doing these 2-5mins run cause bad mid foot pain that i need to stop during the run. i’ve tried neutral and stability running shoes, both not helping at all. anybody else experienced this? any advise? thanks in advance!
midfoot pain, W4R3: doing these 2-5mins run... - Couch to 5K
midfoot pain, W4R3
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mariecyd
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YesletsgoAdministrator
The chances are that one of the tendons in your foot is the cause. Which one? The answer is you need to see a doctor or physiotherapist who is the person who can tell you.Feet are incredibly complicated, through running we learn so much about our fascinating bodies... unfortunately this usually happens when something hurts.
Yes I've had a pain like this but it may or may not be the same as yours. A physio recommended exercises to strengthen the arch of my foot and it eventually sorted itself out. Also orthotic insoles but I didn't manage to buy them (downside of living in a small town, few shop).. If the issue hadn't resolved I'd have booked another appointment for more advice.
Do yourself a favour, book a GP appointment. Don't run until then. Take your running shoes with you. Expert advice is the only answer.
Hope you feel better soon.
You've hit the nail on the head in stating that the human foot remains an incredibly complex structure to those who don't understand it.
However, I'm one of few who does. As such, which tendon is the cause of mariecyd's pain? Is it really tendon pain, weakness or overuse? Or has discomfort simply arisen from the fact that mariecyd has been inactive for many years...and she needs to ensure that her body remains fit to run whilst she runs to get fit? 🤔
Orthotics? Whilst they may have worked for you, are hugely over-prescribed for the masses Yesletsgo . Unless need exists to bring floor to the foot, the majority simply do not need them (and I say such as a community working physio).
What we as a culture need to focus upon is improving hip and foot health, due to the epidemic WFH culture that now exists in 2025 💯.
A Physio I may be, in as much as I'm rubbing my hands with glee💷 , I'm also concerned 😬, since patterns of behaviour and method of treatment needed to put such right worries me greatly 😬.
As a species, we've grown weak. Unless 50+ they're really should be no need for you to be considering physio intervention.
Just to clarify, the physio recommended I try orthotics. Thanks to the way the NHS works I was supposed to make a follow up appointment to get further advice but couldn't work out how the booking system worked so turned to Amazon instead. Couldn't find the product I needed online so left it and just did the exercises. I appreciate you correcting me for saying it could be a tendon. You've just 100% proved why it's better to speak to a professional than to take advice from random internet strangers 😁
Hello, mariecyd.
Sorry to learn that midfoot/arch pain currently troubles 😔.
However, you need not suffer. To avoid the dreaded onset of PHP (plantar heel pain) that may arise through midfoot weakness, perform the following:
1) Calf raises with toes upon a rolled up towel (placement of toes in extension activates the plantar fascia).
2) Calf raises gripping a tennis ball beneath medial malleoli (gripping action of tennis ball activates and strengthens the post-tib).
3) Iso contraction to activate the foot core (lift and press toes into the floor, encouraging contraction of intrinsic foot muscles).
Granted, these are the basics/fundamentals of foot health. Once perfected, however, we can then talk about banded resistance toe extension exercises and continued progressive overload of the 👣🤗.
Thanks for this... but if there is no respite form the pain, when running begins again, after this kind of exercise regime, would it be sensible maybe to go and see the GP?
Absolutely!! If NSAIDs, alteration in training load and rest fail to resolve pain/discomfort within 4 weeks, it's considered chronic. Therefore, a GP consult or similar (preferably biomechanical) is always advisable.
Sharing structural similarity (to tendon tissue), the past 10 years have seen PF/PHP viewed as a degenerative condition rather than inflammatory, so early assessment/intervention is needed to prevent the PF moving from a reactive state to one of the disrepair or degeneration - as is the case with tendinopathic tissue.
Once disrepair or degeneration occur, while some functionality can be restored, chance of a return to a completely uninjured state remains unlikely, due to presence of mucoid degeneration (death of once healthy tissue), loss of mature type I collagen and resulting change in the extra cellular matrix of the PF.
However, since disrepair/degeneration isn't present within the tendon as a whole, all is not lost. Regardless of the latter stage, tendon/ligamentous still healthy tissue has been shown to respond favourably to gradual overload through isometric, isotonic and increased energy loading/storage before an eventual return to running, thus, breaking cycle of injury through improved capacity to tolerate load.
