old female. Ask Date: 2016/07/29

Dr. Yin Xinbei reply Rehabilitation

It sounds like the foot is experiencing muscle and tendon inflammation due to overuse from running.
It is recommended to apply local heat for 15-29 minutes at a time, along with the use of topical anti-inflammatory patches or ointments.
Once the pain subsides, you can resume running, but be sure to gradually increase the duration of your runs.
Additionally, it is essential to warm up adequately before running.

Reply Date: 2016/07/29

More Info

Central foot pain, particularly in the area you described, can often be attributed to overuse injuries, especially in individuals who have recently increased their physical activity levels, such as starting a running routine. Given your recent transition to running every other day for 4 kilometers, it is plausible that your foot pain is a result of excessive strain on the muscles, tendons, or ligaments in the foot.

Understanding the Pain
The location of your pain, as indicated in the reference image, suggests that it may be related to the extensor tendons or the metatarsal region of the foot. Common conditions that could cause pain in this area include:
1. Tendonitis: Inflammation of the tendons due to repetitive stress.

2. Metatarsalgia: Pain and inflammation in the ball of the foot, often exacerbated by high-impact activities.

3. Plantar Fasciitis: Although typically associated with heel pain, it can also cause discomfort in the midfoot area.

4. Stress Fractures: Small cracks in the bones of the foot due to repetitive force or overuse.

Recommendations for Recovery
1. Rest and Modify Activity: Given your symptoms, it may be wise to temporarily reduce your running frequency or switch to low-impact activities like walking or cycling. This will allow your foot to recover without further aggravating the condition.

2. Ice Therapy: Applying ice to the affected area can help reduce inflammation and alleviate pain. Ice should be applied for 15-20 minutes every few hours, especially after activities that exacerbate the pain. Ensure to wrap the ice pack in a cloth to prevent frostbite.

3. Footwear Assessment: Ensure that your running shoes provide adequate support and cushioning. Shoes that are worn out or do not fit properly can contribute to foot pain. Consider visiting a specialty running store to get fitted for shoes that match your foot type and running style.

4. Gradual Return to Running: Once the pain subsides, gradually reintroduce running into your routine. Start with shorter distances and lower intensity, and increase your running time and distance incrementally. A common guideline is to increase your running distance by no more than 10% per week.

5. Strengthening and Stretching Exercises: Incorporate exercises that strengthen the muscles of the foot and ankle. Stretching the calf muscles and the plantar fascia can also be beneficial. A physical therapist can provide a tailored exercise program suited to your needs.

6. Consult a Specialist: If the pain persists despite these measures, it may be advisable to consult a healthcare professional, such as a podiatrist or orthopedic specialist. They can conduct a thorough examination, possibly including imaging studies, to rule out more serious conditions like fractures or significant tendon injuries.

Conclusion
In summary, while it is important to stay active, listening to your body is crucial. Continuing to run through pain can lead to more severe injuries and prolonged recovery times. By taking a step back, applying ice, ensuring proper footwear, and gradually returning to your running routine, you can effectively manage your symptoms and promote healing. If you have any concerns or if the pain does not improve, seeking professional medical advice is always a prudent choice.

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