Burning Pain From New Running Injury at the Foot and Ankle.

by Gary
(Houston, Texas)


Thank you for reviewing this.

I have injured the top of my foot where it meets my ankle. Actually, a bit more on the top of my foot rather than my ankle. This is a burning type of pain. I think that there is a band that spans across.

Anyhow, the pain is a burning type of pain rather than something like an aching tendonitis pain.

Although, it could be, I'm no doctor.

My questions.....

1) Does a burning type of pain indicate a tear rather than inflamation?

2) When ultrasound is applied it actually makes it worse. Could there be some sort of tear?

There is no swelling or redness. I think that I injured it during a trail run. Back in mid-February, I rolled my ankle a couple of times.

Another thing to mention is that the shoes that I was wearing were fairly tight. Tighter than my normal running shoes. Normally rolling my ankle doesn't bother me. I have done it before.

I continued to run afterward and within a few days the pain started. I've tried the traditional; ice, anti-inflammatories and some ultrasound. Nothing is helping at this point

Any advice would be appreciated.



Joshua Answers:

Hi Gary.

You've given me a tough one. Great!

So let's see here.....

I need more info before I can answer your questions.

1. How long has this burning pain been there on the top of your foot near the ankle?

2. This is a new pain yes? Not where it hurt when you turned your ankle.

3. I'm not clear from your description. This happened when you turned your ankle in Feb?

4. How much do you usually run? What kind of runner are you, as far as casual or competitive?

5. How exactly did you ice the ankle? The traditional ice pack for 20 minutes 3x/day?

6. The ultrasound vibration hurts, or it hurts to rub the thing over/on the area?

7. Does the spot constantly burn and hurt, or just when you walk/run on it or touch it, or?

Quick answers to your questions:

A. Burning doesn't necessarily mean tear over anything else. There is a burn associated with fascia stretch and tear, and there is burn associated with

a huge amount of Pain Enhancing Chemical that gets dumped from the Inflammation Process.

No redness or swelling, interesting. Hmmm.

B. Yes, there could be some sort of tear. I rather doubt it, being on the top of the foot, unless you turned your ankle in such a way that that line of force could get tugged on enough.

Would ultrasound vibration make a tear hurt and not anything else hurt? (I'm doing an I-don't-know-shrug.) I've never heard of that, but it makes sense. Let's at this point just say that it could if the spot is in a very acute state, which it is.

I'm guessing you have either a very specific spot of tendonitis micro-tear and intense inflammation from repeated use from the running action plus whatever compensation from structural weakness from earlier turns of the ankle, or...

Or it's possible that your shoes were too tight and you might have given yourself a tiny stress fracture.

I would expect at least some swelling with the tendonitis theory. A stress fracture wouldn't necessarily have swelling, but I'm not sure about the burning feel.

I've never had a stress fracture in the foot, so I don't have first hand knowledge of how that feels.

Poke around the area. See if you can see if there is pain in soft tissue, or pain deeper on bone. If the bone is hurt, it's likely soft tissue will hurt too, so spend some time and see if you can get a feel for what exactly is the source of the pain.

Also, describe in greater detail the pain you feel, the burning and what not, and what your are doing when you feel it.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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May 16, 2009
Part 2 - Burning Pain From New Running Injury at the Foot and Ankle.
by: Gary

Hi Joshua,

Thank you for responding to my post. Here's my answers to your questions.

1. How long has this burning pain been there on the top of your foot near the ankle?

To varying degrees, the pain has been there since late February. Always this burning type of pain.

2. This is a new pain yes? Not where it hurt when you turned your ankle.

This is new pain. I rolled my ankle twice during a race in mid-February. I don't know if this is the cause or not. It may be a coincidence.

It's the only thing that I can really think of. However, i have rolled my ankles in the past and has never bothered me.

The other thing that I would like to mention is the shoes. I guess that my feet are a bit wider than most, but not much.

So, my trail shoe choices are a bit limited. I'm currently running in Montrails which have a lot of support all the way around.

So, they are a bit tight. Initially, when I was researching this, I found that irritation at the top of the foot can be caused by shoes that are tight across the top.

