Common foot injuries in athletes: treatment and return to play

The most common foot and ankle injuries in athletes

Ankle sprains

Ankle sprains are the most common ankle injury in sport. They happen when you land on another player’s foot, step in a hole or change direction fast. Most heal well with early movement, support and balance exercises, but a sprain that isn’t fully rehabbed is likely to happen again. Our guide to a broken ankle vs a sprained ankle explains how to tell a sprain from a break, the grades of sprain and healing times.

Stress fractures

Stress fractures are small cracks from repeated impact. They usually follow a quick jump in mileage, intensity or training days, a switch to a harder surface, or worn-out shoes. Not eating enough for the training you do also raises the risk. In relative energy deficiency in sport (RED-S), the body runs short of fuel, and signs include missed or irregular periods, frequent illness and stress fractures that keep coming back.

An X-ray can look normal for the first few weeks. Stress fractures in some spots, such as the navicular in the midfoot and the fifth metatarsal, are high risk and need stricter rest.

Fifth metatarsal and Lisfranc injuries

Sudden pain on the outer edge of the foot after cutting or landing can be a Jones fracture, which heals slowly and is often treated with surgery in athletes. Pain across the top of the midfoot, with bruising on the sole, can be a Lisfranc injury. Both are easy to mistake for a sprain, and both need an X-ray. Our guide to telling a foot fracture from a sprain covers them in detail.

Plantar fasciitis and Achilles tendon problems

Both are overuse problems that are common in runners. Plantar fasciitis, irritation of the thick band of tissue under your foot, causes stabbing heel pain with your first steps in the morning. Achilles tendinopathy, often called tendinitis, causes pain and stiffness in the tendon at the back of the heel, worst when you start moving. Both usually improve with a change in training load, calf strengthening and supportive shoes, rather than complete rest. See heel pain in the morning and Achilles tendinitis.

A sudden pop or a feeling of being kicked in the back of the heel, followed by weakness when you push off, can be an Achilles tendon rupture. That needs to be seen the same day.

Turf toe

Turf toe is a sprain of the big toe joint that happens when the toe bends too far upward, for example when another player lands on your heel while your toes are planted. The joint swells and hurts to bend, which makes pushing off hard. Mild cases settle with rest, taping and a stiffer shoe or insert. Severe tears can take months and sometimes need surgery.

Blisters, toenails and skin

Blisters, black toenails from toes hitting the front of the shoe, ingrown toenails and athlete’s foot are common in every sport. They’re small problems that can keep you out if they get infected. Keep your feet dry, wear moisture-wicking socks, trim nails straight across, and make sure your shoes have about a thumb’s width of room in front of your longest toe. If athlete’s foot keeps coming back, see choosing the best athlete’s foot cream.

Should you play through foot pain?

Stop, and don’t go back until you’ve been checked, if:

• the pain is sharp or stops you mid-play
• one spot on a bone hurts when you press it
• you’re limping or changing the way you run or land
• the pain gets worse as you keep going, or is there at rest or at night
• you have swelling, bruising or numbness, or you felt a pop

It’s usually fine to keep training, with changes, if:

• you have general muscle soreness a day or two after hard training that eases as you warm up
• you have a known tendon problem, such as Achilles tendinopathy or plantar fasciitis, and the pain stays mild during activity (around 3 out of 10 or less), settles by the next morning, and isn’t getting worse from week to week. A physical therapist can help you set these limits.

Don’t take pain relievers so you can play through pain. Hiding pain can turn a small injury into a bigger one. Taking ibuprofen or naproxen before long races or hot-weather events can also strain your kidneys.

First aid for a sudden foot or ankle injury

For the first 2 to 3 days:

1. Stop playing and get off the foot.
2. Ice for 15 to 20 minutes every 2 to 3 hours, with a cloth between the ice and your skin.
3. Compress with an elastic bandage, snug but not tight. Loosen it if your toes tingle or change color.
4. Elevate the foot above the level of your heart.
5. Protect it with crutches, a brace or a stiff-soled shoe if walking hurts.

Avoid heat, alcohol, running and massage for the first 2 to 3 days, since they can increase swelling. An over-the-counter pain reliever can help if it’s safe for you. For a possible broken bone, some doctors prefer acetaminophen (Tylenol) to anti-inflammatory medicines such as ibuprofen, because of concern that anti-inflammatories may slow bone healing, although the evidence is mixed.

If you have diabetes or numb feet, skip the ice and have any injury checked by a podiatrist promptly.

Getting back to your sport

Go by milestones, not by the calendar. Before returning to full training, you should be able to:

1. walk normally, without a limp or pain
2. move the injured foot and ankle as far as the other side
3. do as many single-leg heel raises on the injured side as on the other
4. balance on the injured leg for 30 seconds, as steadily as on the other
5. hop on the injured leg without pain
6. jog, run, sprint, cut and jump without pain during activity or swelling the next day
7. get through full practices before you play in a game

These rough ranges are for common injuries. Your podiatrist or physical therapist will guide your own return.

Protect it when you go back

• Brace or tape the ankle for sport for up to a year after a sprain. It lowers the chance of spraining it again. See ankle braces after a sprain.
• Build back gradually. After a stress fracture, many athletes start with walk-jog intervals every other day and add running time week by week.
• Keep doing your rehab exercises a few times a week, even after you’re back.

Feeling nervous about the injured foot is common. A step-by-step return rebuilds confidence as well as strength.

