Midfoot injuries related to running are unfortunately common. Many midfoot injuries start out as nagging pain that occurs as you run but go away when you rest. If you experience consistent midfoot pain when running, consult a doctor to gain a proper diagnosis -- especially if your pain gets continually worse.
Metatarsal Fracture
Stress fractures in the metatarsal bones, which are the long bones in your forefoot, are common among runners. The second, third and fourth are most commonly injured. The most evident symptom will be pain that gradually worsens in the top of your foot. You may feel it only when running initially, but if you don't treat it, you'll have pain with daily activities. Swelling may occur, and there may be pain when you touch the affected area. Treatment usually includes taking a break from running for about four weeks. If you have pain with daily activity, you may need a walking boot or crutches. Follow your doctor's guidance for returning to running.
Navicular Fracture
Stress fractures in the navicular bone, which runs along the inside of your midfoot, are less common but more serious than metatarsal bone fractures. You will initially feel midfoot pain while running, which will fade when you rest. However, the pain will come on earlier if you go without treating the condition and will take longer to recede. Your doctor is likely to put you in a cast and restrict weight-bearing activities if you suffer this injury, says Dr. C. David Geier Jr. of Charleston, South Carolina.
Lisfranc Fracture-dislocation
Your pain may be due to a Lisfranc fracture-dislocation. The Lisfranc is at your midfoot, where a cluster of small bones creates an arch on the top of your foot. Your metatarsals extend to your toes from this cluster. These bones are held in place by ligaments, which stretch both down and across your foot. However, no ligaments hold your first metatarsal to your second metatarsal. A foot twist, such as when you accidentally step in a hole on a run, may dislocate these bones. Moving your foot in a circle is painful if you have a Lisfranc injury. Treatment ranges from wearing a cast and keeping weight off your foot to surgery.
Plantar Fasciitis
Plantar fasciitis may cause tenderness in your midfoot area, though pain is more common near your heel. Your plantar fascia is a thick tissue band that connects your heel bone to your toes. Plantar fasciitis is common among runners, particularly women. You are likely to feel pain first thing in the morning or when you stand after sitting for a prolonged period of time. You also may feel pain after running. Rest, ice, nonsteroidal anti-inflammatory medicine, physical therapy and stretching are common treatments.
Shoe Issues
Your running shoes may be responsible for your midfoot pain. For example, small plastic brackets used to reinforce your shoe's midsole may hit you directly underneath one of your metatarsal bones. Investigate this if you feel pain partway through your run that goes away afterward. Even tiny jabs like those from a shoe bracket can bring on pain -- especially after the approximately 1,100 landings you make during a two-mile run, says J.D. Denton, author of the article, "Shoeguy: Midfoot Mayhem," featured in the April 2008 edition of Running Time magazine.
References
- "Running Times": Shoeguy -- Midfoot Mayhem; J. D. Denton; April 2008
- "Baxter's Foot and Ankle in Sport"; David A. Porter and Lew C. Schon; 2008
- Sports Injury Clinic: Metatarsal Fractures
- Children's Memorial Hospital Institute for Sports Medicine: Metatarsal Stress Fracture
- Dr. David Geier: Navicular Stress Fracture
- American Academy of Orthopaedic Surgeons: Lisfranc Fracture
