Have you been ignoring a pain in your foot? Stop what you’re doing. It’s time to give this potential injury the attention it deserves.
Ignoring an issue with your feet is not the same as ignoring a potential injury on another part of your body. While you may be able to make a conscious decision to use other parts of your body less, your feet are pretty much in motion all day long, helping you get from A to B.
At The Feets, we’re all about preventative, active foot care to keep your feet healthy and feeling good. If you’re ignoring a little niggle, it’s time to bump it to the top of your to-do list and address that stabbing pain in the side of your foot before it gets any worse and gets in the way of your training or stops your crushing your running goals.
What counts as the ‘side of the foot’?
Good question, as this could mean different things to different people. The side of the foot could be the lateral part of the foot (meaning the outer edge from your heel to your smallest toe), which tends to be used a lot in sports like football when quick directional changes are needed. Or, it could mean the inside of the foot (meaning the inner edge from your heel to your big toe), which is really important in running for balance as runners rely on healthy pronation (inward rotation of the foot) to avoid injury.
In any case, pain is not good.
Foot injuries at the foot/ankle region account for around 24.4% of running-related injuries, so if you are a regular runner, recognising pain in the side of your foot early can be the difference between you getting back to your training plan next week, or in 6-8 weeks’ time.
What does ‘stabbing pain’ feel like?
Next, let’s determine what kind of pain you’re actually feeling. Pain is subjective, and what someone considers extremely painful may not be to someone else. Stabbing pain may be the easiest type of pain to describe, because it offers the very real sensation of being ‘stabbed’ by something sharp in a particular area. It’s easy to point to where, and say how localised the pain is.
Stabbing pain could be described as a sudden, intense, acute pain that exists in a defined area, like a sharp jolt. Understanding this type of pain in comparison to longer-lasting aches can help to diagnose exactly what is wrong with your foot.
What could be causing the pain in your foot?
Let’s dive into the possible causes of that pesky pain so you can get it sorted as soon as possible. Firstly, we have a whole article all about the different types of pain and what they could be (What Could Be Causing Your Foot Pain From Running?), but if you’re wondering specifically about a stabbing pain down one side of your foot, then here are some of the most common causes:
Tarsal Coalition
The ‘tarsus’ is the area made up of seven bones that form part of the foot, so if you see anything with the word ‘tarsus’ or ‘tarsal’ in it you can bet it’s something to do with the foot.
Tarsal Coalition is a condition you would have had from birth, meaning abnormal tissue has formed in the bridge between two of the tarsal bones. Although not common (The American Academy of Orthopaedic Surgeons say 1 in every 100 people have the condition), it does tend to cause pain specifically on the outer edge of the foot which travels down to the toes.
As well as foot pain, Tarsal Coalition might cause muscle stiffness, cramps and pain that become worse after exercising. If you think this might be the cause of your pain, don’t worry. The worst cases may require surgery, but it can often be treated with shoe inserts that support your tarsal bones, a temporary cast to stabilise the foot, physical therapy to strengthen the area, or steroid injections to relieve pain.
Morton's Neuroma
If you experience pain on the inside of your foot, Morton's Neuroma is something to consider – especially if you feel burning or sharp pain while walking, or a feeling of pressure underneath your toes.
Morton’s Neuroma usually affects the nerves that runs between your metatarsophalangeal joints (which are the joints that connect your toe bones to your foot bones, aka your “toe knuckles”) - most often the 3rd and 4th, but it can also occur between the 1st and 2nd. Studies show that this condition is common in women who have worn high heels for years, but anyone can experience this pain no matter your age, gender or frequency of exercise. If you’re a runner though, you could run into this condition (pardon the pun) sooner than a non-runner due to excess impact on the feet.
If you believe you may be suffering from Morton’s Neuroma, it’s recommended you invest in the right shoes and/or orthotics with metatarsal pads. Your GP may recommend cortisone injections to relieve any swelling, and you should address any other foot conditions you have, such as hammer toes or flat feet, as these can make things worse.
Cuboid Syndrome
The cube-shaped bone in the outer edge of your foot is called the cuboid, and it connects your foot to your ankle to help you stabilise while standing. Cuboid Syndrome is what happens when an injury occurs around the joint or ligaments near your cuboid bone. The result is often sharp pain down the outer side of your foot which worsens when standing on your toes. It can also cause a general weak and tender sensation in the foot.
Cuboid Syndrome happens as a result of overuse and lack of recovery time between any exercise (running, as an example). You could also get it from wearing shoes that are too tight, getting an injury elsewhere in the foot, or being overweight.
The frustrating thing about Cuboid Syndrome is that in order to treat it, it usually means around 6-8 weeks of resting the foot, and possibly physical therapy. Shoe inserts can support your cuboid bone and avoid this condition from forming, as can plenty of stretches before exercising (don’t worry, we’re going to have some great videos on stretching soon!).
Peroneal Tendonopathy
Chronic tendon injuries occur due to continued overload. If this overload continues the tendon can become degenerative, which means it becomes weaker.
Your peroneal tendons run from the outside of your lower leg, with the peroneal bervis attaching to the base of the 5th metatarsal (foot bone) and the peroneal longus running under the foot and attaching to the 1st metatarsal. These tendons can become injured due to overuse, leading to pain on the outside of the ankle/midfoot region. In more severe cases, you may also feel a popping sensation around the ankle. There are a number of reasons for this, but regardless of the cause, it’s not a sensation you want to feel!