What I'm saying is if degeneration is present (goes away and then comes back), when it comes to stages of energy loading (plyometrics) and an eventual return, plyometrics may simply require adaptation (so not as to excessively overload a tendon in disrepair/degeneration) and that running expectations may require revision (reduced weekly running miles/longer rest periods/increased focus on increasing tensile strength.
However, since the same remains true for elite athletes, the latter really does rely upon the individual having an honest conversation with themselves and setting realistic goals over what they may be able to accomplish.
In doing so, behavioural control is more likely to be maintained post-injury, with sense of control (I'm aware of what my body is currently capable of) forming their intentions (I mustn't overdo it) and continued behaviour (I'm running regularly again. Not as far or fast as I'd like, but I'm still running).
A year ago I was diagnosed with anterior tibial tendinopathy by a podiatrist and later, a physiotherapist. This caused sharp pain on the top of my foot towards the ankle when putting weight on the foot and especially when running. They prescribed exercises similar to the ones you suggested but although the condition improved somewhat with rest, as soon as I return to running, the problem comes back and so reluctantly, I have had to make the decision to give up. I really miss it and just wondered if you have any further suggestions which might enable me to run/ jog again please? Many thanks in anticipation!
Hello Upsidaisy.
Was the mechanism of ant tib tendinopathy considered to be foot/calf weakness and that's why exercises similar to those above were recommended?
Furthermore, was an assessment of existing foot posture conducted, to assess how feet presented during static load bearing and how they behaved when walking and running?
What about the ant tib itself?
Was ankle DF/PF RoM and resisted strength assessed and were exercises prescribed to improve?
If not, do look into band resisted ankle DF/PF exercises (not neglecting band resisted ankle inversion/eversion) and also consider ant tib raises against a wall:
youtube.com/watch?v=VzIcGAg...
Too difficult? Try regressions to help develop tensile strength.
youtube.com/watch?v=UUVq8fE...
youtube.com/watch?v=A2s7_mH...
What about developing and improving ankle stability and stored energy capacity (plyometrics) within the ant tib needed for running, such as penguin marches, ankle dances and bi/unilateral pogo hops for example?
youtube.com/watch?v=eInM5IB...
youtube.com/watch?v=7WrhRDJ...
youtube.com/watch?v=Uo7xSkV...
Additionally, see recent post by CBDB over on the strength and flex forum with links to exercises aimed towards improving foot/ankle strength and stability.
Hope some of the above helps 💪🦶🤗
Huge thanks to you MrNiceGuy!
I am so grateful to you for taking the time to look at my problem in such detail and for providing all of the links to exercises which I am sure will make a difference, and hopefully might make it possible for me to return to running in the future.
Neither of the professionals I saw carried out the assessments you mention to the best of my knowledge. The podiatrist gave me orthotics for arch support and told me not to run for two weeks, and the physiotherapist asked me about the pain, printed off some exercises and advised me to take up swimming or cycling instead of jogging. When I saw him on another occasion about lateral hip pain, (greater trochanteric pain syndrome) he did say that I have tight hamstrings, so maybe that is part of the problem.
Thank you again for your splendid advice, and for giving me hope that in time I might be able to take up running/ jogging again. 👟🏃♀️😊
Good evening, Upsidaisy.
You're incredibly welcome. Hopefully, you find some of the exercises useful in facilitating an eventual return to regular running 🤞.
Some time ago now, I suppose it's probably difficult to recall what was discussed with both pod and physio. However, orthotic provision with arch support by pod possibly suggests some assessment of foot posture (to correct static pronation?) The 'couldn't care less' attitude of physio in helping you to manage your tendinopathy, however, leaves me somewhat saddened 😔.
As for greater trochanteric pain, it's possible that tight/weak hamstrings may have contributed, resulting in overuse of gluteal muscles and tendons. Equally, weakness of glute med, for example, may have resulted in over activity and tightness of hamstrings. It'd be interesting to know if physio performed resisted knee flexion and hip abduction tests as a potential indicator.
Did treatment/exercises resolve the issue or does such still trouble too? Furthermore, was pelvic position assessed?
