Causes of Toe Inflammation and Pain in Runners

Injury is a really hot topic among runners. For example, heel strike runners may have a higher risk of toe inflammation and pain because of the way they use their toes during the propulsive phase of running gait.

Toe Inflammation and Pain
Toe flexors may become strained during push-off phase in heel strike running.

Causes of Toe Inflammation and Pain in Runners

Heel strike runners may experience top of foot pain, or localized swelling over the metatarsal heads and toes because of excessive toe strain at toe push-off.

  • After heel contact, the foot rolls heel-to-toe, followed by toe-propulsion, that is the toes propel the entire mass of the body forward to initiate flight.

Toe-propulsion increases bending moments on the toes and plantar pressure in the forefoot, thereby straining the metatarsals heads.

  • toe-propulsion was found to increase dorsal bending moments and dorsal compression strains

No Toe-Propulsion in Forefoot Running

Forefoot running does not use toe-propulsion to initiate flight, rather the combination of tilting forward and quick removal of the stance leg.

  • forward momentum is gained in forefoot running by bending the knee upon foot strike. By nature, this action allows the lower leg to behave like a spring which helps draw the stance leg up from the ground with greater ease, thereby reducing forefoot loading
  • forefoot runners also shift their upper-body weight forward which enhances propulsion

Spring compression in forefoot running adds more ‘boing’ to each step, transforming your legs into pogo-sticks. Therefore, spring compression in forefoot running reduces bending moments and plantar loads in the forefoot as the leg, as a whole, removes the foot from the ground.

Toe Strain from Cushioned Running Shoes

Cushioned running shoes are not effective at reducing forefoot bending moments at toe push–off. Why? Because high bending moments is simply a by-product of heel strike running mechanics.

To reduce forefoot bending moments, modify your foot strike to a forefoot strike to reduce the degree of toe push-off.

To prevent toe strain when running, bend your knees more and relax your foot, especially at foot strike, never lift your toes up, just let your forefoot fall to the ground.  This action creates the spring-like conditions that may reduce toe stain, and top of  foot pain.

To propel forward, let the spring-like sensation of the leg remove your foot from the ground rather than launching your body forward with your toes.

Here are Other Injuries Linked to Heel Strike Running:


Goldman, JP., Potthast, W., and Gert, P. 2012. Athletic training in minimalist footwear strengthens toe flexors. Footwear Science, 5(1):19,25.

Run forefoot, because you are faster than you think!

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!

2 Trackbacks / Pingbacks

  1. Top of foot pain in heel strikers due to excessive toe strain during toe push-of… –
  2. Top of foot pain in heel strikers due to excessive toe strain during toe push-of… – puntoprecisoapp

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.