As mentioned in my recent training update, I’ve been experiencing pain on the top of my foot recently. All the signs are that it’s extensor tendonitis, which is a common condition and easily treatable.
While it’s advisable not to run if you have extensor tendonitis, it’s possible to do so by reducing your training load and putting up with some discomfort. Obviously stop running if the pain becomes severe and seek advice as soon as possible.
I solved my issue by taping my foot and lacing my shoes differently. Quick and easy fixes and ones I recommend you try.
Criss-cross lacing (the standard)
Almost all running shoes come out of the box laced in a criss-cross pattern, as shown below.
It’s comfortable, easy to lace and will serve the majority of runners well. The only issue I’ve ever had with this method is that sometimes, especially on steep descents, my toes would hit the end of the shoe.
The solution was to add the runner’s knot (also known as heel lock or lace lock) which uses the otherwise redundant eyelets at the top of the shoe to form a pulley. This tightens the shoe around the heel and prevents slippage.
I’ve used criss-cross lacing and the runner’s knot for years, with no problems. Until recently, that is…
Ouch, ouch, ouch
My feet are wide with high arches, so I try not to yank my laces too tight, especially if I’m wearing thick socks. During a run recently, I felt a pain across the top of my foot, which I attribute to over tightening my shoe using the runner’s knot.
It didn’t hurt afterwards, so I went for another run the following day and it started aching again. My foot then hurt for several hours and it also developed an unsettling ‘creaking’ sensation whenever I lifted my middle toes.
I took a couple of days off running and consulted Dr Google, who suggested I had extensor tenonditis.
What’s extensor tendonitis?
I’m not a medical professional, so the best thing you can do if you have any concerns about your foot is consult a physio or a doctor. With that out of the way, here’s a good description of what extensor tendonitis is.
Extensor tendinopathy is a condition involving one or more of the tendons that run along the top of your foot. These tendons attach to muscles that lift your foot up and help the foot clear the ground when you walk. If these become overworked they may become painful and swollen.NHS
The symptoms are an aching pain on the top of the foot, sometimes around the front of the ankle and lower leg. The pain usually increases with activity and may be made worse by wearing shoes, especially if they are too tight.
That got me thinking: could this problem be resolved by loosening my shoes? Could the way they’re laced be what’s irritating the extensors?
I set out to find alternative methods that would help relieve the pain.
The one that came highly recommended is the Lydiard lacing method, named after influential running coach Arthur Lydiard. This approach reduces pressure on top of the foot by removing the underlying diagonal crossovers.
I laced my shoe this way and went out for a 90-minute run. It wasn’t entirely pain-free, but it was a substantial improvement. As a test, I went out for a run two days later using the old criss-cross pattern and sure enough, the pain returned.
So it looked like Lydiard way would be the solution to my problem. Except, I didn’t like it.
I found it difficult to get the laces tight and my foot kept slipping, even with the runner’s knot. You solve one issue and then another one comes along…
The answer: gap lacing
I next tried something called gap lacing. The idea is to retain the criss-cross style, but skip the row where you are experiencing pain. As I have high arches, I laced up to the third row and then skipped a crossover, bypassing the sensitive area of my foot.
It looks a little messy, but who looks at their shoes while running anyway? On the plus side, because you have longer ends, you can easily incorporate the runner’s knot as well.
I’ve used this method on several runs now, from easy to long runs, and combined with kinesiology tape, it’s made a dramatic difference. No pain, no heel slippage and my foot is almost back to normal.
Try some tape, too
In my opinion, the benefits of kinesiology tape are largely a placebo effect, but that’s not necessarily a bad thing. If it makes you feel better, then it’s worth using, right?
I use Rocktape instead of KT Tape as I find it remains in place for longer and holds up better under wet conditions. Otherwise, they’re much the same and instructions on how to tape your foot are in the video below.
I think taping helped secure my foot, especially across the metatarsals where I was experiencing the most pain. I also think it acted as a barrier between my tendons and the tongue of the shoe.
It’s not as vital as lacing your shoes differently, but together they worked wonders for me.
Hopefully this proves useful if you’ve got pain on the top of your foot. Chances are it’s nothing serious and you’ll be able to continue running after switching your lacing and applying some tape.
If, however, it becomes too painful and starts impacting your gait, then go see a physio as soon as possible. You don’t want to develop a more serious injury.