Anterior pelvic tilt, for example, causes lengthening of hamstrings and may increase internal tibial rotation and knee valgus, particularly if medial foot arch is flat/collapsed too.
This means the tibial bone cannot internally rotate as it ought to during the mid-stance/shock absorption phase of the running gait cycle as it's already internally rotated, causing mid portion of the ant tib to absorb downward vertical and upward ground reaction forces rather than plantar fascia, which remains in a constantly elongated state (due to flattened arch and permanently internally rotated tibial bone).
Similarly, if medial arch is high/rigid, impaired ability of the tibial bone to sufficiently internally rotate prevents the foot from flattening (pronation). As such, the PF cannot perform its role as a shock absorber since foot remains in a position of supination, therefore, tendon insertion portion of the ant tib is likely absorbing the dissipation of downward vertical/upward GRF.
If you wish, let me know which of the two scenarios remains most applicable to your foot morphology/posture and I'll provide you with more specific foot and ankle exercise/mobilisation strategies to reduce unnecessary loading of your ant tib and provide it with the opportunity to heal so that you can return to running.
For now, I hope the above provides greater insight into the possible mechanism(s) of injury and how to (hopefully) break the cycle 🤞🦶🏃♀️
I'm not a fan of orthotics myself, having worn them for the best part of 30 years before finding an alternative that worked better for me. Podiatrists have had a habit of trying to immobilise the foot to fix it, whereas for me the fix has been to get the foot to do some work.
Of course this might not work for everyone, but if the same approach was taken to hands, you'd be wearing a stiff pair of boxing gloves most of your waking hours.
Good evening MrNiceGuy
Many thanks for your continued interest in my musculoskeletal issues and for taking the time to try to get to the root of my problems. I have to say, you certainly know your stuff and I really appreciate your detailed feedback!
I do still suffer from GTPS, but not all the time thankfully. Unfortunately I can’t recall the exact assessments that were performed during my visit to the physio; possibly the resisted knee flexion was included but I don’t think the hip abduction test was a feature and certainly there was no pelvic assessment.
However, I am certain that I have anterior pelvic tilt and low arches. It was fascinating to learn how this combination can result in the problems you have outlined and I would be very grateful indeed to have access to the exercises you mention to reduce unnecessary loading of the ant tib and hopefully allowing it to heal, with the hope that I might be able to return to running with its many benefits.
Thank you once again for your time and expertise, it is greatly appreciated. 🤗👌🏻🏃🏽♀️➡️
Good afternoon, Upsidaisy.
Once again, you're incredibly welcome.
As RRMI's really do have a detrimental impact on both physical and psychological health, I guess I'm simply passionate about assisting others in allowing them to greater understand mechanism(s) of injury, while adopting a patient/client centred approach by involving them in the management of their injury so that they can return to chosen fitness/sporting activity at the earliest opportunity.
I'm glad to hear that GTPS doesn't trouble as severely as it did, nor would I expect you to fully recall exact assessments performed. However, it's saddening to learn that a postural assessment wasn't performed given the increasingly accepted link between impaired biomechanics and higher risk of injury.
While anterior pelvic tilt on its own isn't necessarily indicative of increased injury risk, if degree of APT is affecting behaviour of the foot, then it's probably best to address it.
Hopefully, the following will further create understanding and provide meaningful relief as you adopt a top down/bottom up approach towards biomechanical improvement at both hip and foot:
Pelvic position: youtube.com/watch?v=AehNg7E...
Although only 20s long, Rachel provides a beautiful demonstration of how a pelvis stuck in anterior tilt creates inward rotation of the tibia and pronation of the foot, as centre of knee cap is positioned in line with big toes, creating knee valgus.
The goal of her postural awareness demo is to find the mid-point between extremes of pronation and supination so that talus bone in foot sits in neutral and centre of knee is lined up over 2nd/3rd toes to switch the glutes on.
Anterior Pelvic tilt correction: youtube.com/watch?v=ELOP2n0...
Although biased towards the PSOAS muscle, the second video by Conor Harris demonstrates how a tight PSOAS can pull the pelvis into anterior tilt, creating the movement demonstrated by Rachel, whilst also providing exercises to help restore neutral position/reduce rotation of pelvis to improve joint stacking from the foot upwards towards diaphragm, thus, reducing lumbar extension and associated rib-flare.
