Run Healthy, Run StrongHi Everyone,

Last week I started to experience pain along the outside of my right foot. It felt better after a few days rest and then started hurting again when I went out for a run today. I am a month out from my first marathon and just want it to GO AWAY. 

Any thoughts of how to stretch it out?

This is going to be long so I hope that it is helpful. Many treatments are offered without knowing what the problem is. Treating the right problem with the right treatment is a science and an art. Many long time runners know more about handling running injuries than most physicians. The folks at the local running shoes store have usually seen it all and they can be a great source. They, along with sports physicians, sports Chiropractors and Physical Therapists are good resources to handle your problem. The most important thing to know is whether or not you have a condition that is dangerous. I offer my insights here and will post this on my blog at the Pasadena Pacers website, for future such inquires.

Pain along the outside of the foot can come from 3 main sources.

The first and most dangerous problem is stress fracture. Stress fractures often come on slowly so they don’t feel like a fracture. Since these are micro fractures they are sometimes not painful until you put the bone under excessive stress, such as running. The pain often intensifies as you run, becoming more and more painful until the bone breaks. The outside of the foot is the most common place for this to occur, along the mid shaft of the 5th metatarsal. Try this test: Find the long bone along the outside of the foot and try to bend it by holding on the the ends and pushing up from the center of it with your thumb. If you feel pain in the mid shaft of the bone then you are probably in trouble and you’ll need to rest it for the next 6 weeks. Keep exercising with a stress fracture and you run the real risk of a broken bone and all of the troubles that ensue, including a cast and possible surgical pin. If you have pain while hopping on the foot, especially on the first hop, you may have a stress fracture.

The second area is tendonitis at the insertion of the Peroneus tendon. This is the tendon that begins as muscle and narrows into a tendon along the outside of the calf and wraps around the back of the ankle bone known as the lateral maleolus. This tendon is attached to the outside of the foot at the wide point near the mid foot. The right foot often suffers from pain at this location because it is usually the foot on the low side of the road. This can be further complicated by a short right leg, thereby placing more stress on the outside of the foot. If you have this problem then there are several things that you can do to mitigate the problem but it will probably not go away anytime soon. You can usually run with peroneus tendonitis though, if you make some changes to the stresses on the outside of the foot.

Take a look at your shoes and see if the wear pattern on the sole of the shoes are more oriented to the outside of the forefoot. If there is, then you are over supinating, meaning you are running on the outside of the foot. Supinators get about half of the normal life out of their shoes and have to replace them much more frequently.

Speed is a major cause of forefoot stress because it causes you to run on your toes. If you add hills and speed you are putting maximum stress on the front of your foot. If this has caused the problem the the fix for it is simple, stop running fast up the hills. In fact stop running fast altogether until the problem goes away. This is what we call rest, which is relative, meaning give the afflicted part some rest from the stresses that caused the problem.

Anti inflamatories can be a help. There are a few approaches to anti inflamatories. Use over the counter medicines called N.S.A.I.D. which mean, non steroid anti inflamatories. Advil, Ibuprofen, Motrin are all pretty much the same. I wouldn’t recommend taking these for extended periods of time, since they can have some deleterious effects on you kidneys and may cause gastric problems. Many runners use Naproxyn or Aleve which can be taken every 12 hours instead of every 6 hours. The idea is that since you have to take less of it, you pose less of a threat to you stomach. The gel caps seem to be easier to digest and are easier on your digestive system. (I welcome Dr. Lerner’s comments here) Since the affected area is close to the surface, you may derive benefit from a topical anti inflammatory such as Aspercreme. Applying folk remedies like Vaporub, Ben Gay, China Gel, etc. are of limited value. they feel good but have no medicinal value. in other words, they cause no physiological effect and contrary to popular opinion, do nothing to speed healing. I use them though, just because they feel good.

Ice is the most powerful anti inflammatory I know of. Use a good gel ice pack that has been kept in the refrigerator. If your ice pack has been in the freezer, it may cause tissue damage so make sure that you have a sock or some other fabric between the ice pack and your foot. A 10 minute treatment time is sufficient, since the affected area is close to the surface.

Ultrasound works very well for this problem. The effect of a single treatment can be dramatic for this problem because the tendon is close to the surface and accessible to the therapy. This therapy should be done in a PT clinic or chiropractic office since the application requires a license. Don’t have very many of these treatments though. If this treatment is going to work, you will know within 2 or 3 visits. Usually 3 weeks of ultrasound is sufficient.

Epsom Salt soaks do a great job at reducing swelling and inflammation. Fill a bucket with enough very warm water to submerge the affected area and then pour in Epsom salts until is will no longer dissolve. This is called a super saturated solution and will draw out any swelling. Do this for 20 minutes every day.

If you are wearing orthotics of any kind, this would be a good time to scrutinize them since many of these appliances are made with the assumption that almost everyone over pronates (rolls the foot excessively inward) during the gait cycle. This often results in improper biomechanics, loading huge stresses on the outside of the foot. Shoes that have too much pronation control can cause the same effect. Take a look at your shoes and see if there is a lot of plastic or other cushioning material along the instep area. If the shoe is nearly straight along the inside of the arch then you may have “Motion control shoes” and need to switch to another type of shoe. Other shoes that control motion known as “Stability shoes” can cause the same problem. In general, runners with high arches should not use either of these type of shoes. The best way to tell if your shoes are the right type is to go to a running specialty store. You can tell if it’s a running shoe store if all of the people who work there are runners, track coaches, winners of running events or well known runners. They are generally skinny runners with stringy muscular legs. They will know what type of foot you have and what type of shoe will work best. Fitting running shoes is not an exact science and they can get it wrong but in general the specialty stores get right way more often than they get it wrong. The key to this is the return policy. Quality running shoe stores will have liberal return policies.

There are exercises that can help to strengthen the the muscles that attach to the tendon. Standing on a step and doing calf raises and slowly lowering can be helpful in developing strength and flexibility. The stretches that we use on Saturday mornings are a good way to stretch the outside of the foot. Start with the toes in contact with the floor and slowing rotate the foot in large circles. Do this for 20 seconds every hour of the day to develop flexibility.

You can try using a foam roller along the side of you calf. this will only help if the area is painful. if there is no pain there then you will not derive any benefit.

There are some don’ts to consider. Do not get a cortisone injection of this area. Not only is it painful but it can weaken your tendon. Do not get orthotics as a first treatment. They often worsen the problem or caused it in the first place. Don’t get off the shelf orthotics either. I often recommend the off the shelf orthotics but this is one condition where they are only going to prolong or worsen the problem. Only in rare cases do they help.

There is a third problem that can cause pain along the outside of the foot. If you have contact pressure along the outside of the shoe it can rub along the wide bony area of the foot, causing an irritation. The best way to handle this is by locating the show laces nearest to the affected area and simple re-lacing the shoe to skip that area. Sometimes the shoes are fine during short runs but as your foot swells on the long runs there is more pressure and the area can get irritated. Sometimes it is just the fit and you need new shoes. The most troublesome shoes are new or very worn ones. Be wary of either. In general. runners are going to need 2 or 3 pairs of running shoes per year if you a Marathoner, less if you run less mileage. I always keep 2 pairs of shoes, new ones and worn ones. That way I always have a god pair to race on without having to run on brand new shoes. Besides, I love the smell of a new pair of running shoes.

Steve Smith D.C.

134 Responses to “Side of the Foot Pain”

  1. I find that ant-inflamatories can be pretty effective when it comes to managing foot pain. Good article, thanks for sharing.

  2. jjenny Samson said

    Usfull info, Im not a runner bur a 63 year old lady who does zumba twice a week! I shall get some epsom salts and try the soak, thankyou

  3. […] the Peroneus tendon, which attaches to the outside of the foot at its widest point. According to Dr. Steve Smith, the right foot often suffers pain there because it’s usually the foot on the low side of […]

  4. geraldine reilly said

    Hi,I found this interesting,I’ve got a hairline crack on outside of my left foot I have it 10yr’s an it never bothered me till now I quit running a year ago but the problem arrived 3 months ago.I’ve a lot of inflammation n the foot but is settling after inflammatory’s but the bone is still tender,doctor said about putting a pin n a a cast 4 6 weeks,am not totally convinced as it never bother me before,also am a hairdresser which I stand all day an as its my own businesses I can’t be of there any other options and if I get the pin an cast what is the down side of having the pin in.ur opinion on this would much appreciated.thanks

    • Geraldine,
      The pain often persists for a long time after the fracture has healed up and you shouldn’t run on it until the pain is completely gone. There is usually a stress reaction in the bone long before the fracture occurs. The stress reaction can only be identified by an MRI or bone scan. It will show up as a bone bruise. If you are not having any pain at work then I see no reason to put it in a cast but you should wear shoes that have a sturdy sole. Clogs can be helpful to avoid bending your foot but they are hard as a rock and may cause fatigue. Wear shoes that are stiff soled but have a cushioning to avoid fatigue. Stiff soled boots can be nearly as supportive as a cast but they are not a good option for the fashion conscious. I wouldn’t hesitate to get it pinned but there is a recovery time involved. If there is bone bruise then the pin might not be an option. Wear a night splint to avoid pain when rolling over in bed and putting additional stress on it.

  5. Really helpful information. I now know I am off to the Doctors tomorrow to get my stress fracture checked out. Supposed to be going to Australia end of March this year so need to get mended soon!!!!!

  6. “fantastic points altogether, you just gained a new reader. What would you suggest in regards to your post that you made some days ago? Any positive?”

  7. Probably one of the most thorough answers I’ve ever read across any subject. Thank you. I’m a new runner and shoes are a year and a bit old but with your comments – I can see they are too worn on the outside of the foot. My right foot is killing me after the Bermuda 10km. So rest and new shoes – and a visit to the chiropractor is in sight. Thank you

  8. sickoffootpain said

    I am not a runner, but am looking for help for the same type of pain. I had surgery for plantar fasciitis in June. The pain on the inner part of my arch was taken care of from the surgery, but very shortly after (while doing PT) the outside of my foot started to hurt and now it hurts all the time. It did not hurt prior to the surgery. I do not want to have to have surgery again…and not even sure it would help for this issue. Any thoughts?

  9. Stacey said

    My 13 yr. old daughter plays Jr. Olympics volleyball. At a tournament yesterday, she stepped (or landed from a jump, she doesn’t really remember) on a teammate’s foot. As the day went on, the outside edge of her foot started to hurt more and more. Today it’s very painful to walk on and just above her outside ankle hurts (this is her left foot/ankle). She says the pain in her foot is mostly along the outside edge towards the front of the foot and then under it just a bit, again more towards the front rather than the arch or heel. Advil does take the edge of the pain. Her foot, especially the bottom outside edge behind the pinky toe is especially painful to touch/pressure. Thinking peroneal tendon strain pain would be more directly below to slightly in front of the ankle bone rather than closer to the toes? Should I be concerned about a Jones fracture? There doesn’t appear to be any swelling. Just the pain and tenderness. She cannot walk w/o limping at this point.

