Barefoot and minimalist running is getting a lot of publicity recently. There appears to be a lot of barefoot runners who are no running injury free after a running injury. There are also a lot of injuries in barefoot runners as well. The most common of these injuries is a pain on top of the foot. While the differential for this is a number of things, probably the most common cause for pain on the top of the foot is a dorsal compression syndrome from the forefoot trying to dorsiflex on the rearfoot more when forefoot striking compared to rearfoot striking. This dorsal compression of the base of the metatarsal bones and the tarsal bones is probably the cause of pain on the top of the foot in runners. The treatment for this pain on top of the foot is to increase the plantarflexion of the forefoot on the rearfoot or reduce the dorsiflexion forces. In the short term, this means using strapping and going back to rearfoot striking. In the medium term, foot orthoses that allow the forefoot to plantarflex can help pain on top of the foot. In the long term, there can be a transition back to the forefoot striking as the tissues adapt, but this can depend on how high the forces are that caused the pain on the top of the foot was in the first place.
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