Posterior tib calf raise: youtube.com/watch?v=IjoSXiL...
Chiefly inserting into the navicular, commonly referred to as the keystone of the medial foot arch, the final video focuses upon strengthening the post tib to improve/maintain its structural integrity. As the ant-tib chiefly inserts into the neighbouring medial cuneiform bone (towards the toes), increasing tensile strength of the post tib (placement of tennis ball behind ankles ensures PT engagement throughout), pulls the navicular back towards its anatomically correct position, reducing stress upon the anterior tib too.
Since natural arch height and foot volume is largely governed by genetics, however, the post tib exercise isn't going to dramatically create a high arched foot from one that's flat. However, as stated above, by increasing tensile strength of the PT, you may observe an increase in arch height lost through muscle/ joint laxity and gradual aesthetic improvement of feet as anatomically correct position of bones is restored.
Lots of information to digest again, but I hope you find some of it useful 💪🏃♀️🦵👍
Once again, many thanks for your time and for this fascinating insight into how problems in different areas can impact function in others.
I will make sure I practise these exercises regularly and hopefully, I will begin to see improvements over time. I’ll look forward to donning my running shoes in the not to distant future and when I do, I’ll take it slowly and listen to my body.
Best wishes and thank you so much for all your help and advice and for sharing your expertise 😊🏃🏽♀️➡️
My pleasure, Upsidaisy.
Since knowledge is indeed power, armed with new information and an array of new exercises which I hope will prove far more conducive to recovery than Physiotools print outs perhaps so far received, I wish you the very best in your determination to once again lace up the trainers and head out the door in the not too distant future.
As a general rule, once ankles remain able to handle plyometric exercises without discomfort, a slow and cautious return to running can be made. Don't rush to get there, though. Remain consistent with the isometric, isotonic and posture improvement exercises, since they are the ones that'll allow ant tib to once again handle dynamic loads.
Since core strength remains important too (last exercise...I promise 😅), rather than struggling with crunches, Russian twists or plank variations, due to the excessive intra-abdominal that each creates (common if unresolved diastasis recti exists), consider the dead bug instead:
youtube.com/watch?v=mCSUBup...
The advantage of the dead bug is that it largely replicates the movement performed by arms and legs when running. Furthermore, reciprocal movement of arms and legs not only improves coordination and rotational core strength (as the oblique sling is activated), the DB exercise improves the ability to resist the same rotational forces that may result in LBP as it engages the transverse abdominus and obliques while arms and legs move reciprocally.
Over a mere 6 week period, the DB exercise proved significantly more effective than the traditional crunch in improving core strength, endurance and rotational core control in untrained adults:
DOI: 10.4103/NJM.NJM_85_20.
Too uncomfortable to lie on the floor? 🤔 As one accustomed to helping individuals regain their sitting balance and core control after a long time 'spent off legs', the DB can also be performed upon the bed 😉. As such, simply consider such a lazy, yet functional, start to your day 😁.
Fantastic!
Thank you so much MrNiceGuy, I will be sure to follow all of your excellent advice. I’ll look forward to trying the dead bug, ( a completely new one to me!) as well as all of the other exercises you have so kindly passed on.
I really am so very grateful to you for giving me a much better understanding of what has led to my problem and the best way to move forward, as well as great optimism that I will indeed lace up those running shoes once more! 😊🏃🏽♀️➡️👍
Kind regards and very best wishes
T2runnerGraduate
I have suffered with Plantar Fascilitas in the past, really painful and took ages to recover. I do calve stretching regularly as well as other stretched and movements, I even purchased a boot to go on my leg and foot when in bed to stop the foot from naturally pointing down, increasing the angle over time, this 'cured' me but that was diagnosed by my doctor. Like anything, get medical advice there should be an improvement that will work for you, Once you can get a prognosis of the issue you can look for the answers. Good luck.
I had similar situation with my knee. Unfortunately I had to seek medical attention. I'm resting my knee for at least 4 weeks. But will be back jogging as soon as I recovered.
drl212Graduate
I think it’s really important for you to have this checked out by your health provider whether that’s GP or physio.
Don’t want to re-injure chronically.
I’m struggling with a bit of metatarsalgia and my physio is sending me to podiatry…
Let us know how you make out!
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