How to prevent foot and ankle injuries

• Increase training gradually. There’s no magic number. Many coaches use about 10% more per week as a rough ceiling, although the evidence for any exact figure is weak. Big jumps in mileage or intensity, and sudden switches to new surfaces, are what cause trouble.
• Plan rest days and easier weeks.
• Warm up with purpose. Structured warm-ups that include balance, landing and strength drills, such as the FIFA 11+ program in soccer, have been shown in studies to lower injury rates.
• Strengthen your feet, calves and hips with heel raises, single-leg balance and hip exercises. The strength plan for runners below works for any sport.
• Wear the right shoes for your sport and surface. Replace running shoes every 300 to 500 miles, or sooner if the cushioning has gone, and break new shoes in gradually.
• Eat enough to fuel your training, including enough calcium and vitamin D for your bones. Athletes who miss periods or keep getting stress fractures should see a doctor.
• Get small problems checked early, such as pain that keeps coming back, blisters that won’t heal or ingrown toenails.

If you have diabetes, check your feet after every session, wear well-fitting shoes and moisture-wicking socks, and see a podiatrist about any blister or cut that isn’t healing.

For runners: stronger feet and smarter training

Every time your foot lands, it takes a force of about 2 to 3 times your body weight, thousands of times in a single run. Your calf muscles and the small muscles inside your foot absorb much of that load. When they’re weak or tired, more of it passes to your bones, tendons and the plantar fascia. In one trial, recreational runners who did an 8-week foot strengthening program had fewer running injuries over the following year. Strength training in general lowers injury rates in sport, while stretching before exercise hasn’t been shown to.

Foot and ankle strengthening exercises

Set aside 15 to 20 minutes, 2 to 3 times a week, after an easy run or on a rest day. Move slowly and with control. The exercises should feel like effort, not pain, and it takes 6 to 8 weeks to notice a real change in strength.

Compare your two sides: if one leg manages clearly fewer slow single-leg heel raises, or wobbles more when you stand on it, give that side extra work. Add hip exercises too, such as side-lying leg raises, bridges and slow step-downs from a low step, because your hips control how your knee and foot line up when you land. Stop any exercise that causes sharp pain.

Build distance and speed gradually

Most running injuries happen when training increases faster than your bones, tendons and muscles can adapt. Your heart and lungs adapt quickly, but bone and tendon take weeks to months, so you can feel ready for more before your legs are. The popular 10% rule is a reasonable rough guide, but there’s little evidence for any exact number. A large 2025 study of more than 5,000 runners found that injuries were more likely after a single run much longer than the longest run in the previous 30 days, even when weekly mileage was steady.

• Keep any one run no more than about 10% longer than your longest recent run.
• Change one thing at a time: distance, speed, hills, surface or shoes.
• Keep most runs easy, at a pace where you could hold a conversation.
• Take an easier week every 3 to 4 weeks, and add hills and speed work only after a steady base.
• New runners can start with run-walk intervals and a rest day between runs. After a break, start back below where you left off.
• Recover well. Sleep, stress and food all affect how your body adapts, and not eating enough for your training raises the risk of stress fractures.

Running shoes and form

• Comfort first. Choosing shoes by arch type or “pronation” hasn’t been shown to prevent injuries for most runners. The shoe that feels most comfortable when you run in it is a reasonable choice, although some people with very flat feet find a more stable shoe more comfortable.
• Fit. Leave about a thumb’s width between your longest toe and the end of the shoe, and shop later in the day wearing your running socks.
• Replace them every 300 to 500 miles, or sooner if the midsole looks creased or squashed or new aches start. One study found runners who alternated between more than one pair had fewer injuries.
• Change shoes gradually. Switching quickly to minimalist shoes, a much lower heel-to-toe drop or carbon-plated racing shoes puts more load on the calves, Achilles tendon and foot bones, and has been linked with bone stress in the foot.
• Loosen tight laces if the top of your foot hurts, or skip an eyelet over the sore spot. If one spot on the bone is tender, stop running and get it checked.
• Form: there’s no single correct way to run. Switching to a forefoot landing moves load from the knee to the calf and foot rather than removing it. If you overstride, increasing your step rate by about 5 to 10% shortens your stride and lowers the load on your knees and hips. A physical therapist can help with gait analysis and training.

Orthotics help some specific problems, such as plantar fasciitis, but most runners don’t need them. See do I need orthotics? If you’re coming back from arch pain, our guide to arch pain in active people includes a step-by-step return-to-running plan.

When to see a podiatrist or physical therapist

Get seen the same day, at the emergency room or urgent care, if:

• the foot or ankle looks deformed, or bone is showing
• your foot is cold, pale, blue or numb
• you can’t put any weight on it
• you felt a pop at the back of the heel and can’t push off, which can mean a torn Achilles tendon

See a podiatrist within a day or two if:

• you can’t take 4 steps without a lot of pain
• one spot on a bone hurts to press
• the outer edge of your foot hurts after rolling your ankle
• you see bruising on the sole of your foot
• your big toe joint is swollen after being bent back

Book a visit if:

• pain lasts more than 2 weeks despite rest
• you keep spraining the same ankle, or it gives way
• pain is changing the way you run or move
• heel or Achilles pain keeps coming back

A podiatrist diagnoses the injury and treats it with boots, braces, orthotics, injections or surgery when needed. Evolve Health podiatrists have digital X-ray on site, so an X-ray can usually be taken at your first visit. A physical therapist rebuilds strength, balance and movement and guides your return to sport, and many athletes see both. Learn more about sports medicine and sports and orthopedic injury rehab, or find a podiatrist or a physical therapist near you and book online.