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BIG TOE PAIN AFTER RUNNING:
HOW THIS HAPPENS AND WHAT TO DO

big toe pain after a run

We all know flat feet, plantar fasciitis, and arthritis (to name a few) can cause major foot pain. But you can also experience isolated pain in just your big toe. Whether this is a common occurrence for you, or something you’ve yet to deal with, it’s certainly no fun to be had.

But all is not lost! Fortunately, there are many steps you can take in order to tackle this kind of pain, like incorporating recovery shoes into your rotation. Even simply giving your toe a break with some R&R can help immensely.

In this article, we’ll go over why big toe pain arises in the first place, and what you can do about it.

Why does my big toe hurt from running?

You’ve seen it in cartoons. The comic relief of one character chasing another, and then - ouch! - they stub their toe in the process, causing it to become red and throbbing. In real life, this would not be such a funny situation. But aside from stubbing one’s toe, we might wonder what else causes big toe pain, and why it happens so commonly from running?

Let’s break down what happens to your foot when you run so we can visualize the impact as a whole. Think of this as a slow motion stride by stride.

  1. Inversion angle: As a runner’s heel strikes the ground, they tend to make contact around the outer portion of their heel, causing a rotation of the foot. Preparing for shock absorption, this is called supination.
  2. Eversion angle: A runner’s foot then loosens up at mid-stance as the arch stabilizes the body on the ground, referred to as pronation.  
  3. Inversion angle: Locking into shock absorption mode (supination) once again, your body is then propelled forward. 

Easy as 1-2-3, right? Not quite. This is a lot of weight and duty each foot is taking on, and your big toe has great responsibility here. Strike after strike, your big toe’s primary joint (aka the metatarsophalangeal, or MTP) is repeatedly subjected to impact. Plus, your toe is under serious pressure to keep you stable as you take flight and sustain your run. 

Inner workings of the big toe

Also known as the great toe, your big toe is a complex, heavyweight champ. Your big toe has to contend with impact while walking and, particularly, while running, since our bodies are gigantic in comparison. In addition to ligaments, tendons, and muscles, your big toe is also made up of one essential joint and two tiny connecting bones that work together.

  • First metatarsophalangeal (MTP) joint: the big toe joint formed by two bones.
  • Sesamoid bones: two small bones underneath the MTP joint that help to increase its mechanical leverage.

The sesamoid bones work in a pulley-like manner, alleviating stress placed on the big toe’s muscles and tendons. Though the MTP and sesamoid bones aid in the mechanics of your big toe, they are nevertheless vulnerable to overuse injuries. 

Why your big toe hurts during and after running

There are many common causes of big toe pain that occur both during and after running, which we’ll cover below:  

Sesamoiditis

This condition occurs when the sesamoid bones are inflamed. When this happens, pain is felt underneath your MTP joint, particularly when pressure is placed upon it. Without proper support, the pain can worsen (i.e. wearing improper footwear or walking barefoot.) 

Sesamoid stress fracture

Severe pain underneath your big toe joint, felt especially while running, is often a symptom of a stress fracture (tiny cracks in the bone) in the immediate area. Sesamoid stress fractures are an overuse injury that will usually take longer to heal than sesamoiditis, and immobilizing the foot is often necessary.

Bunions

The medical term for bunion is hallux valgus, which is when a bump forms on the side of the foot at the base of the big toe. The big toe is drawn inwards towards the smaller toes in an unnatural positioning. This type of foot deformity occurs when some of the bones in the front of your foot become displaced, altering the foot’s natural alignment. Bunions will cause your foot to actually become wider. 

Big toe pain is commonly felt in those with bunions, especially while running, as the MTP joint is subjected to constant friction at the running shoe’s toe box. If wearing ill-fitting shoes, namely footwear that is far too tight, bunions can worsen and become more sore.

Tight shoes put undue pressure around all of the toes and the side sections of the foot. When the big toe joint is in this kind of binding, it can begin to taper in—permanently. Getting ahead of this by choosing proper footwear makes a big difference, as the only lasting correction of a bunion misalignment is surgery (should this be required for more severe cases.) 

