Why Do Your Feet Hurt After Running?

Soothe your sore feet with post-running tips to relieve pain

As the weather warms, you may be lacing up your sneakers for a run. Running is great for your overall health, but it can take a toll on your feet. Know how to care for them so you can stay on track (or road or trail) for years to come.

“Your feet are the foundation of every step. You can avoid many foot problems with the right shoes and a gradual training schedule,” said Justine Metcho, DPM, a board-certified podiatrist who sees patients at Geisinger Elysburg and Geisinger Scranton. A podiatrist is a doctor specializing in feet, ankles and the lower leg.

Tips to care for your feet

Each foot is a complex structure of 33 joints, 26 bones and over 100 muscles and tendons — and every stride pounds it with a force up to twice your body weight. So it’s critical to keep your feet strong, flexible and properly supported.

Find shoes that fit

If you want to run for years to come, select shoes that fit well. Style is a distant second to fit. To find the best running shoe for you:

Try on the shoes after a run or at the end of the day, which is closest to your real foot size when you run.
Wear running socks when you try on your shoes.
Get fitted by a shoe professional at least once a year. Your feet tend to get bigger as you age.
Leave a thumb’s width of space between the end of your longest toe and the end of the shoe. If you aren’t sure, take out the insole, put it on the ground, put your foot on it and measure it that way.
Make sure your toes can wiggle. You might need to go up a half or even a full size from your dress shoes, or find shoes with a large toe box.
Check the heel fit. Though there should be a little space, if you can fit your thumb between your foot and the back of the shoe, it’s too loose and will cause blisters. You may need to add a heel cup or lace the shoes a different way.
Measure the space between the top eyelets. There should be about 2 finger widths between them. If there’s only 1 finger width, the shoe is too big or wide and you’re having to lace it too tightly. If there are 3 finger widths or more, the shoe is too small or narrow.
Retire worn shoes. Most shoes become worn to the point that they need replacing at 300 to 500 miles.

“If you find a running shoe that fits properly, but you still have foot pain, you may want to try an orthotic or physical therapy,” says Dr. Metcho. “Visit a podiatrist and bring your shoes with you.”

Vary running surfaces

“Don’t run on the same hard asphalt or sidewalks every day,” says Dr. Metcho. “Try trails, grass, sand or other soft surfaces.”

Natural surfaces absorb more pounding — but be careful not to roll an ankle on uneven ground.

Gradually build distance and frequency

To prevent foot injuries, build your running routine slowly and steadily.

“Runners who get injured usually run too fast, too often or too long,” says Dr. Metcho. “It’s best to increase your distance no more than 10% each week.”

Like to do a long weekend run? Make it less than half of your total distance the rest of the week.

Warm up and stretch

Get your feet ready to run by walking to increase blood flow or trying other movements and stretches. After running, while your muscles are warm, gently stretch your feet and legs.

Common causes of foot pain after running

When you run, your feet can take a beating. There are several conditions common to runners. Most will get better with rest and other measures at home, but some require medical attention.

Plantar fasciitis

About 1 in 10 people will have plantar fasciitis in their lives. A thick band of tissue runs from ball of the foot to the base of the heel. If you overuse your feet or gain weight, this tissue can become inflamed and cause pain in the bottom of your foot, especially where the heel and the arch meet. The pain is often worse in the morning or after sitting for a while.

This painful inflammation can be tough to tame. At home, you can try:

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS), like aspirin, naproxen or ibuprofen
Rest
Icing the bottom of your foot with a frozen water bottle wrapped in a towel
Massage
Stretching, especially your feet and calves

“If the pain doesn’t quiet down in 2 weeks, contact a healthcare provider,” says Dr. Metcho. “A doctor may take an X-ray or ultrasound to confirm the cause of your pain. We may prescribe a medical boot, orthotics, steroid injections, shockwave therapy or other treatments for this painful and frustrating condition.”

Stress injuries

Increasing your distance or how often you run means you’re more likely to have pain from a stress fracture, often located in the ball of the foot.

“Soreness on the bottom of your foot may mean you’ve injured the metatarsals, toe bones or other bones, which can be strained, inflamed or fractured,” says Dr. Metcho.

Sudden pain that started while you were running could mean you have a stress fracture, so contact your doctor. Stress fractures may be hard to find on an X-ray.

“If you’re diagnosed with stress fracture, it’s important not to do too much too soon — otherwise, you could refracture the bone and need to start the healing process all over,” says Dr. Metcho.

If the pain started more slowly, try rest, ice and NSAIDs. If it still hurts in 2 weeks, see your healthcare provider. They may prescribe a boot and see if your injury needs surgical treatment.

Morton’s neuroma

Sharp, stabbing pain or pain in the bottom of your foot like you’re stepping on a rock might indicate Morton’s neuroma. It’s most common between your third and fourth toe, and occurs when the nerve in that area is injured or irritated, so tissue grows around it.

Your podiatrist’s treatment for neuroma may include putting padding in your shoe, deadening the nerve with ablation, injecting steroids or, in severe cases, assessing you for surgery.

Tendinitis

Tendinitis is the inflammation of a tendon, the tissue connecting bone to muscle. Increasing your running distance or frequency too quickly can lead to overuse of any of the more than 100 tendons in the foot, causing soreness. Peroneal tendinitis is common in runners, affecting the tendon on the outside of the ankle that connects the calf to the foot. It may be swollen or weak and unstable.

Like with other running injuries, you can decrease the soreness with rest, ice, compression and elevation as well as NSAIDS. After 2 weeks without relief, seek help from your healthcare provider, who may prescribe physical therapy, custom shoe inserts or, in rare cases, surgery. Continuing to run with tendinitis will make healing take much longer, so rest up.

Achilles tendinopathy

The Achilles tendon — the strongest tendon in the body — attaches your calf to your heel bone. It can get inflamed or just get worn down, causing pain and stiffness in the back of your ankle and your heel. The pain on the back of the foot or ankle is usually worse in the morning and gets better when you move around.

Like other running injuries, it can usually be treated with rest, ice, compression with surgical tape or an athletic wrap and by elevating the foot. Still have pain after 2 weeks? Visit your healthcare provider. They’ll examine you and may take images like an X-ray, ultrasound or MRI. You might need physical therapy, shockwave therapy or injections.

And listen to your body: “If you can’t walk, you may have ruptured the tendon and need to seek emergency care,” says Dr. Metcho.

When to seek emergency care

Seek emergency treatment if you:

Are in severe pain
Have severe swelling
Can’t walk or put weight on your foot
See signs of infection like redness, warmth or tenderness
Have oozing pus or an open wound

“When you’re a runner, foot pain can really disrupt your training. Even if it’s not an emergency, don’t ignore it or just keep training. Often your healthcare provider can find simple solutions to ease the pain and return you to activity faster without further injury,” says Dr. Metcho.