Foot pain in runners is often attributed to other conditions such as plantar fasciitis, stress fractures, or tendon problems. However, another important but less well-known cause is a jogger’s foot, also known as medial calcaneal nerve entrapment. This nerve entrapment can mimic other causes of foot arch pain and requires careful clinical assessment to diagnose correctly.
What Is Jogger’s Foot?
Jogger’s foot occurs when the medial calcaneal nerve, a branch of the tibial nerve, becomes compressed as it passes into the heel. This nerve supplies sensation to the inner heel and part of the medial arch. Entrapment leads to pain and altered sensation, which is often exacerbated by running or prolonged walking.
The site of entrapment is generally between the navicular bone and the abductor hallucis muscle at the Knot of Henry, where the flexor tendons of the foot cross. Typically, entrapment occurs due to excessive pronation of the foot. Other causes of entrapement include cysts or ganglions in the mid-foot or tenosynovitis of the flexor tendons.
Symptoms of Jogger’s Foot
Typical symptoms include:
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Burning or tingling pain in the inner heel and arch, radiating to the big and second toe, and the heel
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Pain aggravated by running, especially on hard surfaces
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Numbness or altered sensation in the medial heel region
Unlike plantar fasciitis, which causes pain on the bottom of the heel with the first steps in the morning, a jogger’s foot often presents with nerve-type symptoms, such as burning, tingling, or numbness, and is exacerbated during running.
Clinical Presentation
On examination, athletes with medial calcaneal nerve entrapment may show:
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Localised tenderness over the medial aspect of the foot, where the nerve passes between the navicular bone and abductor hallucis muscle
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Reproduction of symptoms with touching or tapping of the nerve
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Occasionally, mild weakness and wasting of the inside foot muscles
Investigations
The diagnosis of jogger’s foot is primarily clinical, but investigations may behelpfull in complex cases:
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Ultrasound: Can show nerve thickening, surrounding soft tissue changes, or compression sites.
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MRI: Useful to exclude other causes of heel pain, such as stress fracture, plantar fasciitis, or tendonitis
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Nerve conduction studies: May support the diagnosis by demonstrating slowed conduction in the medial calcaneal branch, though these are technically challenging. Often, the nerve studies are normal.
Management of Jogger’s Foot
Treatment focuses on relieving nerve compression and addressing the factors that aggravate it.
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Activity modification: Reducing running volume, avoiding hard surfaces, and temporarily cross-training with low-impact exercise.
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Footwear and orthotics: Supportive shoes and customised insoles can reduce stress on the nerve.
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Physiotherapy: Stretching tight calf muscles and improving foot biomechanics.
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Medications: Anti-inflammatory drugs may reduce associated soft tissue irritation.
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Ultrasound-guided injections: Corticosteroid or nerve hydrodissection injections around the medial calcaneal nerve can provide significant pain relief.
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Surgery: Rarely required, but surgical decompression may be considered for persistent cases not responding to conservative management.
Final Word from Sportdoctorlondon about Jogger’s Foot
Jogger’s foot, also known as medial calcaneal nerve entrapment, is often an overlooked cause of heel and arch pain in runners. Unlike plantar fasciitis, it produces nerve-type symptoms such as burning or tingling. With careful clinical assessment and targeted treatment, most athletes can return to pain-free running.
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