Midfoot Pain

Foot arch pain

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 midtarsal 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

Cuboid syndrome occurs when the peroneus longus muscle in the lower leg applies excess traction onto the cuboid bone causing it to partially dislocate. Symptoms are similar to an ankle sprain, including pain when weight is placed on the foot. It often occurs alongside an ankle inversion sprain, although not in every case.

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Tarsal Fracture

The term ‘Tarsal fracture’ specifically refers to the rare occurrence when one of the Tarsal bones in the rear of the foot is fractured. This foot injury can be a traumatic or stress (hairline) fracture. The tarsal bones are rarely fractured individually but may occur after a hard impact or repetitive forces.

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Midtarsal Joint Sprain

A midtarsal joint sprain is an injury to the ligaments holding the midtarsal joint together. This injury is rare but can occur in gymnasts, footballers, and jumpers. Different ligaments can be sprained, which affects exactly how the movement of the foot is affected, and it often causes pain in the middle of the foot.

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Stress Fractures of the Foot

A stress fracture can occur from continuous and repeated loads on the legs. Long distance runners are susceptible to this injury. A stress fracture in athletes occurs mainly in the lower leg and foot (in the calcaneus, navicular and metatarsal bones), with the affected area, aching and showing tenderness.

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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. The muscle supports the arch of the foot so when it is strained it causes pain in the area. The sole of the foot may be tender and the affected foot may overpronate. Resting to allow the muscle to heal is key to recovery and easing the pain.

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Flexor Tendonitis

Flexor tendonitis when the flexor tendons in the foot become inflamed. The tendons run down the inside of the ankle and under the foot to the toes. When they are injured, it can cause foot pain, particularly in the arch of the foot and the inside ankle. Bending the big toe back against resistance may also hurt.

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Extensor Tendonitis

Extensor tendinitis is when the extensor tendons become inflamed. These tendons run along the top of the foot and straighten the toes. The injury often causes pain on top of the foot, which worsens during activity. This midfoot injury is normally brought on by overuse and even badly fitted or too tight shoes.

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Navicular Stress Fracture

A navicular stress fracture is one of the most common stress fractures affecting athletes, especially those in explosive events such as sprinting and jumping. Poor technique may increase the risk of a navicular stress fracture. The injury is often caused by overuse and repetitive stress. It may cause pain in the arch of the foot, which intensifies during activity and eases with rest.

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Plantar Fascia Strain

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 ligament may cause a small lump to appear, and the area will be painful and tender. The injury might be caused by one single traumatic incident, resulting in sudden pain, or may gradually develop over time.

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Tarsal Coalition

Tarsal coalition is when the tarsal bones in the foot fuse, or stick together. 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, especially after hard activity. However, symptoms may not develop until later in some people.

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Peroneus brevis tendon injury

The Peroneus Brevis tendon inserts into the 5th metatarsal bone on the outside of the foot. This foot injury is normally caused by a sudden force or movement of the ankle, which creates pain on the outside of the foot. Bruising and swelling may also show, with the foot being painful to walk on.

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Tibialis Posterior Tendinopathy

The tibialis posterior tendon passes down the back of the leg, inside of the ankle and under the foot. Overuse can cause the tendon to degenerate where it inserts into the foot bones, which can make the inside of the foot painful. This pain may radiate along the tendon and may worsen when the foot is turned inwards or outwards.

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Lisfrancs Injury

Lisfranc’s injury is a dislocation or fracture in the midfoot area, specifically in the joint where the short metatarsal bones meet the long bones. The main symptoms are swelling on the top of the foot and pain when weight is placed on the foot. There may be some deformity in a few cases.

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This article has been written with reference to the bibliography.