Common causes of pain on the inside of the foot include Bunions, Abductor hallucis strain, Tibialis Posterior tendonitis and Navicular stress fracture.
A bunion (also known as hallux valgus) is a painful swelling of the soft tissue with bone enlargement over the inside of the forefoot at the base of the big toe (MTP joint). Symptoms include:
- Pain on the inside of the forefoot becomes progressively worse over time.
- Bunion pain is often relieved by removing your shoes or wearing soft, comfortable, wide-fitting shoes.
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Abductor hallucis strain
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. A strain (tear) of the muscle can occur with symptoms of:
- Pain along the inside arch of the foot.
- The area will feel tender when pressing into the sole of the foot along the length of the muscle.
- Many athletes with an abductor hallucis strain tend to overpronate where the foot rolls in too much, causing the foot to flatten during the gait cycle.
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Tibialis posterior tendinopathy
The tibialis posterior tendon passes down from the muscle at the back of the leg, inside the ankle and under the foot. Overuse can cause injury or degeneration of the tendon causing:
- Pain on the inside of the ankle, which may also radiate along the length of the tendon, under the arch of the foot.
- It is more common in older female athletes but has been known to affect younger ballet dancers.
- If you have significant pain under your foot, then this may indicate a partial avulsion where the tendon pulls away from the bone at the attachment to the bone.
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Medial Calcaneal Nerve Entrapment
Medial calcaneal nerve entrapment, often called ‘Baxter’s nerve’ has similar symptoms to that of tarsal tunnel syndrome including:
- A burning pain radiates from the inside of the ankle.
- Symptoms may be felt under the heel and into the arch of the foot.
- Running will usually aggravate the condition.
- Tenderness over the inside of the ankle.
Navicular Stress Fracture
A navicular stress fracture is a hairline fracture of the Navicular bone in the ankle. It is an overuse injury, and one of the most common stress fractures affecting athletes. Symptoms include:
- A poorly localized ache in the midfoot.
- Pain sometimes radiates along the inside arch of the foot.
- Symptoms become worse with exercise, subside quickly with rest, only to return again as training resumes.
- Tenderness may be felt when the thumb is pressed into the top of the foot over the navicular bone (called the N spot).
- Stress fractures do not always appear on X-rays until they have started to heal when the new bone growth can be seen.
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