    • Stacey,
      I would be thinking about getting an X-ray for this one. From the intensity of pain and the location of it there is a real possibility of a fracture. This doesn’t sound like a peroneal tendon injury. For now use ice on it and keep her away from bearing any weight on it until you can rule out a fracture.
      Good luck,
      Steve Smith

      • Stacey said

        Thanks Dr. Steve. That’s kind of what I was thinking I was going to have to do. Call it that “mom instinct”, lol. Now I just have to get myself shoveled out. Mar. 25th in MD and I’m SNOWED in. Unreal.

        Appreciate your feedback!


  10. Sally Whitehead said

    I have a pain that runs along the right side of my right foot beginning just below the joint of my small toes and ends where my ankel bone is. I’m 61 yr old female and do not run unless I really have to. This pain just showed up last night and I haven’t done anything I know of that would have contributed to it such as twisting my foot. I haven’t worn any different shoes and it’s only on the right foot. It’s not an intense pain and as long as my foot is still and facing straight out not an issue although I know it is there and when I turn my foot to the left or right I can feel the low grade pain. I can walk although when I raise my heel is when I feel it the most. In sitting down when I raise my foot from the toes leaving my heal on the ground there isn’t any “pain” at all. I did have bone spurs removed from the top of both feet in 1990 and my feet do “fall asleep” with the tingling sensation quite easily. I’m also right handed if that means anything. I also am heavy heeled since I was a military training instructor in the late 70’s and early 80’s so I have always stepped down heavier on my heels when walking. Any suggestions?

    • Sally,
      It’s difficult to tell by your description but if I had to guess I would check for cuboid syndrome. This is a misalignment of a small bone on the lateral sole of the foot. This condition responds well to a cuboid pad and manipulation of the foot. Unfortunately, there are few physicians who are skilled at this type of manipulation. I would go to a podiatrist and get evaluated but if this isn’t an option you can find cuboid pads on the internet. Look for a podiatrist, chiropractor, Physical Therapist who has experience with foot manipulation. Wear shoes that have a stiff sole to avoid flexing the foot. Roll your foot on a frozen water bottle if it is very painful or if there is any swelling. If the pain is mild and only present on positional stress then try rolling it on a warm water bottle.
      Please let me know how you fare on this one.
      Steve Smith

  11. Tony Morris said

    I have been having a sharp pain in my right foot on the outside part behind my little toe area. If I step down on the right side of my right foot I get a sharp pain in that area of my foot. I am a runner and have been having this problem for about 4 weeks. Any ideas as to what the problem is ?

  12. […] and completely freaked out at all the doom and gloom results I found.  I did, however, find a great article about assessing foot […]

  13. Joan said

    Hi, I have a pain just below my ankle bone, on the Inside of my foot. I can run on it but it hurts a lot after. I ran all week on old shoes, which I think caused it, but not sure how to treat it since I can’t quite locate the site of the pain

    • I am guessing that you are running on stability or motion control shoes that have lost their support. If this is the case then you are probably over pronating and may be putting a strain on the tibialis tendons where they attach at the cuneiform bone. This isn’t usually serious and you can just rest up until it resolves and use Epsom salt soaks, massage and a new pair of shoes. Stay away from the hard fast runs for a couple of weeks and try to avoid hills as much as possible. Run with the sore foot on the low side of the road to reduce the amount of pronation.

  14. steve said

    I’m a big person but my footing has always been fine. A several months ago I stepped outside my front door for a second and came right back in. on the way back the corner of the storm door swung back and struck the base of my Achilles tendon on the inside of the foot. The force tore the door off the bottom hinges. The pain was horrific I thought I tore the flesh. I didn’t and after some ice and later some soaking I seemed ok. I started getting sore on the bottom out side of my foot and after some time I was walking to my car and I heard a popping sound I was afraid I wouldn’t be able to continue. I did and later went to a doctor with no good result. I can walk ok on the flat or if the incline is up toward the inside of my foot but if it is down toward the outside I have pain and little support. I’m on a weight management program and I have been doing water therapy for about 4 months and the foot is getting better in very small increments. I still can’t do yard work and wondering how long this injury is going to last..

  15. Jesse said

    So I run for about an hour 2-3xs a week. Today about 10 mins into my run I had a sharp pain in my foot – along the outside, starting about half way down and stoping right before the outside of the heel. It is not swollen, it only hurts if I walk and if I relax it and try to rotate my foot inward. It does NOT hurt to push on the bottom of my foot with the thumb tricks mentioned earlier. Any thoughts ?

    • I can only guess but it sounds like you may have pain at the insertion of the Peroneus Brevis tendon. If this is the case then you might have been running on the outside of your foot. If so, it sometimes happens from running on the road crown with the affected foot on the low side of the road. Sometimes it happens when you get a new pair of shoes that over correct for pronation. Also check for tight calf muscles and stretch your calves. Patients who have been increasing the time or height of high heeled shoes will develop over tight calf muscles. A recent onset of hard hill running can over stress the peroneus muscles as well. In either case it doesn’t sound serious.I hope this helps, please let me know how it works out.

      • jenna said

        I have the same problem right now I recently ran up Harlem Hill for the firs time and ran 8 miles for the first time this weekend- I am training for the half marathon-

        My foot hurts right under my right pinky toe to my ankle- when i flex my foot inward it helps and only really hurts when i walk on it- the pain started right after my run but not during- I also have IT band syndrome – perhaps the two are connected? I have been taking advil which helps a bit but I want to know when its safe to start working out on it again- the half marathon is the first week in June-

  16. Jessica said

    10 days ago I started having foot pain after a run. It is my right foot and started at the top of my foot more towards the outside edge. My foot has felt pretty good but I have had some tightness on the outside of my calf but thought I would try running today. I got a few minutes in and the pain started so I stopped. It is not a sharp, shooting pain but it definitely hurts and I know I shouldn’t be doing it. After I stopped I had pain along the right side of my foot. Any thoughts?

  17. joe said

    Went for my typical Saturday run yesterday, approximately 3 – 5 miles. Only difference is I wore new running shoes. I came home and all day yesterday and today I have a lot of pain on the outside of my right foot below the ankle, as well as pain on the outside of my knee. Any ideas of what may be causing this, I have been running for a long time and have never had this kind of pain.

  18. Celeste said

    On Saturday, I did a 5km running corse with obstacles and through bush tracks, and I didn’t wear very good shoes as I didn’t want to destroy my running shoes. It was called warrior dash, and it’s crawling through mud etc… It was extremely cold aswell. anyway by saturday night, I started having pain in my left foot, running on the bottom outside part, from toe to heal. It hurts and aches when I walk, it aches up my leg and ankle when I’m sitting… It hurts to put my weight on it… So I’m limping around. I don’t know whether I should go to the doctors or not… If u could help me it would b great
    From celeste

  19. This is such a helpful and informative article! About a month ago, I woke up to find the top of my right foot swollen and painful I think maybe someone stepped on my foot?) I rested for a few days, but it didn’t hurt that much and the swelling went down, so I resumed my normal lifestyle of kickboxing, yoga, and other active activities. Now it is starting to hurt more on the outer edge of my right foot, and it hurts if i press on the top of my fourth toe. The pain is spreading a bit to the outside of my ankle as well. Does this sound like a stress fracture? I’m really hoping not, because 6 weeks of rest is so long! How can I help it heal faster? Thanks for your help!

  20. Robin said

    I started playing softball again after a few years. This last week I noticed, when we had a scrimmage, that immediately as soon as I started to run I had this terrible pain in my left foot (outside) about an inch below the ankle bone. It’s almost like a shooting pain when I run. After the game and several days later I’m finding that sometimes it’s even hurting when I’m walking. Have you ever heard of this before? Can this pain go away by just doing some basic stretches?

  21. Cody Wienand said

    Thank you so much for this info! I’m currently serving in the US Army and I started having this problem after a 8 mile ruck march with a 50lb ruck on my back, in combat boots and everything. Is there any advice you have for some one that is required to work out every day?

    • Cody,
      Your feet are under a continuous heavy load and are being flexed thousands of times during your march. Try using Spenco Gel insoles Tight calf muscles will overstress your feet and stretching the upper and lower calf muscles several times a day will help. I recommend doing these stretches every hour if you can. There are several other stretches on my youtube channel that will help reduce soreness in your legs, hips and feet.
      Thank you for your service!
      Steve Smith

  22. Amelia Faisandier said

    Thanks for this information, very useful indeed. I just ran my first marathon and I came away thinking ‘my feet are the only things which don’t hurt!’ The next day however I could barely walk (pain on the outside and arch) but I had to work all week so no rest. The pain has come and gone and come back again. Massage seems to help and of course rest. I used crutches one day! Could you please tell me if you think I just need to wait till the pain has gone to begin running again or should I bite the bullet and go to the docs :(
    Crossing my fingers waiting for your reply!

  23. gary rollason said

    Have read your entire article…very problem is my right foot, under the fourth and fifth toe, the bone hurts when pressure is put on it and the bone to the right of my small toe also has pain when pressure is placed. This is noticed when walking in bare feet…but not in my running shoes…thus padding seems to really help. I do not recall banging it….but I do walk 2-3 miles 2x a week…with no problems. I am 70 years old and seem to be in good shape….any suggestions…thanks, Gary.

    • Gary,
      Sometimes older people have atrophy in the fat pad under the metatarsals. This can cause pain at the heads of the metatarsals. I would try “Bunga Pads” they come in thin and thick weights. The thin ones are great but the thicker ones are too bulky and often cause blisters. Also, I have had good luck with “spenco” arch supports. The extra padding can really help if your feet are getting sensitive. Stretching you lower calf muscles and your feet can relieve the extra pressure that can happen if you become stiff, which concentrates huge forces on the metatarsal heads. You can see my stretches on the YouTube channel. Just go to and click on the YouTube link.
      I hope this helps,
      Steve Smith

  24. gary rollason said

    Thanks, I will certainly try what you have suggested…just to get rid of the pain…will let you know…

  25. 20something said

    Hi, thank you so much for this information! I’m a twenty-year old woman in excellent shape. I was just recently in a pair of loafers walking on the street when suddenly I randomly got pain all along the outside of my right foot. I also have plantar’s warts on that right foot (one large and three cluster) as a result of working as a lifeguard/swim instructor. I have not been able to walk all day long and am wondering what is going on. It feels like something is strained or pulled along the outside of my foot. Do you have any exercises to recommend, or any idea what is going on?