Torn tendons will usually require surgery, but if they are simply inflamed they can be treated with 6-8 weeks of rest, pain relief, and possibly physical therapy. One study of 47 patients with lateral ankle complaints found 36% had “attrition of the peroneus brevis tendon”, otherwise known as a peroneal tendon tear. So, look after those tendons (again, we will have lots of stability and strengthening exercise videos dropping here soon)!
Pinched Nerve
Many of us will have felt the uncomfortable and painful feeling of a pinched nerve at some point in our lives. For something with such a cute and unassuming name, it can cause quite a bit of pain. It’s possible to experience a pinched nerve in the foot, which can cause a sharp, stabbing pain if it’s in the lateral plantar nerve - this is an important nerve because it controls the movement of all the muscles in the soles of your feet, so if this one gets pinched you’ll definitely know about it!
Conditions like Tarsal Tunnel Syndrome can cause compression of the tibial nerve, which goes all the way up the back of your leg to your knee, and lead to the pain you may be experiencing, along with a tingling sensation or numbness in the inner or outer ankle.
Bunions
These bony bumps form at the base of the big toe and cause it to point inward to the other toes. This leads to pain that flares up during or after exercise, and limited toe movement.
There is also such a thing as a bunionette; a smaller bunion that forms on the smallest toe rather than the big toe. Both can lead to pain at different sides of the foot, and are caused by anything from a family history of bunions, an imbalance in the foot's structure, or excess pressure on the big toe over years.
Treatment for bunions includes bunion pads or orthotic devices to affect the shape of the foot, medications to reduce inflammation, or sometimes surgery if bunions are very painful. You can avoid bunion pain by wearing the right footwear when running or walking (or going barefoot as much as you can), investing in orthotic insoles, and doing these Effective Bunion Exercises For Relief And Prevention.
Stress Fracture
Unfortunately, stress fractures make up more than 10% of all sport-related injuries. According to research, midfoot fractures are uncommon but tarsal navicular stress fractures account for around one third of all stress fractures, which could be the cause of pain in the side of the foot.
A stress fracture is a small crack in the bone due to repetitive stress or overuse. This can cause anything from a dull ache to an acute pain somewhere in the foot, such as the outer or inner side. This pain may become worse when running and your foot may swell.
The severity and length of recovery will depend on where the stress fracture occurs. For example, if you experience a stress fracture in regions such as the 5th metatarsal, navicular or sesamoids, this could be higher risk due to there being poor blood supply to this area, and normally this needs to be managed carefully. On the other hand, the 2nd metatarsophalangeal joints are lower risk for stress fractures.
When a stress fracture occurs, treatment will usually involve getting a scan such as a diagnostic ultrasound or MRI to confirm the severity of the fracture. You will also be advised to avoid putting weight on the affected foot by using a boot, crutches, orthoses or combination of these things to reduce stress and aid recovery. You will also be encouraged to rest the affected foot, and use I.C.E. (apply ice, compression and elevation). Keep in mind that you should not be taking anti-inflammatory medications if you have a stress fracture, as this can actually slow down the healing process.
If you think you have a stress fracture, you should see your GP or another health professional that can deal with this injury, such as a podiatrist or physiotherapist.
You can prevent stress fractures by never running through pain, and being sure to do a a warm-up and cool-down before and after exercising.
What else could be causing stabbing pain in your foot?
The above conditions are all medical issues, however the stabbing pain in your foot could be due to something you can change at home. Wearing the wrong shoes – particularly while running – can cause foot pain, so if you exercise regularly it is best to get measured for shoes to ensure you have the best fit for your feet. As a start, avoid shoes with a narrow toe box, and make sure you have sufficient arch support.
What to do about stabbing foot pain
If you have pain in your foot, you should address it straight away. Ignoring it or procrastinating on treatment can lead to not only worse pain, but problems in the near future.
Stop exercising and seek professional medical advice from your doctor or a podiatrist as soon as possible so they can examine your foot, carry out any necessary diagnostic checks to determine the underlying cause of your pain, and offer a range of treatment options. These could be a medical procedure, medication or therapy, or recommendations for temporary lifestyle changes you can make at home.
Regardless of what is recommended in your medical consultation, at The Feets we always advise athletes to establish a daily foot routine. By implementing simple exercises and stretches, and applying the proper preventative products, you can ensure your feet stay in great shape. My own night-time foot care routine takes less than 5 minutes, and has changed the way I think about these easily-neglected extremities that carry me each and every day. I will share that routine shortly, so don’t worry.
Whether to address a pain or simply to improve your running, I always recommend taking just a few minutes to prioritise your feet so they can continue to help you achieve your physical and mental goals with ease. Remember, your feet and lower limbs do all the hard work and take all the impact - so get to know them, and give them some tender loving care.
Now, go get it.
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We’re The Feets. We know what it’s like to set the alarm for 5am, drag yourself out of a warm bed, lace up the shoes that are starting to show the miles, and head out in the grey morning to clock a few Ks before work. We’ve been there, we are there, and we’ve got your back. Follow us on Instagram or Tiktok for stories, motivation, tips and tricks, or just to be part of the growing community of those wanting to make something of themselves.
