Midfoot pain is concerned with the middle of the foot where the small tarsal bones are located. The most common cause of midfoot pain other than following a sprained ankle is a mid tarsal joint sprain. A stress fracture of the navicular bone is also common and should not be missed. Pain in the midfoot area for more than five days following injury then a Lisfranc joint sprain should be considered.
Cuboid syndrome occurs when the peroneus longus muscle in the lower leg applies excess traction onto the cuboid bone causing it to partially dislocate. The injury often occurs in conjunction with peroneal tendonitis and overpronation. Pain increases as weight is placed on the foot and medical help is needed to correct the foot injury.
A bruised foot occurs as a result of direct impact or trauma which causes tissues under the skin to bleed. A bruise or contusion is made up of blood beneath the skin, resulting from broken blood vessels. When the foot is bruised, it can normally be left to heal by itself with ice and elevation to help ease the pain.
The term 'Tarsal fracture' is often taken to mean a broken foot in general. It does, however, specifically refer to the rare occurrence when one of the Tarsal bones in the rear of the foot are fractured. These bones are very rarely fractured individually but may occur after a hard impact or repetitive forces. This foot injury can be a traumatic or a stress (hairline) fracture.
A mid tarsal joint sprain is an injury to the ligaments holding the mid tarsal joint together causing pain in the outside middle of the foot. Different ligaments can be sprained, which affects exactly where the pain is located and how it affects foot movement. This injury is rare but can occur in gymnasts, footballers and jumpers.
A stress fracture can occur as a result of prolonged repeated loads on the legs. Long distance runners are susceptible to this type of injury. A stress fracture in athletes occurs mainly in the lower leg and foot (in the calcaneus, navicular and metatarsal bones). Exercise will only worsen the foot pain, so resting is the best way to recover.
The abductor hallucis muscle lies along the inside of the foot and runs from the heel bone inserting onto the side of the big toe. There will be pain in the arch of the foot as the muscle supports it and the foot may roll inwards. Relieving pressure from the foot by resting or doing a different activity will ease the foot pain and allow recovery.
Flexor tendonitis is inflammation of the flexor tendons in the foot which bend the big toes. They run down the inside of the ankle and under the foot to the toes. When the tendons are injured, it can cause foot pain, particularly in the arch and inside ankle. Resting is the best way to treat this foot injury to allow the tendon to heal.
Extensor tendinitis is inflammation of the extensor tendons which run along the top of the foot and straighten the toes. There will often be pain on top of the foot which would worsen during activity. This foot injury is normally brought on by overuse and even badly fitted or too tight shoes. Rest is the main way to recover from tendinitis.
A navicular stress fracture is one of the most common stress fractures affecting athletes, especially those in explosive events such as sprinting and jumping. The navicular bone is in the ankle and can be fractured by overuse and repetitive stress. With this injury there may be pain in the arch of the foot which increases during activity.
The plantar fascia or arch ligament is a band that runs from under the heel to the front of the foot. A strain or rupture to this is quite common which may cause a small lump to appear. A plantar fascia strain might result from one single traumatic incident, resulting in a sudden pain, or may gradually occur over a period of time.
Tarsal coalition is a fusion or sticking together of the tarsal bones in the foot. The tarsals are 7 bones located at the back of the foot. It is a congenital disease meaning you are born with it. Midfoot pain may appear in adolescents with this condition, but symptoms may not show until later in some people.
The Peroneus Brevis tendon inserts into the 5th metatarsal bone on the outside of the foot. A strain or rupture of the tendon can occur at the point of insertion. This foot injury normally occurs after a sudden force or movement of the ankle, causing pain on the outside of the foot. Read more for symptoms and treatment of this injury.
The tibialis posterior tendon passes down the back of the leg, inside of the ankle and under the foot. Overuse can cause injury or degeneration of the tendon where it inserts into the foot bones, which causes pain on the inside of the foot. The pain may radiate along the length of the tendon and can worsen if the foot is turned inwards or outwards.
Lisfranc's injury is a dislocation or fracture in the midfoot area. It occurs in the joint where the short metatarsal bones meet the long bones in the foot. Swelling on the top of the foot and pain when weight is placed on the foot are the main symptoms. This foot injury is very rare but it is vital that it is not missed as long term damage can result.
When should I see a doctor?
When should you see a doctor with your foot pain? Often people do not want to bother their GP or A & E department but if you have any of the following symptoms you should seek further medical assistance.
- Severe pain, especially on walking
- Severe swelling (oedema)
- Altered sensation in the foot – such as a feeling of “pins and needles” (paresthesia) or a “loss of feeling” (anaesthesia) in the foot.
- Unable to complete normal daily activities after the initial 72 hours.
Further medical assistance can be sought through either your local GP or a private clinician such as a podiatrist, physiotherapist, sports therapist, osteopath or chiropractor. If you have followed the P.R.I.C.E. principles (see below) and are still unable to walk after 72 hours or still have severe pain that is not subsiding after the first 72 hours you should visit your local A&E department for further assessment.
Secondly, if you have applied for P.R.I.C.E. principles and still have weakness that lasts a long time (more than 2 weeks) or have ongoing discomfort in your foot or heel, you are highly recommended to seek advice from a specialist expert - such as a podiatrist or physiotherapist, osteopath, or chiropractor - who can provide you with advice and an appropriate and effective recovery and rehabilitation program.