  26. Antoni said

    This article is probably the most relevant to what I have been struggling with for quite some time. Yet it doesn’t really explain what my problem might be. Here’s some background:
    14 months ago (!) after intensive cardio exercise my left foot felt quite sore on the outside. The next day it was very painful and the pain wouldn’t go away even if I swallowed the whole box of anti inflammatory pills. I went to see a physiotherapist and he said that it seemed to be caused by overuse. I thought that he was right as back then I would exercise 6-7 days a week: group fitness BodyAttack twice a week, tennis three times a week, badminton and squash once a week (plus weights training). Before that fatal day I had never have any problems, no sore muscles, no strains, no broken bones. Now over a year later I can’t get back to 100%. I can move again on tennis court (not as good as I used to) but I can’t get back to BodyAttack (lots of jumping) or running. I have this problem now in both feet. It’s simply sore on the outside between toe and the heel. Every now and again while walking I can feel a sharp pain as if something was being torn inside. So far I spent thousands of dollars on physios, doctors, surgeons, podiatrists, MRI, and only got “I dunno” diagnosis. I’m desperate. Have no idea who can help me. I’ve already developed signs of depression, there is no joy in my life any more. If it continues like this it’s very likely that I will need psychiatrist to stop me from suicide…

  27. fee Alexander said

    I hurt my foot 5 days ago when I slipped backwards down some steps. I have had pain on the top of my foot on the outside. Walking and driving bith hurt. I noticed today that sitting on a chair with my feet on the floor makes the pain spread up around the front of my ankle. Any ideas what I might have done? It also hurts to turn my foot to the right. Thanks :)

  28. corey said

    Hi there! I started having lateral foot soreness about 2 months ago after a run. My foot was fine after i stopped running. 2 days later, same thing. The soreness started under the 5th MTP joint and has worked its way back more towards the tubercle on the 5th MT now and also over the cuboid. Any shoe that wraps over my foot makes it more sore as well as any prolonged WBing. I am somewhat tender between the 4/5th MT head where the connect with the cuboid. I had initially thought that i was landing too lateral on my foot and that was causing the pain, as i do have a shorter leg on the painful side. I have changed shoes and had my orthotics adjusted. However, the same problem persists. I had an MRI to rule out stress fracture – it did rule that out. I was instructed to stay in a boot for 4 weeks. So my question is, if the MRI came back negative, should i request i get a bone scan to further reinforce the stress fracture/reaction rule out? What is the likely hood that it was a false negative? OR, of anything else I told you, do you think i should look into anything else? or try anything else? Thanks!

  29. carleen said

    Great info! What do you think about using a valgus wedge to avoid peroneal tendinitis? I supinate and often have peroneal tenon issues. So I recently started using a wedge in my shoe. I think it has helped, but I also tend to get wary of anything that can change my natural gait. So I wonder if I should only use it when I get flare ups, or if it is ok to use all the time as a preventive measure.

    • I am wary of valgus wedges for runners. It sounds like a good idea but distance runners risk over-stressing the 5th metatarsal. It would be best to concentrate on stretching your calves and doing calf presses with your feet turned in to strengthen your peroneals. Supinators need frequent shoe changes due to excessive wear. It is not uncommon to replace them after only 300 miles!
      Good Luck and please let me know how it works out.

      Steve Smith

  30. MMG said

    My daughter is complaining of side foot pain (left foot, outside). She has been running both at the gym and outside. After running on the treadmill at the gym yesterday she said her foot started to hurt and got worse as the day went on. When she woke up this morning she could not walk on it. Her pain level on a scale of 1 to 10 is a 6. The pain she has is a sharp pain and located on the side in the middle of the foot and a little towards the bottom. There is no swelling or bruising. Could this be a stress fracture?

    • It could be. A sharp pain is a red flag and I would get this checked out right away. She will likely have trouble weight bearing and careful palpation by your physician will reveal pain at the mid shaft of the metatarsal bone if there is a fracture.

  31. John said

    I did a half marathon last sunday and all through the day it was fine up until 1 am that night. However when I woke up monday morning the pain was pretty bad and progressively got worse as the day went on. I have been icing it a lot and it seems to help quite a bit. Every time i rest it for even 15 minutes it will get better until i start walking on it again. And the more I walk on it the worse it gets. I have been reading a lot about what it could be and I keep reading it might be the tendon that goes through heel and middle of the foot. Most of my pain is in the upper half of my foot on the outside with the pain getting less and less as it gets to the heel. It has been three days now and its virtually exactly the same.Any idea whats going on?

    • Brandie Morast said

      I have pain on the bottom outside of my foot. Just below the pinky toe. I also have been having issued with my Achilles and/or calf muscle. I run, hike and am an online speed skater. The pain just started and hurts mostly when I am speed skating. Sounds muscular to me but wanted your opinion. Thanks a bunch. I really enjoyed your article.

      • Brandie,
        Speed skating exerts heavy loading on the outside of the right foot and the fifth metatarsal head is where the brunt of the force is concentrated. From the sound of it, you may have a tight achilles tendon resulting from tight calf muscles. If this is true then it would explain why you are having pain on the side of the foot. The ankle doesn’t flex as much as it should when you have tight calf muscles, causing increased bending load on your forefoot. Try doing the upper and lower calf stretches for a week and it should alleviate the problem. A calf rocker can be helpful for this stretch ” Calf Rocker at‎ ” or you can use the stretches on my Youtube channel for the upper and lower calf
        Good luck and please lem me know how it works out,
        Steve Smith

  32. Shehnaaz said

    Hi Dr Smith
    My work requires me to walk alot, and a few months ago, I had swelling on my right foot, and was unable to walk for a few days. An MRI was done which showed Bursitis. The Doctor gave me 2 Cortisone shot, and anti inflammatories, which releived the pain but gave me an ulcer.
    I also had 24 physio sessions, which helped a great deal. Turns out my Pelvis had moved, so one leg was shorter than the other. Thats been sorted out. I think the
    Bursitis is mostly cleared, but I am now getting in both
    feel pain on the outer side of the feet, and when I walk
    abit, much less than my normal walking, Theres an
    aweful ache around the ankle bone, going upto the
    back of my calf muscles. Sometimes, its almost like pins and needles on the outer area from the small toe through to the ankle. I am currently off all medication, and started acupuncture. I am 45 and desperate, I cant even do routine stuff like shopping. My livelihood is my feet, please advise and any exercises to strengthen ankle, knee, foot and calf muscles.
    I cant spend any more time away from work.
    Appreciate your help

  33. Christie said

    Hello. I’ve been running for two years. After a marathon 2 months ago, things have not been the same. My IT band flared up in my right leg…something I’d never had a problem with. A month after that my foot on left leg got painful. It increased to the point where I can’t do over 3 miles right now. The pain is on the outside of my foot below my ankle, a little forward in that soft part of upper outside foot. I went to ortho thinking stress fracture. There is not one. I’ve been off my foot for 3 days. I haven’t run in a week. I still cannot walk properly. I want to run really bad. What does this sound like to you? Can I still run? Ortho said stretch and I got new cushioned shoes with a lateral heel wedge he told me to insert. He said I have a very high arch and a very rigid foot. What is going to get me back to running? Thank you so much for any advice you can offer!

  34. jenna said

    Dear doc, I find your advice very helpfull. I’m. Not a runner,but was told that I have calcaeous spur. I was fitted orthotics, but noticed on day 2nd of wearing it that the side of my foot and heel feels more swollen than ever. No anti flammatories was prescribed by podiatrist and I would like to know what kind of anti flammotories would assist as I’m a nursing sister who is constantly on my feet. I also notice a burning pain.although slight on the side of m leg. Please help!

  35. Elisabeth Cacciattolo said

    Hi Doctor:
    I am not a runner but I have pain on the right side by the ankle for the past 2 years. I have been walking on the side of my foot and screwed up ny knee and just have a hip replacement. I am over weight but only 52 years old and still can’t walk without pain.
    I think its tendonitis but can’t take anti inflammatories what shouldI do?


  36. Kim said

    I am a waitress at 45yrs old and on the outside of my left foot I have a bad pain. It only bothers me when I work long days. If I run my hand down side of arch it’s in he middle where arch is highest. When I come home I usually limp. But next day it’s fine any ideas of what it is

  37. Heather said

    I am not a runner but I am on my feet for 17 hours a day. I woke up feeling pain in the side of my foot three days it goes on the pain is just worse! My foot is swollen it hurts underneath just below my big toe and along the side.and when I put an ice pack on it my calf muscle was cramping up.I am in severe pain I can’t put weight on it at all.

  38. Shehnaaz said

    Hi Dr Smith
    Please advise
    My work requires me to walk alot, and a few months ago, I had swelling on my right foot, and was unable to walk for a few days. An MRI was done which showed Bursitis. The Doctor gave me 2 Cortisone shot, and some anti inflammatories, which releived the pain but gave me an ulcer.
    I also had 24 physio sessions, which helped a great deal. Turns out my Pelvis had moved, so one leg was shorter than the other. Thats been sorted out. I think the
    Bursitis is mostly cleared, but I am now getting in both
    feel pain on the outer side of the feet, and when I walk
    abit, much less than my normal walking, Theres an
    aweful ache around the ankle bone, going upto the
    back of my calf muscles. Sometimes, its almost like pins and needles on the outer area from the small toe through to the ankle. I am currently off all medication, and started acupuncture. I am 45 and desperate, I cant even do routine stuff like shopping. My livelihood is my feet, please advise and any exercises to strengthen ankle, knee, foot and calf muscles.
    I cant spend any more time away from work.
    Appreciate your help, what is the best type of doctor, specialist I could visit.

  39. Charlie Sennes said

    I am 32 and just started getting in shape over the last 18 mo. I have started running with some friends and we did a 5k on memorial weekend. that went fine but realized i need to get out of the gym/track and do something with more terrain changes since my time on the 5k was a bit more than the what I normally do. I went with my friends to run on a route that was all sidewalk and mostly uphill for 3.6 miles and the overall trip was about 7.5 miles which is twice what I had ever done. I ran all but about .25 miles on the way up and when I got to the top I started back down about 100yds, met a friend and ran with him back up to encourage him to finish strong and sprinted about the last 50 yards. I did that twice. Then we walked and ran occasionally on the way back down. I felt pretty good until I got home and rested a bit. We had started at 6 PM and it was about 95 degrees. By the time I went to be I was limping from pain in my left foot on the outside at about the midpoint. It has now been 3 days and it is still painful but a bit better than the first day. It is not sore to touch. When I put my weight on it it has slight discomfort but when I remove the weight the pain increases considerably so I have been limping a bit. I put Ice occasionally the first couple days and used BC Powder twice a day the first two days which helped. I have checked my wear on my shoes but they are pretty new (3mo.) and do not show much wear pattern yet, Adidas AdiZero Hagio. I like them and had not had a problem until now. I believe the pain is from overdoing it and not being use to the shock from concrete. Would like to know what you think and if it is anything I should have checked out.

