This foot pain chart focuses on bottom of your foot ache.
After all, your sole is the veneer between your delicate body and the cold, cruel ground.
(And is, without doubt, the foot part I treat the most)
Loaded with bones, nerves and flesh; there's a lot to go wrong.
So from stretched heel tendons to fat angry toe nerves, these conditions are the ones that I see often.
Bottom of Foot Pain Diagnosis
It's easy to go down a diagnosis rabbit hole. One minute you've got a headache, the next you're planning a cortege.
But here's the thing about foot pain diagnoses:
Without lavish MRI machines, even the best Podiatrists are taking an educated guess.
We deduct based on where it hurts you — and how.
(I'm affectionately known among friends as the Shoefinder General. I'm not shy to opine on the damage that footwear creates)
So, use this foot pain chart to guide you. For proper assessment, consult an IRL Podiatrist!
Bottom of Foot Pain Chart
1. Plantar Plate Tear: The Toe Rupture
If Winston Churchill ever got a foot injury, it would be a plantar plate tear.
This is because a plantar plate tear looks like a cigar holder between your toes.
Compared to the rest, it isn't allll that common. But it's still the scourge of barefoot runners and it splays your toes in a defiant V-shape.
But how did we get here?
Your plantar plate is a hammock of tissue that spans sideways across your forefoot. Its job is to cradle your toe bones and keep them aligned.
It stops them springing up — and spreading out.
Sounds easy, until you consider the force greeting your foot when it hits the ground.
(It's a lot)
Then your plantar plate tears.
Peace Sign (With Your Toes)
(Hammer-toe from an early to mid stage plantar plate tear)
The reason it's between the 2nd and 3rd toes is: they're longer and take more strain.
Now, that spreadeagled toe look is late-stage in other words, a full-blown rupture.
Way before that, a plantar plate tear often masquerades as a hammer toe.
(As well as pain under your second foot digit)
Plantar Plate Tear Treatment
If you suspect a plantar plate tear, ease off any and all high-impact activity.
Definitely no barefoot running, tap-dancing or Parkour.
Now, in an ideal world you'd all be running (actually, slowly walking) to your nearest Podiatrist for treatment.
Then, you'd get bespoke foot therapy and/or surgery.
But last time I checked, we don't live in Unicorn World.
So, what if you can't get to a foot doctor?
Best Shoes for a Plantar Plate Tear?
Here's the thing:
Unlike plantar fasciitis and big toe arthritis, there isn't a one-shoe cure for a plantar plate tear.
This is because the ligament involved is small and needs control down to a micro level.
In other words, more than just trainers.
In other (other) words, you need to fix your sprung toe in place, cushion it and brace with an insole.
Soft Cushions, Tape and Wedges
Nope, it's not the shopping list for a good night in. It's yours for your plantar plate tear.
The best shoes for a plantar plate tear are simple ones that lay a cushion down around that sore-thumb of a forefoot.
They don't need roller bottoms, NASA mesh technology or jingling bells.
All you need are neutral running shoes and ASICS Women's Gel-Excite 8 are great.
But remember: they're one of three moving parts.
Plantar Plate Tear Taping
Next, you're gunna want a toe brace.
The aim of the game here is to pin down your jumped-up little toe so it doesn't spread eagle further.
Now, you can self-tape for a plantar plate tear, but if you want something quick and easy, go for this Bioskin Toe Straightener.
Last, but not least, in the plantar plate rescue kit is an insole.
But not any old insole — one with a metatarsal dome.
This is a raised soft semi-circle o'foam that sits under your plantar torn toes. It protects them from more damage.
(Unless you like the Star Trek live long and prosper look in your shoes)
These FeetTouch ones have a nice big met dome and won't throw your walk all over the place.
Also, they won't break the bank.
Ok, so you've got your shoes for plantar plate tear.
You've got your toe-knit strap and your guardian angel insole.
(This is what Podiatrists do btw, only more expensive)
The first step is to remove the factory-provided insole that come with your trainer. These are just a lightweight version of your (better) one and take up much-needed shoe space.
Then, place the insole in. Get a good feel for it. Get to know it, caress them with your toes and give them a name.
(Mine are Sonny and Cher)
Finally, use your plantar plate strap. Wear it as much as you can, where you can.
2. Morton's Neuroma: The Phantom Sock
(A surgically removed Morton's neuroma)
Some people pay good money to imagine their feet are inanimate objects.
But, if you've got a Morton's neuroma, you get the experience for free.
Thin, delicate nerves run betwixt your foot bones. They flow down to your toes, protected with a sheath that buffers the squeeze of shoes.
