Forefoot Pain in Runners – Why Does it Happen and What To Do

At TFC Podiatry in Point Cook we are currently talking all about pain into the ball of the foot in runners. Why it happens and how to deal with it. 


Why does it happen?


Runners getting pain in the ball of the foot is common, the area takes a huge amount of pressure and the accumulative load from running can be too much for the tissue. This results in pain and inflammation. Although pain in the ball of the foot is not a diagnosis in itself, it is a really useful starting point to start to think about a common problem in runners. Some people call this metatarsalgia, this is a description of pain in the ball of the foot. The pain is almost always on the bottom of the foot but can feel deep inside the ball of the foot. 


The condition usually happens because the load is too high through the area. This load happens because of one or a combination of forces. 

  • Compression; If there is a high compression force from shoes that may be ill-fitted this can crush some of the small structures in the ball of the foot. 
  • Pressure; If there is a high force from the ground on the foot, this can cause a high-pressure area through the ball of the foot and can damage the structures in this area.
  • Pulling; The muscles, tendons, and ligaments in this area can all pull on the small structures into the ball of the foot. This can damage these structures over time and cause pain and inflammation.


These 3 forces are the main contributors to pain that gradually occurs. Trauma is more often a factor in sudden onset pain, this can easily damage these same fragile structures. 


When thinking about “why this happens”. Given that there are 3 big reasons for this condition happens. You can start to think about what training errors this may occur from. These 3 forces all fit into a category called “load”. Some of these loads or forces are easily controllable, for example, compression force. Some patients with mild symptoms find that a simple change of footwear can get amazing results! Some of these forces are of course harder to control and are far more individual. Forces like pushing force from the ground on the bottom of the foot are unique to each individual and a thorough assessment will need to be completed to help identify how these forces may be best controlled.


These forces are a great point for starting to think about pain in the ball of the foot. However to be able to collect more information on the reason this pain occurs it may be useful to complete a gait and running assessment from one of our Podiatrists. 


Each treatment plan will be customised to each patient. An example of treatments that may be used for pain in the ball of the foot include:

Shockwave therapy

Orthotic therapy

Footwear advice

Strength and conditioning

Dry needling

Massage therapy

Injection therapy


Your appointment at TFC Podiatry begins with listening to your story

We want to know how your foot or ankle concerns impact your life and learn about your goals.