Why Does the Top of My Foot Hurt and How Do I Ease the Pain?

During the first year of the COVID-19 pandemic, I noticed something at work. I was completing a lot of assessments for people who had recently developed pain on the top of their feet. I also noticed a trend among these people. Many of them had recently gotten dogs (ie. COVID puppies) and experienced a rapid increase in how much walking they were doing. While it is not a common injury, top-of-foot pain can be quite painful and debilitating!

This is because the bones, muscles, ligaments and tendons of our feet have to carry our weight all day long. If we overload these areas it can lead to pain.

For many, the pain on the top of the foot acts up while they walk, run, or even stand for long periods of time. Other symptoms that typically go along with the pain include tenderness to touch, swelling, inflammation, and bruising.

But is this serious?

Most often resting from walking or running will reduce the pain. Additionally ice, compression and elevation can be helpful. However if you try these techniques and it doesn’t help, you might consider visiting a physiotherapy to get an assessment and a personalized treatment plan. In this article we will discuss the different causes of top-of-foot pain and common ways to treat it.

What is it caused by?

If you experience pain on the top of your foot, it is important to know that it can be caused by different conditions. The most common one is an overuse injury like you would experience in kicking, jumping, or running sports.

Conditions that can occur from overuse include:

Extensor Tendonitis

This an irritation of the muscles which dorsiflex (bring the foot towards the shin) our ankle. These muscles run down the front of your shin and end on the top of the foot and toes. When these muscles become overworked (eg. like with too much walking), the tendons can become inflamed or irritated, leading to pain. Additionally, poor footwear may be involved with extensor tendonitis. Shoes that are too loose or tight can place more strain on the tendons, amplifying the pain.

Stress Fracture

Stress fractures occur when a small crack forms in one of our bones over time. Stress fractures can occur in the tarsal or metatarsal bones which make up our foot.

These injuries are much more common in elite athletes who place very high amounts of repetitive load on their feet with their sport. Additionally, stress fractures are more common in females and thinner individuals. Typically, people with a stress fracture will only experience pain during their sport, and then pain will subside at rest. They may also experience swelling and tenderness on the top of the foot.

Modifiable factors such as muscle weakness and tightness and mechanics during your activity can increase risk of sustaining a stress fracture. A physiotherapist can help you identify and improve these factors to reduce the risk or to help improve an ongoing stress fracture.

In the early stages of recovery from a stress fracture, you doctor may recommend you use crutches on a temporary basis to allow for healing.

Bon Spurs

These are hard and smooth bumps of extra bone that can form on the ends of bones. They often occur at the joint where two bones meet. Bone spurs can develop in the hands, knees, hips, spine, shoulders, neck and feet.

The majority bone spurs don’t cause pain and are incidental in finding. However, if severe enough you might experience stiffness, numbness, and pain.

Plantar Fasciitis courtesy of Physiomobility (Read the caption)

View this post on Instagram

A post shared by Physiomobility Health Group (@physiomobility)

How is the pain diagnosed?

If you have foot pain that persists ever after resting, icing and elevating the foot, then you should consider making an appointment with a Physiotherapist.

During your initial appointment they will ask you some questions and get a full history of your symptoms.

Then they will complete a physical examination of your foot. They may ask you to perform certain movements so they can identify where the root of your pain is. For example, to test for extensor tendonitis they might ask you to pull your toes and ankle upwards and have you resist manual force to see if it elicits your pain. They may also press on different areas of the foot to see where the pain is coming from. Finally, they might assess lower body muscle strength and flexibility to determine which exercises they will prescribe to reduce your pain.

Few tips for those who stand all day courtesy of National Spine Care and Sports Medicine (Read the caption)

View this post on Instagram

A post shared by National Spine Care (@nationalspinecare)

How is it treated?

Once your physiotherapist has identified the cause of your condition, treatment can include:.

Hands-on therapy to reduce pain, and improve foot mobility and strength
An exercise program to address foot and lower body strength and flexibility
Education on proper footwear or a recommendation of an orthotic/foot insert to cushion the top of your foot.

If you’re concerned about your foot pain, then book an appointment with one of our Physiotherapists on this page. We have Physiotherapists all over Canada!

Narrow footwear courtesy of Physiomobility (Read the caption)

View this post on Instagram

A post shared by Physiomobility Health Group (@physiomobility)

Book Your BACK NECK SHOULDER KNEE ELBOW HIP WRIST FOOT Pain Consult

This appointment is your opportunity to tell us what hurts and discover whether physiotherapy or chiropractic care is a good fit for you! During this session, you will talk with a physiotherapist or chiropractor on a phone call (or online) and create the right care plan specifically for your pain. There is no obligation on this session is to find out whether physiotherapy or chiropractic care can help you getting back to doing the things you love in life.

Frequently Asked Questions

What does foot tendonitis feel like?

Symptoms include tenderness, pain, and soreness around and on top of the ankle.

What does arthritis in the foot feel like?

You may experience joint stiffness, pain when you move your foot, and difficulty walking or putting weight on it. Additionally you may feel worse in the morning or after you’ve kept your foot stationary for a prolonged time.

Why do toes bend with age?

Toes may bend inwards or downwards with age due to arthritis and age-related changes in the toe joints

About Taylor Sipos

Taylor is a physiotherapist at The Orthopaedic Therapy Clinic located in Toronto, Ontario. He treats patients with various musculoskeletal conditions using patient education, exercise therapy, manual therapy and acupuncture. His treatment philosophy involves giving his patient’s the means to self-manage their injuries. He does this through reassurance, education and health promotion. Taylor uses the same principles as a patient educator at Pain Hero. He aims to provide you with high-quality, easy to understand information to teach you about your condition and how to improve it.

Medical Disclaimer:

The information presented in this blog post is for educational purposes and should not be interpreted as medical advice. If you are seeking medical advice, treatment or a diagnosis, consult with a medical professional such as one suggested on this website. The Clinic Accelerator Inc. and the author of this page are not liable for the associated risks of using or acting upon the information contained in this article.

Why Does the Top of My Foot Hurt and How Do I Ease the Pain?