    • Charlie,
      I would not do anything for now. If it is improving then take a wait and see approach. This could be just a sore tendon or simple joint strain. It could also be the beginnings of a stress fracture but if it is you will have to just wait for it to stop hurting before you put any stress on it. Avoid running for now, wear stiff supportive shoes and try using the elliptical trainer or aqua jogging to maintain the fitness you have achieved. After the pain resolves and you are able to walk without exacerbating your symptoms you can doa test run. This involves doing a slow warm up for about 20 minutes, slow run for 10 minutes and a cool down for another 10 minutes. If you are not symptomatic the next day then you can do another test run by warming up 20 minutes walking gradually increasing your speed and then breaking into a slow run for 20 minutes followed by a cool down walk. If you get away with this and there is no pain the next day then you are probably good to resume training, being careful not to up the training gradient too quickly.
      Steve Smith

  40. Alana said

    Thanks for your article. I have had problems with my feet for almost 10 years when playing netball and other sports, sometimes even just walking and very quickly if I try to run/jog. The past couple of years I have tried to find a diagnosis or solution. My GP was no help so I saw a podiatrist. Although he was helpful I don’t think they knew what it was either and just offered orthotic insoles to try to correct the overwear on the outside of the foot. After changing GPs I tried again and finally got an xray which showed one foot having a stress fracture although I don’t believe this is the cause of the problem, as both feet are a pain and since it has been happening for 10 years a stress fracture lasting this long is, I thought, unlikely. I actually think the stress fracture came from the orthotics as they caused new types of pain!! My theories from research were some sort of tendonitis. Finding this article gives me new insight to the possible cause – good to know there are others with this it is not just my odd feet! I have tried antiflamm rubs and Ice spray to sooth the pin but I think the one I had was more of a homeopathic remedy than a medicine so I am going to see if I can find one here in NZ that is going to be preventative.

  41. M. B. said

    Thank you for this informative article Dr. Smith.

    I have only started running 8 weeks ago and loved it! I slowly increased my mileage from 1 to 6.2 miles. And 4 days ago, after running the 6.2 miles on the treadmill, I felt pain along the outside of my right foot, in between the end of my metatarsal (?),-long bone and my heel, about 2 hours after my run. I felt some pain towards the end but not enough to make me stop. I didn’t pay any attention to it but as advised by others, I was supposed to not run again for 1-2 days after a long run, so I did yoga and strenght training. After 2 days, I started really feeling pain along that side, and felt like there was a small “ball” attached under where the pain was. The top side was very slightly swollen so I used ice packs and heat. Now, 4 days since my run, I’m feeling sharp pain when I lift up my foot while walking. It also comes and goes as I try to walk avoiding to put weight on the right outer side.

    It would completely devastate me to think I cannot run anymore. Please share what you think?


  42. Hayley said

    Thank you for the informative article Dr. Smith.

    I have been experiencing pain along the outside of my foot for about 6 weeks now. It hurts when walking and standing and the pain subsides while at rest. The pain seems to be localized end of the bone (the part that is closest to the ankle) and feels almost like a bruise.

    I am a teacher, so I an on my feet all day. I had hoped that when the school year came to an end the pain would improve, however that has not been the case.

    I have had x-rays taken by my primary Dr. and no stress fracture was seen. I was advised to take ibuprophen for the pain. I did that for 2 weeks, and there has been no change.

    Is it possible for a stress fracture to be missed on an xray? Is it possible to get a stress fracture from standing all day or could this be something else?

    Thanks for your advise.

    • X-rays are more likely to miss a stress fracture than catch it. In fact x-rays are a poor way to diagnose stress fractures because of the likelihood of a false negative. I would go back to the Doctor and tell him that the problem persists and he will more than likely order more imaging or make a referral to an orthopedist. An MRI would be a good choice to image your foot to see what the problem is. This sounds like a joint problem to me, possibly a cartilage injury. A tendonitis would probably have improved with rest and anti inflammatories so I would rule that our for now.
      Good Luck and please do shoot me a message to let us know the outcome.
      Steve Smith

  43. Jody said

    Thanks for your article. I ran across it when trying to find answer to my own foot pain, but thus far I haven’t been able to discover a fit. Perhaps I am missing something, if you wouldn’t mind taking a minute to analyze my info. I woke up one morning with pain on the lateral side of my right foot, just anterior inferior to my lateral malleolus. It’s pretty much in the middle of the side of my foot if I am not counting my toes. It hurts when I apply pressure such as walking, causing a limp. The pain is localized to a two inch by two inch area, and does not resonate towards my ankle or toes. When applying pressure to my arch there is some pain, but not in the arch itself, but more because the pressures carries up, putting pressure on the 2 inch sq area. There is pain when I rock forward on my toes, but not much when I rock back on my heals. Does this sound like something familiar? I was considering trying ice and Epsom salts to see if that has any affect as trying to sleep it off has done nothing. I haven’t been running regularly, my last run was probably over a month ago..which makes this whole thing even stranger. Thanks!

  44. jacob said

    Hey im jacob and the same thing is happening to me and I play baseball its only when I run that its start hurting but whwn I get done running it hurts for me to walk and Im going to panama city beach to play baseball and I done what you said with the stress fracture and it did hurt real bad but I dont wanna take a six week break what do I do

  45. runningw/theone said

    Hi, I am an avid runner and I fell out of running for a while when I went through a divorce. I gained almost 50 lbs from laziness and stress. So in Nov of last year I found myself with no car so I decided I would fun and walk everywhere I needed to go. I purchased two pair of running shoes in Jan ( mizuno wave creation 13’s and Nike air Pegasus29’s love them both!) I am now back down to my goal weight 145 lbs . Ok now that you have my story I have a few ?’s . Oops I forgot to mention my sister and I just started a training regiment for our first 1/2 marathon in Nov ! We got the training plan from our run keeper app. It’s a sub 2hr plan though I’m shooting for an hour and a half! About two weeks ago I started having some pain in the outer part of my right foot and up the outside of my right leg to the back of my calf. After reading this blog I think I’ve narrowed it down to paronel tendonitis. I’ve been icing, massaging, and taking some naproxen twice a day. It seems to help some but the pain persists. Outside of my training I am forced to do 6.5 mi round trip to work and back Mon-Fri. Our training is starting to get a bit more rigours and I definitely don’t want to risk any further damage. Do you have any tips to keep me from having to stop my training all together? Also I think the cause of the whole problem was the mid sole of my mizuno’s were cracked! I just purchased some new asic gel noosa tri 8’s which I love !!! Any advice would be greatly appreciated!! Look forward to hearing from you!! We have also started a new facebook page entitled (runningw/theone) feel free to come like our page and or join us for a run sometime we are from Oklahoma City, Oklahoma!!!!

  46. Suzanne said

    This is terrific information. Thank you! I’m fairly certain that I’m dealing with peroneal tendonitis related to running but I’m puzzled about how this came about. The onset was quick. I’m in relatively new shoes (around 50 miles on them) which were fit at a specialty running store. I have found them to be extremely comfortable up until the last week or so when my weekly mileage began to increase. With the increased mileage I was beginning to experience soreness in my arches. I would say I have moderately high arches. I’m in a neutral shoe. I was also experiencing tenderness on the back edge of my heel. In response to this discomfort I explored over-the-counter orthotics/inserts from the shop where I bought my shoes. In hindsight the consultation and selection experience wasn’t the best – not at all like the experience I had when buying the shoes – and I’m fairly certain that the orthotic were not what I was after. They seemed to be far to stabilizing when I was looking for more cushioning.
    With that said, I wore the orthotics in my running shoes for 2.5 to 3 hours around the house – intermittent standing and moving. I found them increasingly uncomfortable and when I finally removed my shoes I felt the pain at the outside of my foot at mid-foot. As time passed, the pain crept back toward the ankle and slightly underneath the side of my foot. The pain subsided to mild discomfort but within 36 hours I had swelling below my ankle bone. It is possible that the short time in the orthotics could have triggered this issue or was this a storm that was already brewing and the timing of the orthotic trial was just a coincidence?

    I’m scheduled to see my Primary Care MD tomorrow but I’m fairly certain that he will tell me to do what I’m already doing – rest, ice, take NSAIDs. What I’m interested in is figuring out what factors lead to the problem so that I can address them and prevent reoccurrence.
    I imagine there are various specialists that could weigh in but I’m particularly intrigued by the chiropractic prospective. I see a chiropractor regularly related to spine issues (history of surgery for a herniated disk w/free fragment at L4/L5). While I’m pleased with the care I receive for that issue my doc seems to only focus on the spine. I absolutely believe that the various parts of our body are connected and our ailments tell its story. I just need someone to help me to interpret the messages. So I wonder, could give me some advice about finding a chiropractor in my area who either specializes or has particular interest in caring for runners? I’m in Kentucky so seeing you is just not an option.
    Thanks so much!

  47. Kevin B said

    Thank you for taking the time to write such a detailed article. I stumbled upon it because I’ve had an odd foot discomfort for 2 months and while I’m pretty convinced its not a stress fracture, I’m having trouble being certain. I can illicit a pain response between the head and the bony midfoot on my left outer foot by compressing my foot (squeezing my foot by grabbing the inside and outside and squeezing the 5th bone towards the first bone. It’s been at a 3 or so out of 10 and doesn’t happen all the time and tends to get better if I hold the squeeze. I can hop on that foot. I’ve also ran well over 200 miles on it since I remember feeling it. It never hurts during a run unless I notice it at the beginning but it goes away pretty quickly.

    The one change is that I switched shoe models to their new version which I heard has a smaller toe box. I’ve made accomodations with lacing but it hasn’t seemed to help. I’d hate to try new shoes so close to the marathon but my main concern is that I’m running on a stress injury without realizing it.

    Can this be as simple as shoe irritation?

    Thanks so much in advance for any peace of mind you can offer.

    • Kevin,

      It doesn’t sound like a stress fracture. I would bet that your shoes were just a bit tight. Sometimes skipping a lace or two can help to relieve the stress on the forefoot but it is always best to have good fitting shoes. Try this test: stand on your shoes and if the forefoot is larger than the shoe then they are too tight.


