Avoiding Metatarsal Phalangeal Joint Pain When Forefoot Running

In forefoot running, we strike the ground on the balls of the foot,  just under the toes, but we don’t push off with them. If you were a heel strike runner, you’ll know that toe-pushing is required for propulsion. But, I’d like to mention that in forefoot running, we don’t use the toes as much for propulsion. The biggest problem with toe-pressing on the ground is that fully propelling your body with your toes to initiate flight during running results in metatarsal phalangeal joint pain.

Metatarsal Phalangeal Joint Pain

Avoiding Metatarsal Phalangeal Joint Pain When Forefoot Running

A study by Rodeo et al. 1990 found that metatarsal phalangeal joint pain was common in runners who showed hyper-dorsiflexion of the toes during the end of the stance phase of running gait. This causes flexion angles of the big toe to go beyond its bending resistance, thereby increasing external load on the area, suggesting an inherent link between MTP joint pain and pressing too hard with the toes on the ground for propulsion during running. And, who knows, this load could pass through the foot into the lower leg, causing shin splints or even tibial stress fractures, so hyper-dorsiflexion of the toes should not be limited in causing phalangeal joint pain in runners.

Indeed, you must learn to stop forcefully pressing your toes on the ground to move you forward. I like Pose Running Method’s alternative to toe-pushing in that they recommend pulling your foot up, not pushing. You can read more on how it’s done here.

More Forefoot Running Tips:

How to Swing Your Arms

Proper Forefoot Running Footwear

How to Run Barefoot

Where to Look When Running?


Crandell at el. Forefoot bending stiffness of cleated American football shoes. Footwear Sci, 2015; 7(3):139-148.

Rodeo, S.A., O’Brien, S., Warren, R.F., Barnes, R., Wickiewicz, T.L., & Dillingham, M.F. (1990). Turf-toe: An analysis of metatarsophalangeal joint sprains in professional football players. American Journal of Sports Medicine, 18, 280  285.

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!