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I've been running for 11 weeks doing the Couch to 10K program, with 8-9 weeks of that being in Vibram FiveFingers Bikila LS. As I've steadily increased the amount of running in my workout, I've started experiencing toward the end of my workout (last 10 minutes or so) a semi-painful almost numbing sensation from slightly behind the base of my toes to the ends of the two toes nearest my big toe on my left foot only.

Bottom of Foot Diagram

Bottom of Foot Diagram from Bottom of Foot Pain

The toes hurt in the area right around where the above image is marked "Toe cramps" and feel more numb and less painful toward the ends of the toes. Changing the distribution of weight on my foot as I run doesn't seem to help any with the pain once it starts. The pain goes away just a few minutes after my workout is completed and I've taken a short break.

Is this a result of the minimalist running shoes, am I possibly landing wrong on my foot, or is it something that will work itself out with enough time?

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Nathan Wheeler
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    Given that the numbness goes away, I don't expect its a Morton's Neuroma. Though it could be that due to the increased stress on the metatarsal heads, some nerve gets somewhat compressed. Perhaps you should try running with 'normal' shoes, just to see how it goes – Ivo Flipse May 11 '11 at 22:16
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    Also, how well do the Vibrams fit? All complaints about numbness so far is from people complaining/indicating that they might be too small or too tight. I've been wearing the Vibrams all evening and in the end I started to get a tingling sensation around my toes. So in my case I probably had stuff my toes a bit too far in. So I'd check the fit for sure – Ivo Flipse May 11 '11 at 22:21
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    I've had a problem seemingly similar. My PT told me about an issue connected to low-arched feet - in danish it is know as: forefoot prolapse. I can't find anything on the wording in english though.

    That can be alleviated with a bit of arch support right behind balls of the feet

    As I read about mortons neuroma it seems like that might actually be the same?

     – svrist May 12 '11 at 07:53
  • @Ivo - From what I read, at the onset of Morton's Neuroma (or intermetatarsal neuroma), the pain/numbness/tingling can occur only when performing activities or wearing shoes that aggravate the nerve. The Vibrams fit nicely: snug, but far from tight, and slightly loose without socks. – Nathan Wheeler May 12 '11 at 19:55
  • @svrist - I'm actually considering adding just a bit of padding to that shoe to see if takes care of the problem – Nathan Wheeler May 12 '11 at 19:56
  • What has your doctor told you? – chrisjlee May 30 '11 at 19:17
  • I am having a similar problem, and this is the only thing I've found posted about it! My right foot only has begun to have pain/numbness (a mixture) on the second, third, and possibly fourth toes, but only during running. Not during walking or biking. It began during my faster, threshold workouts at first, but was not affecting my long, slow runs. I actually haven't done a long, slow run in a few weeks so am not sure if it has changed or not, but I've tried different types of speed workouts, different shoes, and so far it has all hurt. I wear neutral shoes, and thought at first it might just b –  Sep 21 '11 at 04:39
  • Uhoh, your image is dead @NathanWheeler! – Ivo Flipse Apr 12 '12 at 09:36
  • I have the same problem. Bought new shoes three months ago. Fitted by sport shoe salesman and experiencing pain in the balls of my feet and numbness in the second two toes next to my big toe. Very frustrating as I like to run regularly and trying to place my feet differently on the road to see if this makes any difference. To date - no change yet.. –  Apr 12 '12 at 08:13
  • I have this same problem. I find it very interesting that everyone on here mentions to add more padding. For me, I take off the offending shoes mid-run and almost magically my feet get better even though I'm running barefoot on concrete. I am trying to find a shoe that does not do this to my feet for my long runs, but so far I have yet to find one. Good luck Nathan and I hope you find some relief from this pain. –  Feb 23 '12 at 17:52

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It sounds like metatarsalgia to me. If you check out the symptoms section that article they match what you described. Running and jumping increase the risk of metatarsalgia, and anything that increases impact on your feet makes it worse. The article lists wearing shoes without appropriate padding as a risk factor, so your vibram's lack of padding may be contributing to the problem. Being overweight also increases impact, which contributes to the problem (I don't know if this is an issue for you or not). I imagine that running on high-impact surfaces like concrete would also increase your risk (grass and asphalt have more give).

Distributing more weight into the ball of the foot also makes it worse. According to Arnheim's Principles of Athletic Training:

One of the causes of metatarsalgia is restricted extensibility of the gastrocnemius-soleus complex. Because of this restriction, the athlete shortens the midstance phase of the gait and emphasizes the toe-off phase, causing excessive pressure under the forefoot.

Translation: if your calves are tight, you run in a way that puts more pressure on the ball of your foot. This might be an issue for you. One of the benefits of barefoot running is that it strengthens your ankles by strengthening the lower legs muscles that support them. The problem is, if you don't stretch those muscles regularly they can get tight. Metatarsalgia can also be caused by a fallen metatarsal arch (the arch that goes across the ball of the foot).

If tight calves are suspected contributors, Arnheim suggests stretching the calves several times a day (see the right column of the Gastrocnemius and Soleus sections on ExRx for some stretches). If you have a fallen arch cauaed by weakness, you should also do foot-strengthening exercises. In addition, both sources I mentioned suggest metatarsal pads, which sit behind the balls of the feet to help with support and shock absorption.

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