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Runners Pain in the Big Toe

Updated on February 1, 2012

Run comfortably

Look after your feet and they will look after you
Look after your feet and they will look after you | Source

A pain in the Big Toe

The runners pain in the Toe……Big Toe

The "metatarsalphalangeal joint " is the first knuckle of the big toe, where the toe joins the foot. This joint is very important for runners. Almost all of the body weight is transferred from the foot to the ground through this toe when pushing off. The faster the pace in running the greater range of motion is all on this joint. Any problems you get with this joint can seriously affect your running if you are not sensible.

If the pain is not caused by a strain through going to far or too fast, too quickly before warming up , or being properly trained for the level of speed there are three other possible causes.

Hallux Valgus commonly known as a bunion


Hallux rigid us ( Arthritis ) or a stiff toe

Athritis can be the cause like an old injury coming back to haunt you, arthritis in any joint is caused by the thinning of the low friction cartilage surface which covers the bones.

Peripheral spurs can form which appear as a thickening of the skin and inflammation can occur in the surrounding area of soft tissue. these are all natures way of protecting the joint in question. These changes contribute to the symptoms of pain and tenderness, stiffness and loss of motion, and warmth and swelling.

If spurs appear on top of the big toe then movement will be reduced which can be a great problem for the elite athlete, but also painful for any runner. Since the speed of running correlates with upward range of motion the limited extension will lead to limited speed.

Before this problem gets out of control with continual beatings there are some steps you can take to avoid full blown injury.

If you are a runner avoid at all costs running uphill for a while. If you are running indoors on a treadmill do not put your machine onto incline. You will read and be told that you need a least incline 2 to resemble outdoor running but big toes don't care about that, they are protecting their joint and they want you to stop doing what you are doing. Pain is the only way to get that message across!. You see, uphill running demands increased toe extension and every time you slam down on the treadmill your toe meets the floor or band first, it pushes off and your whole body weight is slammed through that toe joint. Then when you push off the restricted movement makes you yelp in agony. Now if you are running for a while you might slam that toe down a few hundred times and the fast you go the more often…..get it?

So unfortunately the treatment is slow down and flatten out. If it is not too painful you may get away with training for short distances on a flat surface.

If you have "just" strained the tendon and toe through over use or going too fast too soon!! then a couple of weeks rest/ reduced training should help. To reduce inflammation, ice the area after every run for at least ten minutes and never place the frozen ice bag directly onto your skin.

You might find that your shoes are the cause of the painful toe, some runners find that if they change to a shoe with a more rigid sole they will help splint the joint in a helpful way. The other option is to get custom soles made which are heated up and set in the shape of your foot.

Neither is it uncommon for most runners to experience the black nail syndrome at some time or other. ( I honestly don't know anyone who hasn't ) Because of the constant training and pounding the skin under the big toenail gets bruised and can bleed, in many cases the toenail falls off. Neither is it unusual for runners to lose toenails on several toes. A shoe with a roomy toe box can also help with this problem and double runner socks. When socks have two layers the one layer glides over the other and stops friction. Personally i find these great but cannot use them in the summer as my feet get far too hot.

Gentle stretching can help and this is something you can do even when watching television or sitting at a desk.

If the pain is too great then anti-inflammatory medication might be needed. If the pain persists a visit to your doctor is advisable and there are operations that can help if you are a very serious runner.


Again can be caused by injury or arthritis.

There are two tiny bones that rest beneath the great toe metatarsalphalangeal joint, these are embedded in the tendons that flex the toe (pull the toe down). The pain is on the bottom of the joint and is aggravated when you put your weight onto them.

As with hallux rigidus, uphill running usually makes things worse. to Orthotic treatment can also be helpful. This is special soles where they cut a hole in the insole directly beneath the painful little bones that are no bigger than two little beans. If ice and medication are unsuccessful, occasionally a steroid injection and/or a rest period with casting may be necessary.

Sometimes toe injuries can be greatly helped by the use of Rocktape sports tape and i personally have bought this and used it for many small aches and pains during running and in competition.

The good news is that many people do experience when running at some time and don't have to give up, especially if they have run before and start away again after a few years. Where the mind and the leg muscles are prepared to go the feet say wait until i am ready…………A real pain.

Good luck with your running and don't give up. You are doing your body more good otherwise than not.


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