  48. garry said

    Hi, A great article and something that’s really help me try and understand my problem. My left foot started hurting about 4 months ago and I thought it might have been down to stress on my plantia as the pain was always high first thing in the mornings and if I was sitting for long periods of time at my desk. The pain would reduce slowly once I started walking. I bought arch supports for my shoes and night support socks for sleeping in. The problem I’m having now though is my pain is still there but it seems to be now worse on the outside of the foot mid way down. Its sore to touch and I’m now worried it may in fact have been a stress fracture. Should I be taking anti-inflammatory drugs too. The pain subsides once I have stopped using the foot but the soreness to touch remains. Any thoughts?
    I’m active away from work so the pain is sending me crazy and will soon drive me to the doctors if I cant sort it out myself.

    Please can you help thanks so much.


    • Garry,

      From what you tell me it sounds more like Plantar Fasciitis. there are 3 branches of the plantar fascia and it sounds like the central and medial branches were irritated and now the central branch is doing better, leaving the medial branch to heal up later. I would give it more time and continue with a night splint and stretch the lower calf and feet. If you have pain on hopping or severe pain on walking then it’s time to go to see your Doc.


  49. Jennifer said

    I am 13, and I play soccer a lot. I usually have soccer everyday of the week, sometimes twice a day. The outside of my foot has been hurting.

    It only hurts after I have soccer, and when I am walking around my house, but not running… Any thoughts as to what it might be? It hurts when I press on the top and the bottom of my foot, and when I bend my toes too far. The pain is kind of a full, ache-like pain that is along the outer portion of my left foot. I have sprained that ankle 4 times and wear a brace for soccer, if that info helps at all. The pain has only been around for a few days, maybe a week, and I think it is slowly getting worse. It has begun to hurt more when I am just resting, instead of when I am walking or playing soccer.

    I am wondering if it is a stress fracture, or what.

    Thanks for any replies, as they are welcome. :)

    • Jennifer said

      I also have has severs in both feet, and Achilles tendinitis in both feet also.

    • Jennifer,
      It doesn’t sound like a stress fracture. More likely it is a tendon attachment that causing your problem. I am wondering about your previous ankle sprains causing an alteration in your running gait. You may be turning your foot or tensing the muscles on the outside of your lower leg in an attempt to protect your ankle. If this is the case then your tendons on the outside of the foot will put extra stress on the attachments at the fifth metatarsal. Check your running gait and if see if this is the case. If so then you will need to do ankle strength exercises. There are several exercises that help with this, toe tappers, theraband resistance turning the foot to the outside and inside, theraband pulling the foot toward you and away from you, one legged calf raises with the foot turned out, turned in and straight ahead. Some self massage over the specific tender areas can really help to ease the pain. Go slow with any massage and probe carefully for the most tender area, applying steady, even, deep pressure. If the pain is definitely along the mid metatarsal shaft then you may may have a stress fracture and should get it looked at by your sports doc.
      Steve Smith D.C.

  50. Gaynor Jakeman said

    My son has been complaining that the area around the bone on the outside of his foot is sore. This has gone on for weeks now and is particularly sore during/after sport and at the end of the day. Was checked by local GP a couple of months ago but no xray. Pain seems to have been made worse by a fall off a tree? Any suggestions?

    • Gaynor,

      If it has gone for a long time and is not resolving it is a good idea to take action and do some imaging. Start with a visit to a sports doctor or a podiatrist and get and examination. A careful history and examination of the foot may be all that it takes to get an accurate diagnosis but I would bet that an x-ray is warranted by now.

  51. gaynor said

    Many thanks for your response. Have tried to self refer to such depts today but due to being only 10 years old must go through GP for referral but agree as it is certainly not healing on it’s own.

  52. Danielle Atkison said

    For about 3 weeks now I have had a pain on the outside of my left foot. I started exercising in January and have lost a total of 52 pounds. I worked out 3-4 hours everyday. I run 8 miles almost everyday, do combat, attack, and pump classes. 3 weeks ago while I was running my foot started aching, so bad I couldn’t even finish a mile. I have been trying to rest it for the past 2 weeks. I still do pump and I try to do cycling for cardio. The instructors from the gym tell me that cycling shouldn’t hurt it, but it does. I am wondering what you think is wrong? There are days where it really doesn’t hurt at all, and other days it hurts pretty bad. I just feel like if there was something major wrong it would hurt a majority of the time. I don’t want to be resting my foot if nothing is really wrong. I miss my running! :)

    • Danielle,

      I think you are right, it doesn’t sound like a fracture to me. More likely is is the peroneus tendon. Try self massage therapy on the outside of the foot and use an ice pack. Change your shoes if they are getting worn. Do the step out calf raises on one leg for a couple of weeks but only if it can be done pain free. Use the elliptical trainer and consider aqua jogging to maintain your fitness level while you heal up. In the meantime, give it a complete rest from running for a couple of weeks or at least cut back on frequency, intensity and duration of the current workouts that are causing your pain. If there is no resolution to it then you are going to need to get it looked at. Unless you regular Doc is sports oriented, skip it and go to someone who understands the importance of what you have done. Weoo done on your program and your success, I love your story and thanks for sharing it!

      Steve Smith DC

    • Danielle,

      I think you are right, it doesn’t sound like a fracture to me. More likely is is the peroneus tendon. Try self massage therapy on the outside of the foot and use an ice pack. Change your shoes if they are getting worn. Do the step out calf raises on one leg for a couple of weeks but only if it can be done pain free. Use the elliptical trainer and consider aqua jogging to maintain your fitness level while you heal up. In the meantime, give it a complete rest from running for a couple of weeks or at least cut back on frequency, intensity and duration of the current workouts that are causing your pain. If there is no resolution to it then you are going to need to get it looked at. Unless you regular Doc is sports oriented, skip it and go to someone who understands the importance of what you have done. Weoo done on your program and your success, I love your story and thanks for sharing it!

      Steve Smith DC

  53. Jennifer said

    I know that I have already asked for an opinion, and not many days ago, but my foot has begun to hurt more and in different places in addition to where it hurt before.

    As before, the edge if my foot, along the fifth metatarsal hurt after soccer and while resting sometimes, and if I pressed on almost any part of the bone along the outside, near the middle of the outside bone. It was a dull, achy throbbing pain. Anyways, now, my foot has begun to hurt more towards the top and middle, and around my ankle. I have a small bruise on my heel from something, but I am not sure what. It has begun to hurt when I put all my body weight on that one foot, and my ankle has been a little stiffer than usual.

    If anyone knows what might be going on, please let me know.


    Oh, and by the way, I play soccer everyday, and sometimes twice a day, and do quite a lot of running during those practices. Could these be signs if a stress fracture?

    • Jennifer said

      Sometimes it throbs when I am trying to sleep… :/

    • Jennifer,
      I don’t know if you saw my original answer so I’ll copy it here:
      It doesn’t sound like a stress fracture. More likely it is a tendon attachment that causing your problem. I am wondering about your previous ankle sprains causing an alteration in your running gait. You may be turning your foot or tensing the muscles on the outside of your lower leg in an attempt to protect your ankle. If this is the case then your tendons on the outside of the foot will put extra stress on the attachments at the fifth metatarsal. Check your running gait and if see if this is the case. If so then you will need to do ankle strength exercises. There are several exercises that help with this, toe tappers, theraband resistance turning the foot to the outside and inside, theraband pulling the foot toward you and away from you, one legged calf raises with the foot turned out, turned in and straight ahead. Some self massage over the specific tender areas can really help to ease the pain. Go slow with any massage and probe carefully for the most tender area, applying steady, even, deep pressure. If the pain is definitely along the mid metatarsal shaft then you may may have a stress fracture and should get it looked at by your sports doc.
      Steve Smith D.C.

  54. Jennifer said

    Thank you! I did not actually see your original answer, but I do now. (Sorry! ) :) Thanks again!


  55. painful puppies said

    I am a server, so I am on my feet constantly. I am also on the heavy side (5″8 190). I have heavy to moderate pain in what I believe to be the outside bottom of my calcaneus. The pain is from a small area on the bottom of my heel And goes up the side of my foot about an inch and a half. The pain stops below my ankle. It sometimes feels as though the tendon along the bottom of my foot is too short for my foot, and I often have to walk tip toed after a shift. I would really appreciate an opinion on why my foot hurts like this. Do you think I need new shoes, or different insole maybe?

    • Carly Evans said

      I started having ankle pain in my right ankle around 2 weeks ago, immediately after a 9k run. I have signed up to my first 10k which is at the end of September, I have never really done much running before. I had no pain during the run but as soon as I stopped and started to walk, it became difficult to walk and became progressively worse as the day went on. There was no swelling but I continued to hobble in pain when walking for a few days after. From the day after I also had the same symptoms in my left ankle but on a smaller scale. After around 4 days the pain had subsided. This weekend (a week after the original injury) I have spent 4 days at a music festival which involved a lot of walking, dancing and general jumping around. There was a little discomfort in my right foot but nowhere near as bad as the original pain, and I could still manage to walk around without any problems (I did wear wellies the whole time). It wasn’t until I got home yesterday and had a proper look at my ankle that I noticed how swollen it is! Only my right one though, the left seems to be OK. The swelling is located next to the ankle bone on the side towards the front of the foot. I have pain on the outside of the sole my foot from my little toe back to my heel and my little toe is turning numb. It is also uncomfortable on the outside of my calf. No sharp pain though. I’m guessing I won’t be able to manage the 10k race. Maybe I did too much too soon? I went from only being able to run 4k to 9k in less than 3 weeks with not very many rest days. I am running on a treadmill in standard running shoes. Any advice you can give me would be greatly appreciated!
      Thank you for your time.

      • Carly,

        This sounds like tendonitis. It involves the peroneus muscle and tendon and isn’t dangerous. The increase in mileage is a training error that is common, too much too soon. I am suspicious about your shoes. You probably have shoes that correct for overpronation, I am guessing they are stability or motion control shoes that transfer the biomechanical load to the outside of the foot. If this is the case then get new shoes and use some ice and self massage on the affected areas. Go to a running specialty shoe store to get your shoes. The folks who work at these stores know which shoes to give you for your type of foot and can tell you if you have the wrong shoes. If all this is correct and if you get new shoes, the massage and ice works and you are not sore then I would give you the green light to run the 10K this weekend. this assumes that you are in good enough condition to run it. Your general fitness and age has a lot to do with the wisdom of running this race.
        Good luck and please let me know how it works out.

