Do you get pain under your big toe or ball of your foot from running? Well, it could be a simple overuse injury that is easy to fix with by adding some routines into your programme and changing other simple habits.

A tendon runs from your big toe, along the arch of your foot to your ankle. It can become inflamed, stiff and painful. More specifically, the sesamoid are the two bones that connect your tendons to your big toe, allowing it to flex. They are small, but the pain is serious.

Stop wearing flip-flops 

Without even noticing, you curl your big toe every time you step when you wear flip-flops. This is to stop the flip-flop falling off. This shortens the tendons, makes them stiff and eventfully causes sesamoiditis or tendinitis.

Wearing proper shoes, not flip-flops, will help prevent inflammation in the tendons around the big toe. Photo: Shutterstock

Wear proper shoes, or buy some sandals if you must air your feet. Walk in bare feet if that is an option. Anything but flip-flops.

If you do go on a hike or run, make sure you wear appropriate shoes with a thick sole. Plimsolls or gym shoes may add to the problem. Replace your shoes regularly, so they are not worn, which will cause further inflammation.


As the injury is an overuse injury, taking a break from running or hiking will help. The suffix “-itis” means swelling, so give it some time for the swelling to reduce. Ice the toe to speed up the process and resist the urge to hit the road or trail.

Once the toe is healed, ease back into running. Doing too much was the cause of the injury in the first place, so don’t make the same mistake twice. Build up your mileage bit by bit, as your body and tendons get stronger and used to this distance.

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Cross train, by adding swimming, cycling, rowing and weights to your training programme, so you can get the benefits of training but sparing your toe all the load.

Roll your arch and calves

Your posterior chain runs down your back, the back of your legs and calves, under your foot and to your toe. Other tight parts of the chain may be pulling on your toe, particularly the arch of your foot or your Achilles tendon.

Release this tightness by getting a ball, like a lacrosse, golf or tennis ball. Stand on it, or sit and place it under your foot, and begin to move your foot around while applying pressure. This will relax your arch.

To release your calf or Achilles, sit on the ground with your leg extended in front of you. Put a ball under your calf and roll it around. If you find a particularly tender spot, spend some time focusing on it with the ball.

Strength exercises 

A weak arch or calves can result in your toe taking more load than it should.

Strengthen your arches by putting a towel on the floor, sitting on a chair and placing your foot on the towel. Inch by inch, pull the towel towards you with your toes. Make sure you do both feet, to keep them even.

Build strength in your calves with calves raises. Slowly raise your heal, and slowly lower your heal. Complete four sets of eight, and add weight if you are finding it too easy.