Steve Smith’s Blog

Pain On the Bottom Of The Feet, Just Behind The Toes

There is one kind of foot that is particularly susceptible to pain in the forefoot. This type of foot is often miserable during a long run and sometimes walking is even more painful than running. Running on a hot road or going down steep hills is miserable for them. The pain seems to subside immediately when rested.

Such is the plight of the runner with a high arch, a foot that is factory made to give you trouble! This type of foot is often rigid and the calf muscles are tight resulting in excessive pressure on the forefoot. When I evaluate this runner they often come into the office with a bag full of different kinds of shoes, pads, special socks and remedies. They hate shopping for running shoes. This type of foot seems to do well in low heeled shoes.

They start a training program to do a particular race and they are fine on the short runs. They seem to do quite well in the beginning of a training program until they start into the higher mileage, say 8 or 10 miles. Once they hit the 10 mile mark there is pain in the forefoot usually at the area just behind the 2nd, 3rd & 4th toes. Then hot burning sensation starts up and intensifies with each passing mile. Running down hills is murder on their feet.

What is the cause? This is the High arched foot and the second metatarsal is longer that the first. The pressure is all directed onto the 2nd and 3rd metatarsal bone and there is usually a callous on the bottom of the foot, just behind the second and third toes. If you look closely you will notice that they place very little weight on the big toe with no and the long bone connected to it. You will not see any callous or wear in the shoes around the 1st metatarsal area. In other words, the ball of the foot is not bearing very much weight despite being the largest load bearing joint of the forefoot.

What can you do about this type of foot? There are several strategies for managing this foot problem. I said manage, not cure. You can often get this type of foot to work well under limited conditions. I always advise this runner to limit mileage, stick to races with shorter distances. Even a half Marathon can be a real challenge for this runner. The long miles required to train for a full Marathon can take a toll on this foot so I recommend not running marathons. Increase your base training by running less miles but more often.

Train on mildly hilly terrain being careful to avoid running down those steep hills. Avoid long flat race courses, since they can be just as bad as a steep downhill course.

Stretching the calf muscles is helpful and I recommend doing it hourly, even just before starting your run. Use a calf rocker every day to lengthen the calf muscles and you will lessen the pressure on the forefoot.

Calf Rocker

Watch the video below to see how to do a thorough lower calf stretch.

Use Bunga pads to cushion the forefoot and lessen the pressure on the 2nd metatarsal. You can often find them at your local running shoe specialty store. Get the “diminuitive” pads because they have very light thin material and a fabulous silicone metatarsal pad.

Remove your callouses often, being careful to avoid running if there is tenderness afterward.

A padded extension under the ball of the foot can be a real help if you are not putting any load on this area. This is often referred to as a “Mortons Extension.” A good Chiropractor, Podiatrist or Physical Therapist who is knowledgeable can do this in the office.

Use a cushioned shoe, no correction please, since stability and motion control shoes often exacerbate the problem.

If you have a rigid, high arched foot you are at a disadvantage for running long distance. But, that doesn’t mean that you can’t run. In fact, most high arched runners are fast paced and springy, they can really tear it up on a race course. Just use some of these simple tricks and please don’t pass me at the finish line!

Steve Smith


Founder, Pasadena Pacers Running Club

  1. TD06-26-2018

    The info in this post was the only thing that worked in helping relieve the pain in my right foot. Thank you, thank you, thank you.

    • Robin Smith06-26-2018


      Thanks for the great feedback! You”re welcome!

      Dr. Steve

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