        Steve Smith

  56. Catherine said

    Hi Dr. Smith, thanks for such an informative article. My foot problem started a week ago. For two days I ran errands in flip flops– walking around the mall, grocery stores, etc. (Usually I wear running shoes when I’m going to be walking that much.) The day after all of that, I had been doing housework for most of the day in my bare feet and intermittently taking laundry out to the clothesline in my flip flops. Late in the afternoon I was working in the kitchen and I started to feel a lump forming on the bottom of my right foot, on the outer edge, halfway between my heel and little toe. It felt like I was standing on a soft wad of putty. I didn’t think too much of it until it started to hurt a couple of hours later. When I looked at my foot, that area was swollen. No redness, not tender or warm to the touch, but slightly discolored. I elevated and rested my foot that evening, but the swelling increased and the lump ended up being a 2×2 inch purple square that wrapped around the outer edge of my foot. You can see a half inch of it on the top side of my foot if I’m standing, and my foot “puffs” out where the swelling is. I already had a callous there, and this bruised area formed right underneath my callous. One thought I had is whether my stiff flip flop strap was pressing too hard on that area when I was at the mall. The strap wraps around my foot right at mid-foot and I actually stand on the part of the strap that connects to the sole. Another thought: 10 days earlier, I had done yard work where I used a spade to shovel a couple of scoops of hard clay soil, and I put weight on that part of my foot to turn the shovel. Also that day I had been breaking branches with my right foot. Not too many, but a few. I wore some thin-soled canvas shoes at the time. Could I have done the damage at that point and it just took a few days to flare up after I did all that walking?

    The podiatrist took x-rays and didn’t see a stress fracture… he thinks it’s some form of peroneal tendonitis, and said that I may want to consider wearing a boot. I’m not sure if that’s the right thing to do. Any thoughts on that? He also has me on Meloxicam, rest, ice and elevation. I use crutches to get around right now.

    A bit more background info: 49 years old, 5’6″, 128 lbs. I did sprain my right ankle, but that was 35 years ago. I had achilles tendonitis 10 years ago. More recently, I strained my left adductor muscles last September, lost flexibility in my left hip and groin, had a meniscal tear in my left knee in December, followed by surgery for it in May. That’s why I hesitate wearing a boot, because I don’t want to cause a flare in my left side by being uneven. But 6 days from now I head to Disney World with my husband. I would sure like to be able to enjoy the parks, so I’m hoping for the right treatment and some quick healing! (Or do I need to think about using an ECV when we’re there?)

    Any advice would be greatly appreciated!

    • I can see how you could have bruised your foot doing the activities you described and this is what I think it is. If it is bruised, then give it a rest, stay off of it, use ice and self massage doing stroking toward the heart and continue with the anti inflammatories. I’ll bet that it gets better in a week and you can travel. The x-ray is good for peace of mind but there is no guarantee that is not a stress fracture. A bone bruise is a possibility but they cannot be seen on x-ray either. If this is the case then it will take several months to heal up. You’ll know over the next 10 days or so because if it a simple bruise then it will fade away and you have a good time at Disney World.

  57. Paula Dickinson said

    Very informative article and will try the Epsom salt soak. I was wondering if a muscle or tendon spasm could cause this pain, as mine started in the middle of the night on the underside of my left leg and up the outer side of my calf and beyond. It felt very much like it does when I know I am getting a cramp in my toes or hamstring, which I can usually help by standing up, taking extra potassium/magnesium and/or using a heating pad. This pain persisted all the next day not matter what I did including Advil and ice packs. The next night I took a muscle relaxant that I had been given for a back injury and the next morning the feeling that there was a spasm was gone, but the tendon on the outer side of my foot was very sore to touch and walk on and throbs most of the time and there is still some pain up the outer side of my leg I am a 68 year old woman who is fairly active, exercising most days. I would be very interested in knowing if a spasm could cause this and if there is anything different that I should be doing, if it is.
    Many thanks for your helpful information.

    • Paula,
      It sounds like you did have a muscle cramp and the course of action you took makes sense to me. Muscle cramps are still an enigma to the medical community. Despite the many articles written on this problem, there remains no definitive solution to treatment. Potassium, magnesium, calcium, salt, quinine and water all seem to have benefit. If you have repeat episodes I would suggest increasing the potassium in your diet. A diet rich in beans, oranges, bananas etc. will help. Add some Calcium and magnesium as a supplement as well. If you are not consuming enough water, an increase may help as well. You can learn more about the nutritional value of foods by downloading the free app. “My Food’ or ‘My Fitness Pal.”

      Steve Smith

      • Paula Dickinson said

        Thank you so much for your reply. Now I have two other questions… I do drink a lot of water, take magnesium and calcium supplements daily. When I get cramps, I usually take the potassium, but was wondering if it could be lack of sodium as well. Because of heart issues, I avoid salt and wondered if the muscle spasms could be lack of sodium. My other question is whether if a prolonged spasm could cause a more long term tendonitis? I did try the Epson salt soak and think is has provided some relief, though have not been on my feet much since soaking. Again, thanks for your fast response. Paula

        On 9/3/13 5:37 PM, “Articles from Dr. Steven Smith” wrote:

        > runmastergeneral commented: “Paula, It sounds like you did have a muscle cramp > and the course of action you took makes sense to me. Muscle cramps are still > an enigma to the medical community. Despite the many articles written on this > problem, there remains no definitive solution to t” >

      • I haven’t heard of a cramp causing tendinitis but you may have other stresses on the tendon that, coupled with a cramp produced a problem of greater magnitude than would be warranted by a spasm alone. Check your calcium intake and shoot for 1,000 to 1,200 mg per day. Your magnesium level is going to be about half of the amount of calcium. If you continue to have cramps you can try taking some quinine. They don’t sell it over the counter but you can get tonic water in liquor stores and it has a small quantity of quinine. I wouldn’t increase sodium intake if you have high blood pressure but a brief intake for experimentation shouldn’t be a problem. Your doctor should be consulted on this though.

        This may be one of those simple problems that will go away in a few days on its own so I would give it the old tincture of time treatment and just wait it out for the next couple of weeks.

        Please post the outcome so we can all see what comes of it.

        Steve Smith

  58. Michelle said

    You are so great for maintaining responses on this article. I think my problem is a stress fracture, but Id really like to hope that it isn’t. Maybe you will have some advice.
    I ran a typical 5 mile run last Thursday, and noticed a moderate pain on the 5th metatarsal, near the ankle bone. The pain has continued to increase over the last few days and has reached a severity of about 7/10 while walking, and a dull throb while resting. I did run 5 miles this morning and felt it at the beginning of the run, with an intense pain after I stopped. I cannot walk without a limp at this point.

    I am also just getting back at 100% after recovering from bilateral grade 2 stress fractures in both tibias in April, so the pain is familiar in its patterns. Is this another stress fracture? Or maybe a result of something residual from my tibial stress fractures?

    Any advice would be appreciated!

    • Michelle,

      It does indeed sound like a stress fracture. I hate to give bad news but I would like it even less if you kept running on it and fractured your foot. I would get an x-ray of your foot first and if it is inconclusive then an MRI. Until you prove otherwise, treat it as a stress fracture. Stay off of it as much as possible, wear the most supportive shoes you have and use ice. A shoe with a very stiff sole will help prevent movement of the affected area.

      I hope this helps and please post the outcome of any I,aging or treatments.

      Steve Smith

  59. Glory said

    I am 51 yrs old, I am in reasonably good shape, I wake up each morning with very sore feet as soon as the touch the floor. After a while they let up, but I do have a constant ache at outsides of my feet the bone near the heels and sometimes on top. I work on concrete floors all day and pack a lot so I really can,t stay off them.

    • Glory,

      This sounds like plantar fasciitis to me. If I am correct on the diagnosis then you probably have a lot of pain when you first step on it in the morning or after a long car drive. If this is the case then a night splint on your foot will help. You’ll have to get used to the splint but it is well worth it. You will notice and appreciable decrease in pain after just one night. Skip the soft splints and get the hard one. You don’t have to tighten it very much for it to do the job of keeping your foot stretched out during the night. Try sleeping with your feet out from under the blankets and sheets to avoid plantar flexing. Try doing the lower calf stretches every hour. Do the stretch for 20 seconds on each foot. You can see the stretches by going to my website and clicking on the youtube stretch videos. A frozen water bottle will serve the dual purpose of massage and ice treatment. Freeze the water bottle until it is hard then put on a thin sock and roll your feet on it for about 10 minutes each. If you have plantar fasciitis it may take a long time to resolve if it is severe. Try the above measures for 3 weeks and if you don’t see a improvement then it’s time to go to the doc.

      Please let us all know how you are doing.

      Warmest regards,

      Steve Smith DC

  60. Michelle said

    Thanks for the reply. I had X-rays today that came back negative. My PA thinks it’s a stress fracture, will have a bone scan in the coming weeks. Until then, I’m in a CAM boot until further notice. I did have a little swelling and slight bruising show up this morning. Bearing weight is a no go without great pain. Not good for helping my pace out. I won’t be running for a bit!

  61. Very interesting article. I have been having similar pain for this entire week and since I have been slowly incorporating running into my exercise routine over the last few months I am very frustrated that my foot hurts! My pain is on the left outer edge of my left foot. It seems to start around my ankle bone and there might be some very slight swelling around the ankle but it’s hard to tell (I’m just comparing it to my right ankle). I can walk on it a short ways with no problem but then it starts really hurting and I have to sit down. I do wear orthotics in my work shoes to correct over pronation but I do not wear them in my running shoes. I usually stand on a cement floor at work for 3-4 hours at a time and that’s when I initially noticed the pain. I’m really hoping I can heal this quickly and get back to running soon. Thanks for any help.

    • Ashley,

      I’m suspicious about the orthotics that may have caused your foot to supinate, placing stress on the outer foot and ankle tendon. The tendon that I am thinking about, (Peroneus Brevis) runs through a sheath that curves around the outer ankle bone (Lateral Malleolus) and terminates at the widest point of your foot Base of the (fifth metatarsal). If this is what is causing your problem then stop using the orthotics and apply massage to the area. Use a slow deep stroking technique along the tendon followed by a 15 minute ice pack. Us anti inflammatories if you are not averse to it. I like to use a combination of ginger, turmeric and botswelia for inflammation, since there are no adverse side effects to your kidneys. I often use a 3/8 heel lift on both feet to reduce tension on the tendons. Don’t attempt to put a heel lift on one foot because it will cause back or hip problems. Please let us know if this works for you by posting your results.