Gout

When the body overproduces uric acid, crystals can accumulate in a joint, causing this condition. Gout often affects the big toe joint, and can be worsened by habits or activities that cause inflammation like drinking, or running. Running naturally puts pressure on the joint, and someone with gout may have extra toe pain after running.

Turf toe

Turf toe can occur while playing a variety of sports or engaging in high-impact activities, including running. When the MTP is bent into hyperextension, your toe tip points too far upwards. Sudden extension of your big toe and hard, repeated push-offs can equally cause this spraining of ligaments. 

In these circumstances, your big toe will often swell, bruise and create pain while running, or even walking. Your ligaments will need time to heal after this kind of injury, so you’ll need to keep off running for some time.

Hallux rigidus

This condition, referred to as stiff toe, is most common among older aged runners. It is a form of arthritis that affects the MTP joint and is a degenerative condition, thus worsening over time. Through the wear and tear of the cartilage in your joint, your big toe joint will become stiff and painful. 

While running, this type of pain can be particularly felt at push-off, but also throughout the run and even afterwards. Wearing improper or worn out running shoes will cause this condition to flare up. 

Hallux limitus

The latin term ‘limitus’ will naturally make you think of something being reduced or restricted, which is precisely what this condition does. Hallux limitus refers to your big toe having a limited range of motion. There are two types of hallux limitus:

  • Structural hallux limitus: A result of the degeneration of the MTP joint
  • Functional hallux limitus: Limited MTP movement when enduring weight bearing, this type is caused by a physical blocker versus degeneration

How runners prevent & treat big toe pain 

It’s time to get healing! Here are some treatments and preventative measures that can be taken to help you alleviate big toe pain running:

Wear recovery footwear

A great addition to your round up is to grab some recovery footwear. Active recovery shoes are made to help your feet restore and renew after long days of walking, running, standing or other activities. You’ll want to ensure your recovery footwear of choice has solid traction, cushioning, flexibility and support.

Test out orthotics

These specialty running shoe inserts can help alleviate and support instances of overpronation, which occurs when the ankle rolls downward and inward unnaturally with each step. This can eventually lead to too much pressure on the big toe.

When extra pressure is placed on your big toe, you can experience pain while running, which often lingers even afterwards. This would be a moment to seek out the advice of a podiatrist (foot specialist) for orthotics, or even try OTC insoles to see if they help. 

Try RICE 

The trusty rest, ice, compression and elevation treatment is a surefire way to ease pain and inflammation quite quickly. This may not completely cure your big toe pain, given the many potential causes and whether it’s short-term or long-term in your case, but this will certainly give your toe some much needed relief!

Cross-train

Incorporating low-impact activities into your routine is a great way to keep active while taking the pressure off your big toe for the time being. Swimming, as an example, is always a healthy option as it is extremely gentle on joints, while still facilitating a solid workout. 

Replace your running shoes

Got ratty runners? It’s likely high time for a replacement. Aesthetics aside, these worn out, old shoes are not going to do the trick any longer. In fact, they’ll start to work against you. 

Without the proper support needed for your runs, you will exacerbate (or even cause) toe pain and other foot ailments. When it comes to bunions especially, go for shoes that have wider toe box options. Your local running shoe store or online footwear company will have what you need.

Stretch your calves

Did you know having tight calves can actually be linked to bunions? If your calves are tight, you’re limited in your ability to flex your foot upwards. This means you're more likely to land on your forefoot, adding extra stress to your big toe. Stretching your calves out with various stretching and strengthening exercises can help immensely. Just keep consistent!

Contact a doctor 

With any kind of persistent or severe foot pain, which may include big toe injuries, or other foot injuries, be sure to contact a medic or physical therapist for next steps. This is particularly crucial if you’ve attempted at-home remedies that aren’t at all effective in the timeframe of about a week or so.
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