Running isn't always a pain free activity and as much as 75% of athletes may get an overuse injury every year. More often that not that exercise related injury is not sufficient to stop them exercising and they commonly simply have to back off a little and make use of some modest interventions to let it get better. Occasionally the injury is significant enough that this forces the runner to quit on the running. There are numerous injuries that may affect runners, affecting many different parts of the lower limb. Among the most frequent injuries is what has become known non-technically as “top of foot pain” or ToFP. Medically this is what's called dorsal interosseous compression syndrome. This is an overuse injury which causes pain on the top of the foot, commonly about the top point of the arch of the foot. This generally occurs in barefoot runners and also runners who tend to forefoot strike rather then rearfoot strike initially when they are running. Running in this way is likely to try and force the forefoot upwards on the rearfoot resulting in the jamming of the bones of the top of the foot, leading to the pain in that area.

To begin with this top of foot pain is managed with ice to handle the inflammation and possibly anti-inflammatory medications to settle it down. Nearly all runners will need to cut back on their weekly mileage to also help settle it down. The ultimate way to address this is to use more of a heel strike when running and make use of foot orthotics to help keep the arch up so the jamming in the midfoot does not occur. While the change in running method may be a good way to help this, it's difficult to try and do, which is frequently avoided in the beginning to try and address the problem without doing that. When the other methods are unsuccessful, then a change in the running technique is almost certainly advised for top of foot pain.