      Good luck,

      Steve Smith

  62. I am a 72 yr. old active male. I walk, ride a bicycle, and golf 3 times
    a week. For 4 weeks I have been having intermittent pain on the outside of my right foot. On days that it hurts I contemplated calling my doctor, then it starts to feel better. I feel it is nerve pain, as it can occur at night in bed to the extent it wakes me up. On my last physical my doctor said my sugar was 105. He wasn’t too concerned, but said we keep a watch on it.

  63. HI – I wonder if you can offer me any advice. Five weeks ago I fell and my ankle twisted under me and was very painful. There was a lot of swelling and bruising in the foot. After a couple of days the pain started to subside and it was improving. Three weeks after the fall, the pain has started again but this pain is on the right outside edge of the foot more towards the arch area and nowhere near the toes. I have just started using crutches to try and keep the weight off the foot. Over the last couple of years I have had to have a tremendous amount of Xrays and the reason I have not gone to the hospital re the injury to my foot is fear of more radiation from more Xrays. The pain seems to be when the foot is flexed or if I happen to put the weight on the side. I realise you cannot give a diagnosis but wonder if in your opinion this has the potential to resolve itself if I keep my weight off it, or does it sound as if there could be a broken bone that will require Xrays and treatment. I would value your opinion. thank you

    • Rita,
      This is a case where I would definitely recommend an x-ray. I appreciate your concerns about X-rays and would recommend that you be cautious if you have had radiation treatment for cancer or a lot or CT scans. If your radiologist or oncologist tells you that you have reached your limit on X-rays then you should probably get an MRI, since they emit no significant amount of radiation. If you have just had a few standard x-rays then i would not hesitate. You are probably aware that there are X-rays naturally present from solar radiation. The amount of x-rays on a three view foot is roughly equivalent of being in a high altitude such as Denver Colorado for a few months. In your case the amount of damage that may be caused by lack of proper medical care probably outweighs any potential risk of an x-ray.
      Please let us know the outcome so that we may all learn from you.
      Steve Smith
      Author, Run Healthy Run Strong

  64. Hi many thanks for your reply. The advice is very welcome. I guess you have suggested what probably deep down I suspected. I have up to now been hopeful that the problem would just resolve itself without the need for more X-rays. In the last two years I have had over 25 Xrays, 3 MRI’s, 2 CT scans and live fluoroscopy for a disc replacement. I will follow this through as obviously I need to think long term. thanks again

  65. Kim said

    Dr Smith I’m wondering about in ability to supinate the foot can cause side if the left foot pain, I am disabled and am trying to walk again, I still have paralysis in my ankle and wear a leg bracethe goes under my foot and up my lower leg to my knee. I can use my had to move my ankle, but doing calf raises is not possible. What do you recommend for my side of the foot discomfort?please email me!

  66. Schiff said

    I found this post while researching my foot pain and hope you might have some advice since you seem to respond to everyone’s questions.
    I’m 29 and have been Marathon training for 15 weeks, regular runner before that essentially since middle school. On Saturday after an easy 4 miles I was doing some strides in the park and stepped in a hole. Slight ankle roll but no pain, did 3 more strides and went home.
    On Sunday, woke up feeling a bit of pain on the outside of my left foot, ran in a one mile race as scheduled, and since then have continued to feel pain in the area when walking. It does feel worse than it did at the outset but only moderately so — in general it is quite uncomfortable. I would say it runs more towards the heel than the toes.
    I’m trying to get an x-ray scheduled but in the meantime I’m wondering what your initial diagnosis might be and what you would recommend as next steps.

    • Steven,
      I don’t really have much information from what you have given here but i would make a guess that you sprained your ankle. it is possible that you have a small avulsion fracture (where a small piece of bone has been ripped loose by a tendon that has been over stressed) in which case you will need an x-ray. If you can bear weight on it, that is a good sign and if you can do a calf raise that is even better and you might just want to wait for a 10 day or so and if it is getting progressively better then it is probably going to resolve without intervention. If this is an ankle sprain then it may turn purple and over the next few days may turn a yellowish color that spreads toward the toes.
      Hope this helps, please let me know the outcome,
      Dr. Steve Smith D.C.
      Author, Run Healthy Run Strong

  67. jennifer said

    how long does this take to heal and does it cause further problems to try to run thru the pain? I am a runner and out of nowhere had a stabbing feeling in the bottom of my foot. Could not walk well for the following 24 hours. No swelling, could balance on the foot but it hurt to walk. Rested it and want to get back to running. When I tried, It hurt on the top area of my foot and not the bottom where th pain originated from. I can jump on it, balance on one foot but the running movement is bothersome. How long does this typically take to heal and can I do more damage by trying to work thru it? I’ve been doing the bike and elliptical pain free. I am not usually injured and this has thrown me for a loop!

    • Jennifer,
      I’m not sure what the problem is but my general advice is don’t run through pain in the foot until you know what it is. You will not lose much conditioning by continuing on with elliptical trainer and bike while whatever it is goes away. Judging from what you have told me here it sounds minor and will probably be gone in another week to ten days. You’ll be better off running without pain rather than to come back too soon and restart the clock on your healing time.

  68. Jyoti said

    Wow great post I found looking for something for my foot pain. I went for a walk yesterday – after 6 months of leaving the gym where i did an hour of high intensity aerobics- for an hour 3 days a week. Yesterday i went for a walk and thought maybe i can jog for a minute – just one minute, I did, but when i came back the outer length of my right foot is paining – no swelling, no nothing – but when i walk i cant do so without a pain. what could this be, i am am thinking i pulled a ligament. Also whenever i did aerobics, i had a pain in the same region which lasted for 10 minutes after exercise and went away. Could this be something breeding – serious?

  69. Erin said

    Such a great article! I recently took up running and am doing the couch to 5k program (I haven’t exercised in over 5 years so this is big for me:). I started out on the treadmill and have tried to transition to pavement so that I’m ready for my 5k but have had some difficulties. My shoes were a bit worn and I felt major joint pain from the waist down (hips, knees, you name it) when I tried to run on pavement for the first time. I figured I would buy some new shoes and went with a very well known running brand. Did the 2nd pavement run this morning and it was worse! Had major pain within 5 minutes on the bottom outside edges of my feet however no joint pain so I guess it’s a wash. Should I continue to try and break the shoes in or just switch to a new pair? I might add that I am a larger female with over 100 lbs to lose so I know for sure that is a major factor in this. Any insight would be helpful. Thanks!

  70. notsolightonmyfeetnow said

    Hi I am a 22 year old studying abroad and don’t have the luxury of getting my foot x-rayed or looked at by a physician, so I thought you might be of some help.This past weekend I ran a 10K, which is more mileage than I have been doing. I typically run pretty comfortably on a daily basis for 30 to 40 minutes, but this race took me a right at one hour and was about double my normal distance. I run with a mid-foot landing, if that information helps any. I didn’t notice any pain during the race, but hours after I began to notice a sharp pain on the lateral side of my right foot. The pain is pretty concentrated on the 5th metatarsal and has not improved at all- it actually has increased. I wear the women’s Asic Gel Forte shoe. It’s a motion control shoe that was “ordered” by my physical therapist because I have Morton’s neuroma in my left foot.The neuroma has not been a problem for over a year. I have been reading some of the comments and responses on this blog and I think my shoes might be the issue, but I am weary to just assume that. The pain in my foot is a pretty constant throb. When I walk and put pressure on my right foot, the pain is stabbing and shooting (I tread as lightly as possible to avoid extended time striding with that foot). The pain level when I put pressure on it is about an 7. I have not run since the race on Saturday and don’t think I will be able to anytime soon with the level of pain I am experiencing in my foot. Any ideas?

    • Kathleen,
      I does indeed make me suspicious about your shoes. Motion control shoes should only be used with runners who have marked over pronation. Runners who are very flat footed often wear motion control shoes. If you have a high or medium arch and your foot does not over-pronate then you are concentrating too much stress on the outside of your foot at the cuboid and fifth metatarsal head. When you go into the push off or propulsion phase of your gait you are also putting a lot of strain on the peroneus tendon. Try this: Carefully feel the head of the fifth metatarsal, that’s the widest bony point on the outside of your mid-foot.
      Feel around the bone and see if you can identify an area of tenderness. If this area is tender put some massage oil or moisturizing cream on it and massage it until the soreness diminishes. If there is tenderness there, you can often trace it along the side of your foot to the lateral malleolus, that’s the large bone on the outside of your ankle. there is a soft spot behind that bone and it may be tender to deep pressure. If this is the area of pain then you have tendonitis. Give it 10 days before you try to run on it again and do the massage technique every day for about 3 or 4 minutes. When it is no longer tender to deep pressure massage then you are ready to run but don’t use the motion control shoes.

      I hope this helps. I wish I could take an x-ray over the internet!

      Dr. Steve Smith D.C.

  71. BCM said

    Thanks for that great informative article, but I want to present you my specific problem. I have been training for a 10k (with a local running store’s training program) for about 8-9 weeks now. A week or two ago I noticed some pain in my right foot. That pain was in my heel near my arch on the inside of my foot. It wasn’t enough to keep me from running so I just have been pushing through it. This past Saturday I did a long run of 6.5 miles and several hours afterwards, I started getting pain on the outside of my right foot. It seems like it runs from my pinky toe almost to my heel, but it is most pronounced about midway between the two. Also, now my heel/arch pain seems worse too. Both pains in that foot had me limping around the rest of Saturday and all day Sunday (and this morning too). I did your aforementioned push test on the outside edge of my foot and didn’t really feel any pain. The outside area is not painful to the touch either, but if a poke around my heel/arch that area is. I only seem to have the pains when I put weight on my foot. If I flex my foot and really point my toes hard, then I do feel some pain on the outside of my foot. I run in neutral shoes (Air Pegasus indoors on the treadmill and Brooks Ghost for outdoor runs) and always have. Even before the outside edge pain, I had been trying to stretch my calves a lot and the they really don’t feel tight (and I seem to have good range of motion). My 10k race is in a couple weeks so I am really hoping there are some things I can to help me get back on track soon.

    • BCM,

      It sounds like you are developing Plantar Fasciitis. There are three branches to the plantar fascia and the area you are having trouble is the lateral branch. Do you have pain during the first step in the morning? If you do then this is nearly proof positive that you have plantar fascitis. Try stretching your feet on a step or doing the stretches on my YouTube videos. The stretches work but only if you do them every hour or so. You’ll need to keep your feet stretched and stay off hard surfaces in your bare feet. Use a frozen water bottle to ice massage your feet in the evening before bedtime and then wear your splint all night. If you are developing Plantar Fasciitis it would be wise to give it a rest until it goes away. I know runners who continue to run and most of the time it just delays the healing process and certainly increases the risk that the condition will worsen. At the very least, it will slow the healing process if you continue to run.