3. I'm not clear from your description. This happened when you turned your ankle in Feb?

Shortly after. About 2 days afterwards it started. I'm assuming that rolling my ankle was the cause.

May 16, 2009
Part 3 - Burning Pain From New Running Injury at the Foot and Ankle.
by: Anonymous

4. How much do you usually run? What kind of runner are you, as far as casual or competitive?

Usually..... Well, currently I try to run as much as possible. Maybe 15 miles each week.

Casual or competitive? I would say competitive against myself. I have 9 marathons under my belt. Which means numerous races. Also many triathlons, from sprint to Ironman distance.

I like long distance. My last running race was a 50 mile ultra. I tore my gastroc two weeks prior. that was about 2 1/2 years ago. Since then
it's been one injury after another. Shinsplints in both legs, plantar fasciitis, achilies tendinitis etc. I'm trying to get back into triathlons, but the injuries keep getting in my way.

I'm currently doing mostly cycling. I plan on hitting the gym to work on strength training and flexibility.

So, it could be the fact that I'm going out too hard too soon. Speed work isn't even a part of my vocabulary right now.

5. How exactly did you ice the ankle? The traditional ice pack for 20 minutes 3x/day?

I used the typical ice pack. But only once a day for about two hours. About 20 minutes on and keep it off until my skin is just barely cool to the touch.

6. The ultrasound vibration hurts, or it hurts to rub the thing over/on the area?

Using ultrasound was fine for the most part. But, it seems sore and tight in the morning afterwards.
Maybe even "feels" swollen, but doesn't look swollen.

7. Does the spot constantly burn and hurt, or just when you walk/run on it or touch it, or?

It's not constant. It's more of when I lay off of it, then stand up. It seems to tighten up over night while sleeping.

Just like plantar fasciitis.

If I run, the pain is there in the beginning, but resides after 7-10 minutes. Like a typical soft tissue injury. What really caused my concern is that the ultrasound seemed to aggravate the injury, rather than helping. I have always had good results from ultrasound.

May 17, 2009
Part 4 - Burning Pain From New Running Injury at the Foot and Ankle.
by: The Tendonitis Expert

Hey Gary.

In no particular order....

1. That ultrasound thing makes no sense to me. Or at leas, I don't have an answer for you.

A microfracture makes the most sense. I can't even begin to imagine ultrasound bothering tendon or ligament, or any kind of tendonitis in the ankle.

If it were a little fracture, it would have to be so small you don't have pain from walking but that it still creates a big inflammatory response.

2. That's a lot of leg injury.

Worst case scenario: You just aren't built for running. Pick another activity to get your fix.

More likely scenario: Not enough protein intake to match your activity level. Overtraining and not enough sleep and recovery.

I'm certain you don't eat enough protein. Period.
I'm certain you overtrain. My proof? These last two messages to me here.

Not good, not bad, just a mechanical function of too much wear and tear on the legs, not enough nutritional building blocks and rejuvinative sleep to repair and maintain and build, and training/racing too hard through injury.

In a perfect world you would take a year off from running, get skilled massage on nothing but the legs a couple times a month, increase your protein intake.

But you're probably not going to do that, so let's keep talking.

3. Maybe it has something to do with the right shoes and the right stride, but at this point, it's about damage and recovery.

In the light of all the other pain spots and problem I'm not so focused on the burning pain at the ankle. We're now looking at an overall system. We need to heal the system, or the ecology of the lower legs, and then focus on whatever specific is then left.

4. The icing is pretty good actually. 20 on and 20 off for a couple hours. I'd prefer 10 on and 10 off.

We're going to move you to an Ice Dip. More work and not so fun, but it will actually be effective.

5. If you have insurance or whatever and it's not a problem to do, get an xray to see if there is a micro-fracture. Maybe ask a doc how small a fracture an xray can pick up.

I'm curious and would like an xray to rule out fracture or not, but I bet that it's too small to even show up on xray. But I'm not an Xray expert, so it's your call.