But sometimes they just can't take the pressure anymore. The nerve cushion throws in the towel.
It swells, throbs and becomes a neuroma. A Morton's neuroma.
Morton's Neuroma: What to do
This nerve condition comes with unconventional symptoms.
You might feel an invisible sock underneath your toes; or a phantom pebble in your shoe.
(And a zapping pain that shoots down to the ends of your toes)
Most Morton's neuromas don't end up in surgery. But to stay out of that club, you need to swerve tight clamp shoes like the plague.
Some cases need a metatarsal dome. This is a foam semi-sphere stuck on an insole that protects the angered nerve case.
Morton's Neuroma Home Treatment
A full-blown, full-thickness Morton's neuroma may well need surgery to resolve.
Or a course of pain-relief steroids.
But but but.
If you've got tell-tall early zapping and numbness in your middle toe digits, there's hope for you yet.
Get yourself a set of insoles with a metatarsal dome.
This chucks a cushion under the angry nerve and splays your toes so the pressure stays off.
Tailor your shoes around the insole (I repeat, put relief for your fat, angry toe nerve before fashion)
3. Tailor’s Bunion: Le Bunionette
The tailor's bunion.
In ye olde days, tailors sat hunched over in candlelight, one leg crossed over the other.
As they nimbly weaved away, they got lost in their work. They forgot all about their pinky toe pressing down on the bone opposite.
Then one morn, they all came into work with a bunionette (probably).
As the ancient clothiers learned, strain on your little toe joint causes a tailor's bunion.
In my experience, this can be from flat feet and over-supination (see below).
Or as, Steven Tyler from Aerosmith learned, really tight high-heeled boots.
Tailor’s Bunion: What to do
As it grows, a bunionette pushes into your shoe; so you'll get plenty of red chafing and yellow callus.
(To soothe and stop the jagged hard skin, use Gehwol Fusskraft Mint)
Like large bunions on a big toe, tight shoes speed-up a tailor's bunion.
At this stage it's your call whether you want to pause it with wider shoes — or opt for surgery.
(I'd opt for the former)
4. Over Supination: The Outer Limits
Supination is a normal stage of walking. It's when your weight rolls out to the outside edge of your foot.
Your foot stiffens up and pushes forward — off into the great unknown.
Over-supination is when this propulsion happens too much (or for too long).
The calling card of excess supination is aching outer foot bones i.e. fifth metatarsals.
You'll feel like you're always "on the outside of my feet".
(Also, look out for tenderness shooting down the top of your foot down to your toes. This extensor tendonitis is a bed-fellow of over supination)
Over Supination Causes
Over-supination isn't "caused" by any one thing. It's a particular type of foot shape.
You have it (and don't know it) until it becomes a problem. It creeps up on you.
(Though it's far more common in those with high-arched feet that have little movement).
Over Supination: What to do
The biggest tip I can give you for solve over supination is:
Don't to fall into the trap of buying any ol' insoles.
95% of the orthotics you can buy are tailored for over pronation. In other words, arch support and heel strengthening.
Let me repeat that, if you're an over supinator, you DON'T need arch support.
It's the exact opposite to what you need and want.
Insoles and Shoes For Excess Supination
Insoles for over supination are harder to find than for pronation — but they do exist.
Vasyli Hoke are one of the very few specifically for the stiff foot crew.
See the red cushion areas on the big toe and arch? Those are super flexible to encourage your weight to spread here.
But be mindful: these are thick insoles. You can trim them down to size but may need to remove your shoes default lining.
I'm not aware of any shoes (on this side of the Atlantic, anyway) purpose designed for supinators.
In fact, be wary of anyone other than legit foot experts (as opposed to shop staff) who tell you otherwise.
5. Hallux Limitus: Low-Key Arthritis
Hallux limitus is the polite way of saying big toe arthritis.
Your large toe joint is restrained from moving up.
You get pain under your big toe because your body has to shift the stress somewhere. You get more burn under your big toe and more pinch callus.
Hallux limitus is a gradual condition.
Eventually (think years), it gets worse and your big toe becomes stiff. This is called hallux rididus.
Hallux Limitus Symptoms
But, before you get images of wheelchairs and walking sticks, don't panic. It's really minor.
It's also a super common condition, including myself!
Pain under the ball of your big toe (and only there) is one the best indicators.
Your log jammed large foot digit throws off the load underneath.
Also be aware of a chunky osteophyte. An osteophyte is a bone build-up from joint on joint friction, as seen in the picture above.
Hallux Limitus: What to do
Running trainers are are the gold standard to pause the damage of big toe arthritis.
Most of you'll do well with a super-flexible shoe to encourage more big-toe movement.