      Steve Smith
      Author, http://www.RunHealthyRunStrong

  72. Gina said

    Hi! I read the article but unsure if it applies to my situation. A few weeks ago, I had some sharp shooting pains in my heels off and on for a few days. That seems to have mostly subsided. However, more recently, I have swelling and pain on the outsides of both feet. It has become very uncomfortable and especially difficult at work these past few days.

    I have been working a retail job for the past 4 years. The past two years have been full-time. An average day is spent mostly on my feet with the past month or so almost entirely on my feet. (I have been a walker all of my life (5-7 or more miles a week and hike frequently as well) and have never experienced any kind of foot pain previously. I don’t have pain when not standing but some tingling for awhile when I’m first off my feet. One other thing is that when I get up in the morning, my feet feel so stiff that I seem to stumble a bit and feel a little unsteady. I am in good health (53 yrs old) and fit (other than being 15 lbs overweight) and have enjoyed Pilates, swimming and other exercises for many years.

  73. Gina said

    I should’ve mentioned that this is the ‘bottom’ outside of both feet. I first became aware of it when standing up after putting on my shoes — when I mistakenly thought something must be in my shoe. I am not a runner but several times in the past month have worked one minute of running into every four minutes of my walks.

    I appreciate any suggestions/ideas you may have.

  74. Gina said

    After a couple of days off my feet, the pain is only on the bottom outside of one foot. The other symptoms must’ve just been coincidence (simply too many hours on my feet) but this one foot has brought me to a halt.

  75. Dave Stauffer said

    My outside bone and under midfoot hurts bad when going up hill or down hill. This just started. What is it? What can I do?

  76. samantha morrison said

    Hi, I would love some help please! About 3 years ago, I came off a curb wrong and rolled my right foot. The severe pain I had that night was unbearable. I was on holiday and didn’t see a doctor for it. I had 3 days of wearing sneakers and limping. Then the pain went away. 1 1/2 years ago, I had a charlie horse in the same foot and ended up with plantar fascitis under the mid way of my foot. I went to see an orthopedist and was given an X-ray, a walking boot and stretches to do. I saw someone else when the pain didn’t subside and got an MRI and 2 cortisone shots. Now the pain is solely on the outside of the foot from the edge of the toes down to mid way of foot. It is unbearable now and hurts when i walk and hurts to be rubbed. I get hot flushes through the foot every now and again. Please advise, Samantha

  77. Jenna said

    I injured my knee three weeks ago playing soccer, and was on crutches for 2 weeks, and a few days. After I started walking withy knee brace, I noticed that the outside of my left leg (the one with the hurt knee) was hurting. It was sharp pain, but not constant, and mostly hurt when I am walking. I have not told my physical therapist for my knee about it and I’m not sure if I should. There is a small lump on my leg, just a little above my ankle, and it hurts to press even just lightly on the bone there. I think it is right above my fibula, but I’m not sure. Any thoughts as to what it may be?


  78. Can I bike, swim, or do the elliptical if I have a possible stress fracture and or possible peroneal tendonitis? The podiatrist could not determine my problem, but I am in a walking boot.

    • If it is peroneal tendonitis then the elliptical trainer is a perfect exercise modality. It will help you maintain your fitness and if you are a runner you will not loose much ground if you are training for a race. If it is a stress fracture then complete rest is best, usually for 8 weeks. However, stress fractures can tolerate the pool and you can aqua jog and still maintain a fairly high level of fitness. Use the bike only if it is not painful. I would definitely get on the elliptical trainer and give it a 10 minute test to see if it is painful. If not then gradually build up time on it and assume that you have peroneal tendonitis.

      Here’s how to tell the difference: Carefully investigate the peroneal tendon by putting the tip of your thumb along the tendon and try to find an specific area of tenderness. Try using a moisturizing cream or massage oil to help you slide your finger over the area, moving along very slowly, a few millimeters at a time. If you can definitely feel an area of sharp pain along the tendon then just hold pressure there and slowly roll your thumb over the site. If it is tendonitis the tenderness will probably lessen quite a bit. If this happens then you have tendonitis and you can expect a good recovery. Do this massage technique every day, use an anti-inflammatory, do epsom salt soaks and stretch the lower calf. Take a look at your shoes to see if you are wearing on the outside of the FOREFOOT. If you are then it is time for shoe replacement. Please let me know how it works out.

      Steve Smith DC

  79. Thank you so much for this info. This was definitely more helpful than the two doctors I visited here. I am going to hold off on massaging it or doing any cardio (I think I aggravated it by massaging it about a week ago and continuing to do cardio) until I go for a check up on Monday. It feels much better since I have been resting it and wearing the boot. Hopefully, I will have a better idea of what the problem is and then go from there. Again, I cannot thank you enough for this valuable info.

  80. Lyndsay said

    I recently started running to train for a 1/2 marathon and this exact pain started on the outside of my right foot. I really appreciate the lengthy explanation. It has helped me determine I have peroneal tendonitis and now I know how to approach its recovery. Thank you so much for your insight. Best of health to you!

  81. Pamela Melton said

    I have begun to have burning in my right foot on the right side, midway. I broke the bone going to my pinkie toe in 1980 and never really had any problems from that, wore a cast for 6 weeks. I wear flat shoes and boots most of the time. The boots have heals, about an inch. I’m just wondering what I can do to help this burning sensation to stop, if possible.

  82. Lee said

    I have new orthotics due to very flat feet which are garnished with bunions and I foot strike outside and then follow through the gait rolling the knee in until the inside of the foot hits the road. I suffered ITB but never foot pain (only ever on the left side). The new orthotics have been fine and I have graded down my shoes to the Asics 3000 instead of the heavy support shoe I was running in. I run usually in the centre of the road (no traffic where I live) and avoid side slopes where possible. I have just increased my milage over time and since the new shoes and orthotics I have come home with the above problem. I can hop on the foot and after a few days of non running it goes. I do still get the ITB that side which aggravates the hip and below knee, sometime refers into upper calf but not as bad with the orthotics, but I don’t like this new thing. I ran a long run today and noticed I began to feel pressure in that left arch from the orthotic then the outside sole pain began.

    • Shinez,

      There are always new pressures and altered biomechanics when Orthotics are introduced. This is the nature of the beast and without those changes the orthotics are are no value. The question here is: did the orthotist get it right? Correcting the alignment of the foot is very tricky. Getting just the right change in just the right place is part science and part art. The person id familiar with these challenges and will more than likely make adjustments in the orthotics to accomodate for any problems. But, you have to give yourself some time to adapt to the new orthotics and this is usually a 2 to 4 week period of time. During this time you may have differing symptoms and as long as it isn’t particularly severe or painful I would ride it out and see where it goes. Definitely give the Orthotist or Podiatrist a call or a visit and let them take a look at it though.

      Hope this helps,

      Steve Smith

      • said

        Hi Steve, I had the orthotic checked and the podiatrist tweeked it a bit, I did a 19k run two days after, absolutely no pain. He thought the outside top edge of the orthotic may have been flicking up and causing irriation on the centre part of the outside foot which eventually caused my to complete the run unbalanced by trying to run off it. Thanking you once again for your advice. cheers, have a great Festive Season!

  83. lee said

    Thank you so much for answering me. I was quite concerned. I have had the orthotics for about two months but the last two runs were much much longer than I had run before with them in my shoes. I will call my Podiatrist and have a chat.
    thanking you once again.

  84. ayanda said

    Hello, I spent a month preparing for my 10km race and i extended my distance a bit while training. While doing my hills there was a whole on top of the hill, I entered one foot on the whole while my heel was on the edge I guess I got a strain from there, but it wasn’t painful so I streched. The following week I extended a distance again but my foot was sore everytime I stride especially next to my ankle towards my small toe and below my foot. I stop running for two weeks because I couldn’t even walk properly. I’ve been taking ibrufen and using some heat rub ointment but the pain comes back again, so will I be able to run again?

    • Ayanda,

      It is difficult to tell when you will be able to run from what you have told me here. Do you have any pain when you stand up and put your weight on your foot? You may have a contusion (Bruise) deep the foot that is causing the pain. If this is the case just give it a rest and soak your foot in hot water with Epsom salt. Wear a hard sole shoe, such as Dansko Clogs, that prevent the forefoot from bending to give the area a rest. Diagnosing this type of problem is difficult but you can often tell if you have pain when you carefully apply deep pressure to the bottom of the lateral foot. You may also have a tendon that is sore and if this is the case it will go away in a few weeks. Don’t run on it until you are sure that there is no fracture or bone bruise.

      Dr. Steve Smith

  85. Paige said

    Thank you so much for this information, and for keeping up with responses over a year later! Like so many others, I have a question about my particular problem.

    I’m a 27-year-old group-fitness junkie, and I generally work out at least 6 days per week with high-intensity bootcamp, cardio-kickboxing, and weight training. I started getting pain on the outside of my right foot 2 and a half weeks after badly spraining my left ankle in mid-November (yes you read that correctly – right foot, left ankle – go figure). I was on crutches for 2 weeks, and would often jump on the right foot around the house because it was just more convenient than using crutches when I wasn’t going too far. About 5 days after starting to walk on my left foot again, and 3 days after restarting my workout regimen (I did spin, elliptical and some weight training including squats with some extra weight on my shoulders), the outside of my right foot began to hurt. It worsens with use and improves with rest, which, judging by your article, makes me think that it’s a problem with the peroneus tendon.

    All of my symptoms don’t quite match up, however. For example, pressing on the outside of my foot with my hand didn’t cause any pain at all. I also realized that walking on the ball of my right foot makes the pain go away completely. Doing a full heel-to-toe walking motion, however, would slowly cause considerable pain.

    I had no pain at all for almost 2 weeks, and then it randomly started hurting again when walking about a week ago, but not nearly as bad as the first time. I went back to walking on the ball of my foot (probably not good for my hips), and it seems to be better again. I’ve gone back to more intense cardio-kickboxing workouts, and they don’t cause pain because the workout is almost always on the balls of my feet, and/or the full motion is ball-to-heel, not heel-to ball. So here’s my question: Can I continue my intense workouts if they’re not causing pain when I do them, but then also use ice and NSAIDs? I’m a PhD student, and working out keeps me sane after spending 9-10 hours every day at a computer!

    Again, thanks so much for responding to our questions and concerns – Happy Holidays to you and yours!

  86. Sydnee said

    I have tendonitis on the side of my foot and I was put in a cast and it felt better and then it started hurting again! The doctor gave me inserts for my shoes but they don’t seem to be working! What should I do?

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