(Plus, if it's just a micro fracture, there's nothign specific to do about it but help it heal. Still, it's good to know so can intentionally HELP it heal.)

6. Also, how old are you? If you said I've missed it.

I was up at 6am today after up a lot of the night with a loud rat rummaging around the walls. I think this all will make sense, let me know if it doesn't. And it may be a little short and terse, I can expand on it all later.

Ask questions. Let's get you healed up.


Mar 03, 2010
I too have burning in my tendon
by: Ryan

My injury seems similar to yours, maybe i can get a little help.

in 2008 i rolled my ankle in a bounce house while playing with my kids on her birthday. I'm 28 years old. When i broke my ankle the tendon actually ripped off a small piece of the bone.

After healing the doc said i would live the rest of my life with often sprained ankles.

Well that has lived true I often roll my ankle anytime it gets off balance. Problem is i have a constant pain in my ankle. I will limp for 2-3 days cause i have pain is if it was sprained. then it goes away for a few days and repeats.

As of lately I have severe burning in the tendon and i can not turn my foot inward (as if rolling it inward) without sever pain. Several days later it goes away. Seems it keeps coming back more and more.

Do you have any ideas as to what may be causing this? I am a police officer and am on the swat team so running is a requirment. I wear high boots that cover the ankle and i am often running after badguys in a split second that causes pain afterword.

Any ideas???

Thank you.


Joshua Comments:

Well, if you're constantly rolling/respraining your ankle, then you have some muscle imbalance/weakness.

That's different than Tendonitis per se. You have to work your ankle such that you can have firm footing and stop the rolling/adding pain.

Check out the Ankle Sprain Solutions ebook by my friend Barton. He's a big time athletic trainer and this is his thing.

I'm more a 'fixing tendonitis' kind of guy. I deal with damage, and not really muscle strength/balance. Spend the $15 and get the ebook.

Also, fill your tank with Magnesium for Tendonitis.

Also, spend some time Ice Dipping as described on the How To Reduce Inflammation page.

Do the above three things, put some time/effort into it, and then update me. If we need to fix any actualy tendon/ligament damage, we can do that then. But do the above first, or it will be a waste of time to work on any 'damage'.

Sep 23, 2011
Burning pain from dropping a can on my foot.
by: Mary

I also have burning pain on my whole foot.Two weeks ago i dropped a can on the top of my foot and it swelled and bruised the whole top of foot.

Some of the bruising is going away but i still have the swelling and the burning and sometimes pain.i have tried ice, elevating my foot.nothing helping.Can you give me an idea why i'm having such a hard time with this?

It shouldn't take so long for this to heal.


Joshua Comments:

Hi Mary.

Says who it shouldn't take this long to heal?

I know what you're saying, though.

Probably have some bone bruise, meaning the connective tissue that wraps the bone, and the bone under it, as swollen and aggravated. They 'heal' pretty slow.

Stubborn and slow.

Don't think about it like 'heal'. Think about it like you need to create more circulation.

Make sure you understand how the Process of Inflammation works. The burning is from pain enhancing chemical.

And, it's not that nothing works, it's that you're not doing enough of it.

Negative factors are pushing one way. You need to push back hard enough to push it back. Like a tug of war...only with pushing.

If you don't push hard enough, you lose.

It's as simple as that.

Ice dipping. Lots.

Ice massage. Manually force fluid out of the tight dense sponge of the periostium and bone.

Irritant out, new blood and nutrition in, fell better faster.

Feb 06, 2012
What is going on with my left foot?!!
by: Mike

2011 has been an horrible year for my foot!

Everything started happening back in February with my 3rd toe.. i couldn't bend it and the pain was coming from my top toe 'knuckle' where that whole top area was swollen and I was unable to walk or put weight on it. I still to this day have bouts of pain in that area especially after doing calve raises.

Then in June I got Plantar Fascittis, the heel pain was extremely painful up until November BUT after that I started developing ankle pain which hasn't gone away.