Certain models encourage that seamless roll over your big toe joint — aka rocker bottom.
Hoka One One and the Asics glide range are the go-to's for my patients.
6. Metatarsalgia: Ball (of Foot) Ache
Metatarsalgia: the wild child of bottom-of-foot pain.
The condition is a catch-all term for balls-of-the-foot pain (algia = inflammation).
As you can see from the foot pain chart, you'll feel a dispersed ache across the sole of your upper foot.
Your toe balls take a vast amount of your weight — so the delicate tissue inflames.
Now, some Podiatrists claim it doesn't actually exist. They say that it's a cop-out instead of an actual diagnosis.
Needless to say, I disagree.
Metatarsalgia: What to Look Out For
Remember, any foot pain = something is wrong.
This could end up as a Morton's neuroma or plantar plate tear. Or it could stay as metatarsalgia.
You're overstretching, pounding or straining your bottom forefoot to some degree.
Therefore, you need to get pressure off the sensitive spot.
Metatarsalgia: What to Do
Most metatarsalgia cases I see are straightforward and need a simple cushion.
Before you go off and spend lots of money on trainers that may (or may not work), try a simple set of insoles.
Something like these Powerstep Metatarsalgia orthotics will do fine.
Give yourself a few weeks of wear to let any inflammation settle down.
7. Medial Arch Strain: Middle Bottom Foot Pain
Middle-bottom foot pain is usually from a strained foot arch. Aka medial longitudinal arch pain.
And this is usually from over-pronation.
Pronation is when your feet dip low and loose to absorb shock from the earth.
As you may have guessed, over-pronation is when this goes haywire.
I say haywire, what I really mean is that it lasts too long.
This forces your foot arch to flex much more than it wants. And you end up with foot arch strain.
Medial Arch Strain: What to Do
Think of your foot arch as a bridge. A small one, made of flesh, but a bridge.
Anyway, crumbling bridges need support. You can cure most middle bottom foot pain cases with a simple stiff insole.
8. Plantar Fasciitis: Woke Heel Sting
Your plantar fascia is a flat tissue ribbon that starts at your heel and ends at your toes.
Plantar fasciitis is when this tissue-strap gets super sore.
It can be "can't walk" painful and is the most common foot pain I treat by a country mile.
Plantar Fasciitis: What to Look Out For
The time-honored symptom is pointed pain on the inside of your heel when you first step out of bed.
(Or when you get up after resting)
It hits your heel because it's the part that takes most stress when your dainty foot lands.
Most I see with plantar fasciitis heel pain have either changed shoes; or upped their activity.
They're working extra shifts or undergoing a new running regimen.
Plantar Fasciitis: What to do
The quickest cure for plantar fasciitis is lots of ice and a pair of Hoka Bondi 7's.
You need a bouncy-castle cushion shoe and prop for the inner-heel area. Avoid stiff-soled shoes and barefoot walking
Traced right back, plantar fasciitis comes from tight lower leg muscles. Piano string calves force your thin plantar tissue to work too hard.
So after you cool the sore, regular achilles tendon exercises are vital.
Think of them as insurance.
One More Thing: Foot Corns
It was an itch I just had to scratch. There was no way I could make a foot pain diagram without including foot corns.
Yep, lost in the jungle of exotic conditions is good ol' (ingrowing) hard skin.
Now, I could easily have added corns onto this foot pain chart.
Why didn't I?
Because the purple and orange foot pain chart would look like Alice in Wonderland.
(For every person I see with Morton's neuroma, I'll see dozens with undiagnosed foot corns)
They cause as much agony. And the same stone-in-shoe symptoms.
But How Do I Know If I've Got Foot Corn!?
The easiest way is to literally look. Or take a phone photo if the angle is awkward.
Corns are normally lighter than your surrounding skin, with a darkish center.
Or feel like raised, ridged and rough dry skin.
Home Foot Corn Removal
The key to home corn removal lies in your skin.
Corns responds rapidly to the right foot cream — and a good sanding.
When I say right foot cream, it can't be the stuff you use on your face or legs.
It has to contain urea.
Gehwol Fusskraft Mint is best I've tried. Rub it in twice a day to the painful spot and let it soak awhile.
A few days later remove the hard skin left with a good foot file.
If you do have a corn, you'll notice a limp-free improvement in your walk.
Bottom of Foot Pain Chart
The soles of your feet evolved for soft surfaces — not the concrete we pound today.
Due to this, I can count on one hand the patients I see who don't come to me with bottom of foot pain.
Hopefully, this foot pain chart has helped you diagnose your bottom-of-foot pain.
Or at least put you in the right direction!