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Foot Pain When Running: Hammer Toes, Ball-of-Foot Pain, and Top-of-Foot Pain Explained

Press on the painful spot: a toe that curls and will not straighten is a hammer toe, pain under your second, third or fourth toe is pain under the ball of the foot (metatarsalgia), and pain along the top of the foot, often under the laces, is top-of-foot pain. This page covers those three, not heel pain, plantar fasciitis or black toenails, which have their own pages. Below: a quick answer to tell them apart, a section on each problem, the red flags that need a podiatrist (a foot specialist), and common questions.

Your feet strike the ground close to 800 times every mile, each time with two to three times your bodyweight, so something is going to complain eventually. I coach runners through foot niggles most weeks, and the ones written off as just tight laces are the ones that now and then turn out to be something more.

Quick Answer: What Kind of Foot Pain Is This?

Press on the painful spot and ask where it is. A curled toe that won't straighten is a hammer toe. Pain under your second, third or fourth toe when you press there is pain under the ball of your foot. Pain along the top of your foot, especially under the laces, is top-of-foot pain — see the differential below. Heel pain, plantar fasciitis and black toenails aren't covered on this page — see heel pain and plantar fasciitis and black toenail instead.

In my coaching groups, pain under the ball of the foot is the one I see most often, with hammer toes a close second. Top-of-foot pain gets less attention than it deserves — runners tend to write it off as "just tight laces" when, once in a while, it's something more.

Hammer Toes: The Toe That Won't Straighten

So, what's a hammer toe? When one of your toes won't straighten — even when you consciously try to force it — that's a hammer toe. Any toe can be affected except your big toe.

You'll usually notice a corn forming on top of the affected toe first, and that corn is what actually makes running uncomfortable, not the bent toe itself. The cause is almost always your shoes: a toe-box that's too narrow or too short forces your toes into a curled position for hours at a time. Keep that up for long enough in shoes that don't fit, and the tendons along the underside of the toe shorten to match — which is why the toe stops straightening even when you're barefoot.

The fix is straightforward, if not always convenient. Refit into shoes with a genuinely roomier toe box — for your everyday shoes and not just your running shoes. A specialist running shoe store can check this properly rather than you guessing at it. Pain that persists despite refitting is worth a podiatrist's opinion rather than pushing through it.

Pain Under the Three Little Toes (Metatarsalgia)

Press your fingers into the area between the ball of your foot and your toes. If that spot is tender, you're dealing with pain under the three little toes — the second, third and fourth. The clinical name for this is metatarsalgia, and it's caused by a small cushion in your foot called the bursa becoming irritated from repeated pounding — bursitis, in other words.

Relief is fairly quick to find. Press your toes backwards until you locate the exact painful spot, then tape a metatarsal pad directly behind it — not under it — so the pad takes the pounding instead of the tender area itself.

Padding treats the symptom, though, not the cause. This kind of pain is usually a sign of an imbalance in your foot that your current shoes aren't correcting, or running shoes that have simply done too many miles and lost their cushioning. If a specialist shoe store can't sort you out easily, a podiatrist is the sensible next step.

Top of Foot Pain: Stress Fracture, Bone Spur, or Just Your Laces?

A runner wrote to me a while back with pain on the top front of her foot, near the ankle — not severe, but enough to make her stop mid-run. It's one of the most common questions I get, because top-of-foot pain has three quite different causes, and they call for three quite different responses.

Here's the fastest way to tell them apart: press directly on the painful spot. Sharp, focal pain that makes you wince points toward bone — possibly a confirmed metatarsal stress fracture, along one of the long thin bones running to your toes. Pressing along the bone shaft from either side and getting a stabbing pain is a strong sign of exactly that, and it's not something you fix yourself. Swelling and redness alongside that pain make a stress fracture more likely still.

Diffuse, milder pressure pain tells a different story. It could be a bone spur — a small bony lump where sustained pressure has made the bone grow slightly out of shape — in which case easing the pressure with looser laces or some padding over the spot is the first step. Or it could be nothing more than laces done up too tight, cutting off blood flow and adding pressure across the top of your foot.

Likely cause	Pain quality	Press-test result	First step
Metatarsal stress fracture	Sharp, worsens with running	Focal, stabbing pain on direct pressure	Stop running — see an orthopedist or podiatrist
Bone spur	Mild to moderate, localised	Diffuse, mild pressure pain; visible or palpable lump	Ease pressure — loosen laces or pad over the spot
Tight laces or shoe pressure	Mild, comes and goes	Diffuse pain, no lump	Loosen laces or change your lacing pattern for a run or two

Your first move, whatever it turns out to be, is a low-risk one: loosen your laces or change your lacing pattern for a run or two and see if it settles. If it does, you've likely found your answer. If it doesn't — or the pain is sharp and focal from the start — get your shoes checked at a specialist running store, and see a podiatrist if the pain persists.

One thing worth being direct about: the press test is a coaching-level triage tool, not a diagnosis. It tells you which direction to head in, not what's definitely wrong. If in doubt, get it looked at properly rather than guessing your way through weeks of running on a possible fracture.

Red Flags: When Foot Pain Needs a Podiatrist, Not a Home Fix

See a podiatrist or orthopedist rather than trying to self-manage if any of the following apply: pain that's sharp, focal and point-tender when you press on it — the pattern most consistent with a stress fracture; visible swelling, redness, or a lump you can feel; pain that doesn't ease with rest, or gets worse from one run to the next; or pain that's there at rest or when you're just walking, not only while running.

This is exactly why I push runners toward a proper diagnosis rather than a generic "see someone" line: your doctor will tailor their advice to which bone is fractured, where in the bone the fracture sits, and how serious it is. That's specific medical decision-making, not something a self-test can replace.

Most foot pain that isn't plantar fasciitis, heel pain or a black toenail comes down to one of these three things, and each has a straightforward next step once you know which it is. Get the self-test right, make the sensible call, and you'll know within a run or two whether this is something you can manage yourself or something that needs a professional look. :)

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