Top top it off.. 4 weeks ago I started getting this strange burning sensation all around my ankle and the entire top of my foot area. The burning pain is especially bad at night and makes it difficult for me to sleep. Not much swelling either.. if there's any swelling then it's normally the top of my foot region and very minimal but enough to notice.

Also i'll get random shooting pain from my ankle/foot all the way to my knee and even my head.

This has been going on everyday now and every morning is a challenge.. i wake up in pain in my ankle and top/foot.. take an advil... wait until it kicks in.. walk it off a little and the pain somewhat goes away enough for me to walk for the rest of the day only for the pain to start back up again once I lay down and go to bed.

I've had xrays.. nothing came up. Doctors don't seem to be very helpful at all. I'm 33 male, eat pretty healthy and use to be active up until this injury! I want my life back!

I'm trying to think back to what might of happen, i do remember jamming my toe over a year ago but i also remember having the edge of a table (which was standing up in my garage) fall and strike about 3..4 inches above my left ankle area. I remember my entire foot getting bruised after that incident.. even the toes! But it hit above my ankle?! This happened 2 years ago.

Feb 10, 2012
What is going on with my left foot?!! Toe pain, burning, and plantar fasciitis
by: The Tendonitis Expert

Joshua Comments:

Hi Mike.

2 years doesn't mean anything to the body, really. We think that things should 'heal' in 2 years, and they do, in a way.

But the problem with injury isn't really the injury (obviously it is, depending), it's the body's response to the injury. Meaning, the body can heal a break or rip or tear, but two years later, or 10 years later, you can still be experiencing problems, and/or you can start experiencing symptoms of various sorts all of a sudden after any length of time.

It's all about the Pain Causing Dynamic.

I'm curious what's up with that one toe. Ultimately, your muscles aren't firing correctly and aren't absorbing the load, and all that force is going to that one toe, and the toe's not particularly happy about it.

And as the body is want to do, as it tries to guard and protect, it makes things worse, thus the Plantar Fasciitis.

The burning could be a few different things.

So...what have you been doing for it to try to make it better? Have you learned How To Reduce Inflammation?

Jun 29, 2012
Sprained Ankle from basket ball, rolled ankle 8-10 times
by: Allan

Hi my name is Allan and I sprained my ankle about a week and a half ago while playing basketball the swelling went down about two days ago but yesterday I was getting icy hot rubbed on it and the person doing the rubbing pressed on my ankle a few times then I felt a burning sensation throughout my whole foot so we stopped the rubbing I assumed that it had to do with the icy hot getting to hot.

But then today my ankle swelled up a little bit again so I had my feet elevated and I touched my ankle with my other foot and I felt the burning sensation throughout my whole foot and was wondering what that was?

The ankle that I sprained is my bad ankle I rolled it about 8-10 time from march through the beginning of may but I bought a very good brace and it got good again so I had not been playing with my brace for about a month and then I stepped on someones foot I twisted it and sprained it so I wanted to know if that maybe had something do with it.


Joshua Comments:

Hi Allan.

So you're wondering if rolling your ankle ten times has contributed to your current experience of burning sensation and swelling?

I'm going to make an educated guess and say 'absolutely yes'.

See: Process of Inflammation

See: Pain Causing Dynamic

Muscles don't do their job and the ankle rolls. There is some amount of injury, inflammation kicks in.

Inflammation traps fluid in the area and releases a chemical which enhances your sensitivity to pain.

Swelling going down doesn't mean that you are all fixed and good to go.

Jul 20, 2012
Does Ultrasound Work?
by: G

Nowhere in your books have I seen you mention ultrasound as a treatment. Do you believe ultrasound has any value in treating tendonitis?


Joshua Comments

Hi G.

I don't talk about Ultrasound much for a variety of reasons.

1. People would have to get one to work with one.

2. They sound good in theory, but I've never talked to a single person that said 'Ultrasound totally fixed my tendonitis'. Nor have I ever heard 'Ultrasound helped my tendonitis'.

I'm sure some people have been helped by it, but in 15 years of working with people and the 4+ years this site has been around, I haven't met any of them.

Splints work in theory, anti-inflammatories work in theory, rest works in theory, but really, they don't.

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